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https://www.readbyqxmd.com/read/28643552/drug-induced-physeal-abnormalities-in-preclinical-toxicity-studies
#1
Kendall S Frazier
Most toxic physeal changes are characterized microscopically by altered chondrocyte development, proliferation, or maturation in the growth plate and eventually result in disordered appositional bone growth. Many therapeutic drugs directly or indirectly target proteins involved in chondrocytic differentiation and maturation pathways, so toxic physeal injury has become increasingly common in preclinical toxicologic pathology. While physeal dysplasia has been associated with several different drug classes including bisphosphonates, vascular endothelial growth factor receptor inhibitors, fibroblast growth factor receptor inhibitors, transforming growth factor beta receptor inhibitors, and vascular targeting agents, physeal changes often share similar morphologic features including thickening and disorganization of the hypertrophic layer, increased numbers of hypertrophic chondrocytes, altered mineralization of endochondral ossification, and/or increased thickness of subphyseal bone...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28636058/percutaneous-tibial-physeal-fracture-repair-in-small-animals-technique-and-17-cases
#2
Dirsko J F von Pfeil, Mathieu Glassman, Meaghan Ropski
OBJECTIVES: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures. METHODS: Clinical data of 14 dogs and three cats were included. The "spiking" technique was described. RESULTS: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures...
June 21, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#3
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28612581/surgical-options-for-anterior-cruciate-ligament-reconstruction-in-the-young-child
#4
Meghan J Price, Lionel Lazaro, Frank A Cordasco, Daniel W Green
Injury to the anterior cruciate ligament (ACL) is becoming increasingly common in the skeletally immature population. Historically, there was a reluctance to operate on skeletally immature patients due to potential damage to the physis and subsequent growth disturbances; however, more recently, ACL reconstruction techniques specifically developed for this young population have shown good outcomes and low complication rates. In this article, we briefly discuss the modifiable and non-modifiable risk factors for ACL injury in children, options for conservative management for ACL rupture, and outcomes for delayed operative management...
August 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28601180/musculoskeletal-traumatic-injuries-in-children-characteristic-imaging-findings-and-mimickers
#5
REVIEW
Victor M Ho-Fung, Matthew A Zapala, Edward Y Lee
Musculoskeletal traumatic injuries in children demonstrate characteristic imaging findings. The physis is the most susceptible structure to traumatic injury. The periosteum in children plays a key role in rapid bone healing and stability. The main complications of fractures in children are premature physeal closure, potential limb length discrepancy, and angular deformities. Understanding the normal bone growth, healing, and complications of pediatric fractures is crucial for appropriate imaging diagnosis. This article discusses currently available imaging modalities with up-to-date techniques, underlying mechanisms, and characteristic imaging findings of musculoskeletal traumatic injuries and mimickers encountered in daily clinical practice...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28594522/skeletally-immature-anterior-cruciate-ligament-injuries-controversies-and-management
#6
Shital N Parikh, Bradley P Jaquith, Christopher M Brusalis, Lauren H Redler, Theodore J Ganley, Mininder S Kocher
At one time, anterior cruciate ligament (ACL) tears in skeletally immature patients were considered rare. The recommended treatment option for skeletally immature patients with ACL tears was to modify activities until skeletal maturity, at which point definitive ACL reconstruction could be safely performed. The management of ACL tears in skeletally immature patients has evolved as a result of the increased frequency of ACL tears in younger patients and an increased awareness for the potential development or worsening of meniscal tears, chondral lesions, and degenerative changes that occur with the "wait-and-fix-later" approach...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594521/pediatric-distal-radius-fractures
#7
Karan Dua, Joshua M Abzug, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Distal radius fractures are the most common orthopaedic injury that occur in the pediatric population. The annual incidence of distal radius fractures has increased as a result of earlier participation in sporting activities, increased body mass index, and decreased bone mineral density. Most distal radius fractures are sustained after a fall onto an outstretched arm that results in axial compression on the extremity or from direct trauma to the extremity. Physeal fractures of the distal radius are described based on the Salter-Harris classification system...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28590374/return-to-sport-after-pediatric-anterior-cruciate-ligament-reconstruction-and-its-effect-on-subsequent-anterior-cruciate-ligament-injury
#8
Travis J Dekker, Jonathan A Godin, Kevin M Dale, William E Garrett, Dean C Taylor, Jonathan C Riboh
BACKGROUND: Anterior cruciate ligament (ACL) graft failure and contralateral ACL tears are more frequent in children and adolescents than adults. The reasons for higher subsequent injury rates in this population are incompletely understood. METHODS: We analyzed a continuous cohort of patients who were <18 years of age. Subjects underwent isolated, primary ACL reconstruction with autograft between 2006 and January 1, 2014, and had a minimum 2-year follow-up. Return-to-sport characteristics were described, and multivariable Cox regression modeling was used to identify predictors of a second ACL injury...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28567429/are-the-current-little-league-pitching-guidelines-adequate-a-single-season-prospective-mri-study
#9
Andrew V Pytiak, Phillip Stearns, Tracey P Bastrom, Jerry Dwek, Peter Kruk, Joanna H Roocroft, Andrew T Pennock
BACKGROUND: Little League throwing guidelines have recently been implemented in an attempt to lessen the growing number of elbow injuries occurring in youth baseball players. HYPOTHESIS/PURPOSE: The purpose of this study was to examine pre- and postseason changes seen on magnetic resonance imaging (MRI) in youth baseball players' elbows in an attempt to identify risk factors for pain and MRI abnormalities, with a particular focus on the current Little League guidelines...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28554104/capitellar-fracture-with-bony-avulsion-of-the-lateral-collateral-ligament-in-a-child-case-report
#10
M Fuad, A Elmhiregh, A Motazedian, M Bakdach
INTRODUCTION: Isolated capitellar fracture is a rare injury accounting for 1% of all elbow fractures Bryan and Morrey (1985) and Poynton et al. (1998). In children, a fall on an outstretched hand, before the fusion of the epiphysis, usually leads to lateral condyle physeal fractures. Very few cases of capitellar fractures in the paediatric population have been reported. PRESENTATION OF CASE: Our patient, a 9-year-old girl presented with a capitellar fracture and lateral collateral ligament (LCL) avulsion of her left elbow...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28538289/a-three-dimensional-analysis-of-the-fracture-planes-in-pediatric-lateral-humeral-condyle-fractures-for-image-based-pin-positioning-during-fixation
#11
Do Young Park, Jae Ho Cho, Doo-Hyung Lee, Wan-Sun Choi, Jun Young Bang, Xiang Yun Yin
OBJECTIVE: To determine the 3 dimensional morphology of pediatric lateral condylar physeal fractures using 3-dimensional computed tomography (3D-CT) and to identify optimal pin positions for percutaneous pinning. DESIGN: Prospective case series of consecutively treated patients SETTING:: Tertiary university hospital setting. PATIENTS: Preoperative 3D-CTs in pediatric surgical candidates diagnosed with lateral condylar physeal fractures INTERVENTION:: Closed reduction and percutaneous pinning was performed...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28529660/biomechanical-considerations-in-slipped-capital-femoral-epiphysis-and-insights-into-prophylactic-fixation
#12
E Leblanc, J M Bellemore, T Cheng, D G Little, O Birke
PURPOSE: Slipped capital femoral epiphysis (SCFE) is a deformity of the proximal femur secondary to widened and unstable physis. In stabilising the slip, gold standard treatments stop growth and involve premature physeal closure, which prevents the remodelling of the acquired deformity and creates a leg length discrepancy that may be significant in younger patients. METHODS: We measured the impact of placing threaded screws across the proximal femoral physis by measuring the centre-trochanteric distance (CTD) and articulo-trochanteric distance (ATD) in participants with or without prophylactic fixation...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28509827/leptin-elevation-as-a-risk-factor-for-slipped-capital-femoral-epiphysis-independent-of-obesity-status
#13
Schuyler J Halverson, Tracy Warhoover, Gregory A Mencio, Steven A Lovejoy, Jeffrey E Martus, Jonathan G Schoenecker
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is strongly associated with childhood obesity, yet the prevalence of obesity is orders of magnitude greater than the prevalence of SCFE. Therefore, it is hypothesized that obesity is not, by itself, a sufficient condition for SCFE, but rather one component of a multifactorial process requiring preexisting physeal pathology. Leptin elevation is seen to varying degrees in patients with obesity, and as leptin has been shown to cause physeal pathology similar to the changes seen in SCFE, we propose that leptin may be a factor distinguishing between patients with SCFE and equally obese children without hip abnormalities...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28506249/an-unusual-case-of-proximal-humeral-simple-bone-cyst-in-an-adult-from-secondary-cystic-change
#14
Mamer S Rosario, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Hiroaki Kimura, Shinji Miwa, Takashi Higuchi, Hiroyuki Inatani, Kensaku Abe, Yuta Taniguchi, Hisaki Aiba, Hiroyuki Tsuchiya
BACKGROUND: Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now. CASE PRESENTATION: A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification...
May 15, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28473935/surgical-fixation-of-bilateral-simultaneous-avulsion-fractures-of-the-proximal-tibia-in-a-12-year-old-with-history-of-conservatively-managed-unilateral-tibial-avulsion-fracture
#15
Christopher Newman, Dharsh Musiienko, Samuel Law
Fractures of the proximal tibial epiphysis are rare, representing less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are extremely rare. The specific anatomical and histological features of the proximal tibial epiphysis make it vulnerable to a specific fracture pattern that occurs when the tensile force of the quadriceps is greater than the fibrocartilaginous tissue underlying the tibial tuberosity. We report the first case to our knowledge of a 12-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed unilateral tibial tuberosity avulsion fracture...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28444758/intraoperative-use-of-a-transarticular-circular-fixator-construct-to-facilitate-reduction-and-stabilisation-of-a-proximal-tibial-physeal-fracture-in-a-dog
#16
M D Johnson, D D Lewis, M D Winter
CASE REPORT: A 4-month-old female intact American Pit Bull Terrier was presented for right pelvic limb lameness 1 day after the dog had been hit by an all-terrain vehicle. Orthogonal radiographs of the right stifle revealed a Salter-Harris type IV fracture through the proximal tibial physis extending caudodistally through the proximal tibial metaphysis. The distal tibia was markedly displaced cranially, laterally and proximally, resulting in complete overriding of the fracture segments...
May 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28439307/fluoroscopic-imaging-overestimates-the-screw-tip-to-subchondral-bone-distance-in-a-cadaveric-model-of-slipped-capital-femoral-epiphysis
#17
M J Heffernan, B Snyder, H Zhou, X Li
PURPOSE: Intra-operative imaging plays a key role in screw placement for slipped capital femoral epiphysis (SCFE). Complications have been associated with inadequate screw position. The purpose of this study was to evaluate computed tomography (CT) (3D fluoroscopy) and standard fluoroscopy (C-arm) images as compared with direct anatomic measurement to determine final screw position in a cadaveric SCFE model. METHODS: Osteotomy with pinning was performed at the physeal scar in ten cadaveric hips...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28403653/congenital-pseudoarthrosis-of-the-distal-radius-treated-with-physeal-sparing-double-barrel-vascularized-free-fibula-transfer-a-case-report
#18
David Y Ding, Joey LaMartina, Chau Tai, Nirav K Pandya
BACKGROUND: Neurofibromatosis type 1 is a hereditary disease that can lead to pseudoarthrosis of various long bones. Rarely, pseudoarthrosis affects the forearm, and to the best of our knowledge, this is the first reported case of pseudarthrosis of the distal radius treated by this unique method. METHODS: We present a case of a 7-year-old male who underwent multiple operations to treat pseudoarthrosis of the distal radius. RESULTS: After failed conservative and operative fixation augmented with autologous iliac crest bone grafting, the patient underwent a successful double-barrel vascularized free fibula graft while preserving the physis of the distal radius...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28396049/acquired-femoral-flexion-deformity-due-to-physeal-injury-during-medial-patellofemoral-ligament-reconstruction
#19
Gerd Seitlinger, Philipp Moroder, Christian Fink, Guido Wierer
BACKGROUND: Reconstruction of the medial patellofemoral ligament (MPFL) is the most frequent surgical procedure performed in patients with patellar instability. Recently, concerns regarding physeal injury during femoral tunnel placement for anatomical MPFL reconstruction in children have been discussed. METHODS: This is the first case to report partial posterior physeal growth arrest and subsequent flexion deformity of the distal femur after MPFL reconstruction in a skeletally immature patient...
April 7, 2017: Knee
https://www.readbyqxmd.com/read/28383417/short-double-elastic-nailing-of-severely-displaced-distal-pediatric-radial-fractures-a-new-method-for-stable-fixation
#20
Marcell Varga, Gergő Józsa, Balázs Fadgyas, Tamás Kassai, Antal Renner
RATIONALE: Short double elastic nailing is a minimal invasive, modified ESIN (elastic stable intramedullary nailing) technique for severely displaced distal radial fracture in children. The aim of this technical report is to introduce our new method and evaluate the final results of the procedure. PATIENT CONCERNS: We reviewed retrospectively 24 patients who underwent short double elastic nailing due to distal radial fractures between November 2012 and December 2015...
April 2017: Medicine (Baltimore)
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