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https://www.readbyqxmd.com/read/29781820/management-of-pediatric-femoral-neck-fracture
#1
Joseph T Patterson, Jennifer Tangtiphaiboontana, Nirav K Pandya
In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29762188/the-reliability-of-radiostereometric-analysis-in-determining-physeal-motion-in-slipped-capital-femoral-epiphysis-in-standard-uniplanar-and-low-dose-eos-biplanar-radiography-a-phantom-model-study
#2
Jennifer K Hurry, Saad Rehan, Alan J Spurway, Elise K Laende, Janie L Astephen Wilson, Karl J Logan, Michael J Dunbar, Ron El-Hawary
Physeal closure after slipped capital femoral epiphysis fixation can be difficult to assess on two-dimensional conventional radiographs. Radiostereometric analysis offers improved motion detection over conventional radiography, whereas the EOS biplanar imager provides a means for low radiation weight-bearing images. This phantom study assessed the reliability of measuring motion using radiostereometric analysis in the EOS using a slipped capital femoral epiphysis model. The accuracy and precision were better than 0...
May 14, 2018: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/29761106/current-strategies-and-future-directions-to-optimize-acl-reconstruction-in-adolescent-patients
#3
Dustin Jon Richter, Roger Lyon, Scott Van Valin, Xue-Cheng Liu
The incidence of anterior cruciate ligament (ACL) injuries in the pediatric population has risen in recent years. These injuries have historically presented a management dilemma in skeletally immature patients with open physes and significant growth remaining at time of injury. While those nearing skeletal maturity may be treated with traditional, transphyseal adult techniques, these same procedures risk iatrogenic damage to the growth plates and resultant growth disturbances in younger patients with open physes...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29682681/patellar-instability-in-the-skeletally-immature
#4
REVIEW
Charles A Popkin, Ahmad F Bayomy, Evan P Trupia, Charles M Chan, Lauren H Redler
PURPOSE OF REVIEW: This review will focus on the evaluation and management of patellar instability in the developing patient. RECENT FINDINGS: A large number of surgical techniques have been described to prevent recurrent patellofemoral instability in the pediatric population, including both proximal and distal realignment procedures. The wide variety of treatment options highlights the lack of agreement as to the best surgical approach. However, when a comprehensive exam and workup are paired with a surgical plan to address each of the identified abnormalities, outcomes are predictably good...
April 23, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29682313/systematic-assessment-of-the-growth-plates-of-the-wrist-in-young-gymnasts-development-and-validation-of-the-amsterdam-mri-assessment-of-the-physis-amphys-protocol
#5
Laura S Kox, Rik B J Kraan, Kees F van Dijke, Robert Hemke, Sjoerd Jens, Milko C de Jonge, Edwin H G Oei, Frank F Smithuis, Maaike P Terra, Mario Maas
Objectives: To develop and validate a protocol for MRI assessment of the distal radial and ulnar periphyseal area in gymnasts and non-gymnasts. Methods: Twenty-four gymnasts with wrist pain, 18 asymptomatic gymnasts and 24 non-gymnastic controls (33 girls) underwent MRI of the wrist on a 3T scanner. Sequences included coronal proton density-weighted images with and without fat saturation, and three-dimensional water-selective cartilage scan and T2 Dixon series. Skeletal age was determined using hand radiographs...
2018: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/29681707/pediatric-proximal-femur-fractures
#6
REVIEW
Brian L Dial, Robert K Lark
Pediatric proximal femur fractures are rare injuries resulting from high-energy trauma. The Delbet classification is used when describing these injuries, and associates fracture type to the development of avascular necrosis. Historically, casting was utilized in the treatment of these injuries, but high complication rates following this approach have changed the treatment modality to early and anatomic fixation. Complications associated with these injuries including avascular necrosis, non-union, coxa-vara, and premature physeal fusion...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29673344/the-risk-of-violating-the-posterior-malleolar-fracture-when-nailing-the-ipsilateral-concomitant-spiral-distal-tibial-fracture
#7
Yu Zhang, Xiaodong Qin, Lijun Song, Xiang Li
BACKGROUND: For a distal tibial spiral fracture combined with a non-displaced posterior malleolar fragment (PMF), we proposed a hypothesis that the treating surgeon could assess the size of the PMF to determine the need for stabilizing that structure first before rodding the tibia. MATERIALS AND METHODS: Fifty 3-D models (22 females) of combined distal tibial and posterior malleolar fractures from one trauma center were reconstructed. In each case, a virtual tibial intramedullary nail (vIM nail) with three distal anteroposterior (AP) locking screws (S13 , S15 and S37 , the number indicating the distance from the screw to the nail tip) were inserted into the center of the tibial canal and ended on top of the distal tibial physeal scar...
April 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29629581/vascularized-fibular-epiphyseal-transfer-for-proximal-humeral-reconstruction-in-children-with-a-primary-sarcoma-of-bone
#8
J D Stevenson, R Doxey, A Abudu, M Parry, S Evans, F Peart, L Jeys
Aims Preserving growth following limb-salvage surgery of the upper limb in children remains a challenge. Vascularized autografts may provide rapid biological incorporation with the potential for growth and longevity. In this study, we aimed to describe the outcomes following proximal humeral reconstruction with a vascularized fibular epiphyseal transfer in children with a primary sarcoma of bone. We also aimed to quantify the hypertrophy of the graft and the annual growth, and to determine the functional outcomes of the neoglenofibular joint...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29628701/management-of-growth-arrest-current-practice-and-future-directions
#9
REVIEW
Sherif Dabash, Gautham Prabhakar, Eric Potter, Ahmed M Thabet, Amr Abdelgawad, Stephen Heinrich
Introduction: Premature growth arrest can pose a challenge to the orthopedic surgeon. Various options for treating physeal arrest exist. Methods: Systematic searches were conducted on PubMed/Medline, ScienceDirect, OVID, and Cochrane Library. Secondary searching was performed, where certain articles from reference lists of the selected studies were reviewed that were not found in the primary search. Results: This review article discusses the different methods of management for premature growth arrest...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29589503/treatment-and-functional-outcomes-of-complex-tibial-fractures-in-children-and-adolescents-using-the-ilizarov-method
#10
J Messner, L Johnson, D M Taylor, P Harwood, S Britten, P Foster
Aims The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method. Patients and Methods Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29574193/nonclinical-assessments-of-the-potential-biosimilar-pf-06439535-and-bevacizumab
#11
Marjorie A Peraza, Karen E Rule, Michael H I Shiue, Gregory L Finch, Stéphane Thibault, Paul R Brown, David W Clarke, Michael W Leach
Bevacizumab, a recombinant humanized monoclonal antibody targeting vascular endothelial growth factor (VEGF), is approved for treatment of metastatic colorectal cancer, nonsquamous non-small-cell lung cancer, metastatic kidney cancer, and glioblastoma. To support clinical development of the potential bevacizumab biosimilar PF-06439535, nonclinical studies evaluated structural, functional, toxicological, and toxicokinetic similarity to bevacizumab sourced from the European Union (bevacizumab-EU) and United States (bevacizumab-US)...
March 21, 2018: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/29573446/scoliosis-vertebral-growth-plate-histomorphometry-comparisons-to-controls-growth-rates-and-compressive-stresses
#12
Donita I Bylski-Austrow, David L Glos, Eric J Wall, Alvin H Crawford
Scoliosis progression in skeletally immature patients depends on remaining growth. Relationships between vertebral growth plate histomorphometry, growth rates, and mechanical stresses have been reported in several animal studies. Hypertrophic zone heights and chondrocyte heights have been used to assess treatments that aim to modulate growth. The purpose of this study was to determine whether human vertebral physeal hypertrophic zone and cell heights differed between two groups: severe scoliosis and autopsy controls...
March 24, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29559325/physeal-bar-resection-under-guidance-with-a-navigation-system-and-endoscopy-for-correction-of-distal-radial-deformities-after-partial-growth-plate-arrest
#13
Yoshinori Takemura, Narihito Kodama, Hiroaki Ueba, Kosei Ando, Kensaku Kuga, Shinji Imai
Partial growth plate arrest caused by trauma may lead to severe deformity and dysfunction. The Langenskiöld method is a surgical technique that involves resection of the physeal bar causing partial growth plate arrest. However, it is a technically demanding procedure. We used the Langenskiöld method under guidance with a navigation system and endoscopy and obtained good results in 2 cases. We consider that use of these tools can be a helpful adjunct to the carrying out this procedure.
March 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29549568/cozen-s-deformity-resolved-by-guided-growth
#14
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29526160/basic-principles-of-fracture-treatment-in-children
#15
Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29525032/pediatric-sports-medicine-injuries-common-problems-and-solutions
#16
REVIEW
Joel B Huleatt, Carl W Nissen, Matthew D Milewski
The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...
April 2018: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/29509618/maternal-diets-deficient-in-vitamin-d-increase-the-risk-of-kyphosis-in-offspring-a-novel-kyphotic-porcine-model
#17
Matthew A Halanski, Blake Hildahl, Laura A Amundson, Ellen Leiferman, Annette Gendron-Fitzpatrick, Rajeev Chaudhary, Heather M Hartwig-Stokes, Ronald McCabe, Rachel Lenhart, Matthew Chin, Jennifer Birstler, Thomas D Crenshaw
BACKGROUND: The purpose of this study was to explore the role of perinatal vitamin-D intake on the development and characterization of hyperkyphosis in a porcine model. METHODS: The spines of 16 pigs were assessed at 9, 13, and 17 weeks of age with radiography and at 17 weeks with computed tomography (CT), magnetic resonance imaging (MRI), histology, and bone-density testing. An additional 169 pigs exposed to 1 of 3 maternal dietary vitamin-D levels from conception through the entire lactation period were fed 1 of 4 nursery diets supplying different levels of vitamin D, calcium, and phosphorus...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29509609/using-the-medial-and-lateral-humeral-lines-as-an-adjunct-to-intraoperative-elbow-arthrography-to-guide-intraoperative-reduction-and-fixation-of-distal-humerus-physeal-separations-reduces-the-incidence-of-postoperative-cubitus-varus
#18
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
May 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29497620/anterior-cruciate-ligament-reconstruction-in-skeletally-immature-patients-early-results-using-a-hybrid-physeal-sparing-technique
#19
Robert G Willson, Regina O Kostyun, Matthew D Milewski, Carl W Nissen
Background: Reconstruction of the anterior cruciate ligament (ACL) in the skeletally immature patient is frequently performed in hopes of preventing new or additional chondral damage and meniscal injuries. Patients within a few years of skeletal maturity are more at risk for ACL injuries than prepubescent patients, about whom several physeal-sparing techniques have been described. Reconstruction techniques in the former higher risk group need to be better understood. Purpose: To review a series of adolescent patients with ACL injuries surgically treated with the hybrid physeal-sparing technique...
February 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29490406/distal-femoral-physeal-fractures
#20
Ernest Y Young, Anthony A Stans
Physeal fractures of the distal femoral are rare injuries accounting for less than 2% of all physeal injuries, and tend to have a worse prognosis than similar injuries in other locations. This article reviews the evaluation (including imaging), classification, and treatment of these injuries, and discusses their most important complications and their management, including vascular injury and growth arrest.
February 28, 2018: Journal of Knee Surgery
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