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Missed fractures in children

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https://www.readbyqxmd.com/read/29787531/blunt-traumatic-scapular-fractures-are-associated-with-great-vessel-injuries-in-children
#1
Ibrahim Abd El-Shafy, Lisa M Rosen, Jose M Prince, Robert W Letton, Nelson G Rosen
BACKGROUND: Patients with stable blunt great vessel injury (GVI) can have poor outcomes if the injury is not identified early. With current pediatric trauma radiation reduction efforts these injuries may be missed. As a known association between scapular fracture and GVI exists in adult blunt trauma patients, we examined whether that same association existed in pediatric blunt trauma patients. METHODS: Bluntly injured patients under 18 years old were identified from 2012-2014 in the National Trauma Data Bank...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29784263/tertiary-care-referrals-for-fractures-in-children
#2
Jennifer K Marsh, David J Murray, Anshuman Sharma, Kavya Narayana Reddy, Alyssa Naes
PURPOSE: With limited local access to pediatric subspecialty care outside major metropolitan areas, tertiary care hospitals treat many children originally seen at outside facilities for relatively brief but urgent surgical procedures. This referral-based care imposes significant financial and psychological stress on the families. DESIGN: Prospective, survey methodology was used. METHODS: Families of children aged 0-18 years admitted to the St...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29713746/the-treatment-of-chronic-radial-head-dislocation-in-monteggia-fracture-without-annular-ligament-reconstruction
#3
Hsuan-Yu Chen, Kuan-Wen Wu, Zheng-Ren Dong, Shier-Chieg Huang, Ken N Kuo, Ting-Ming Wang
INTRODUCTION: The treatment of neglected radial head dislocation after missed Monteggia fracture dislocation in children is a controversial issue. The purpose of this study is to report our clinical experience in the treatment of the condition without annular ligament reconstruction. METHOD: This is a retrospective review of 20 patients between 2008 and 2014. Procedures included open reduction of the radial head and ulnar lengthening angulation osteotomy. In cases of unstable radial head reduction, a trans-capitellar K wire was applied...
May 1, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29603635/the-impact-of-crown-fracture-in-the-permanent-dentition-on-children-s-quality-of-life
#4
Josiane Pezzini Soares, Jéssica Copetti Barasuol, Fernanda Marques Torres, Angela Giacomin, Bruna Miroski Gonçalves, Daniele Klein, Adriano Ferreti Borgatto, Maria Letícia Ramos-Jorge, Mariane Cardoso, Michele Bolan
BACKGROUND/AIM: Among the diseases related to oral health, traumatic dental injuries (TDI) can lead to pain, loss of function and esthetic problems, with physical, emotional and social consequences for children and their families. The aim of this study was to investigate the relationship between enamel fracture and enamel-dentin fracture with oral health related quality of life (OHRQoL). MATERIAL AND METHODS: The cross-sectional study had a representative sample of 1,589 children between 8 to 10 years of age from public schools...
March 30, 2018: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/29589502/comparison-between-a-multicentre-collaborative-closed-loop-audit-assessing-management-of-supracondylar-fractures-and-the-british-orthopaedic-association-standard-for-trauma-11-boast-11-guidelines
#5
MULTICENTER STUDY
R Goodall, H Claireaux, J Hill, E Wilson, F Monsell, Boast Collaborative, P Tarassoli
Aims Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29529004/one-brace-one-visit-treatment-of-pediatric-distal-radius-buckle-fractures-with-a-removable-wrist-brace-and-no-follow-up-visit
#6
Megan H M Kuba, Byron H Izuka
BACKGROUND: Previous studies have showed the efficacy of removable brace treatment for distal radius buckle fractures in children, whereas others have independently suggested that these injuries do not require additional radiographic imaging. However, no study has sought to collectively determine whether treating pediatric distal radius buckle fractures with a removable brace and no follow-up visit or imaging after the initial visit is a safe and satisfactory protocol. METHODS: In total, 42 consecutive patients with a distal forearm buckle fracture seen by a single fellowship trained pediatric orthopaedic surgeon were eligible to participate...
March 9, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29484463/medial-humeral-condyle-fracture-in-childhood-a-rare-but-often-overlooked-injury
#7
F F Fernandez, S Vatlach, T Wirth, O Eberhardt
The medial condyle fracture of the humerus is-in comparison to the lateral condyle fracture-a very rare Salter-Harrison IV-fracture of the elbow. In this prospective study 14 children were included and reviewed. One child had minimal displacement fracture type I, one child had type II, and 12 children had type III-fractures. One patient was treated conservatively by an upper arm cast; thirteen were surgically treated using open reduction and osteosynthetical treatment. Postoperatively the elbow was immobilized in 90° flexion and neutral position in a long-arm cast for 4-6 weeks...
February 26, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29371238/potential-opportunities-for-prevention-or-earlier-diagnosis-of-child-physical-abuse-in-the-inpatient-setting
#8
Henry T Puls, James D Anderst, Jessica L Bettenhausen, Abbey Masonbrink, Jessica L Markham, Laura Plencner, Molly Krager, Matthew B Johnson, Jacqueline M Walker, Christopher S Greeley, Matthew Hall
OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children's hospitals. Children <6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls...
January 25, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29206097/a-closed-claim-analysis-of-complaints-after-paediatric-antebrachial-fractures
#9
Christian Wong, Søren Bødtker, Peter Buxbom, Michael Schultz-Larsen
INTRODUCTION: Antebrachial fractures in children (AFC) are common and account for one third of all paediatric fractures. The Danish Patient Compensation Association (PCA) receives complaints from patients who believe that they have sustained injuries due to potential malpractice or unfortunate circumstances. Case files on AFC from the PCA were assessed to identify causality and factors contributing to complaints and potential malpractice. METHODS: A closed-claim analysis was performed in 138 cases with the diagnosis codes DS52...
December 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29201310/a-neglected-markedly-displaced-medial-epicondyle-fracture-with-simultaneous-ulnar-nerve-palsy-in-an-adolescent
#10
Tamer Ahmed El-Sobky, John Fathy Haleem, Hossam Moussa Sakr, Ahmad Saeed Aly
Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29174834/a-systematic-review-and-meta-analysis-of-the-management-and-outcomes-of-isolated-skull-fractures-in-children
#11
REVIEW
Silvia Bressan, Luca Marchetto, Todd W Lyons, Michael C Monuteaux, Stephen B Freedman, Liviana Da Dalt, Lise E Nigrovic
STUDY OBJECTIVE: Most studies of children with isolated skull fractures have been relatively small, and rare adverse outcomes may have been missed. Our aim is to quantify the frequency of short-term adverse outcomes of children with isolated skull fractures. METHODS: PubMed, EMBASE, the Cochrane Library, Scopus, Web of Science, and gray literature were systematically searched to identify studies reporting on short-term adverse outcomes of children aged 18 years or younger with linear, nondisplaced, isolated skull fractures (ie, without traumatic intracranial injury on neuroimaging)...
June 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29041997/a-web-based-module-and-online-video-for-pain-management-education-for-caregivers-of-children-with-fractures-a-randomized-controlled-trial
#12
Stevi Golden-Plotnik, Samina Ali, Amy L Drendel, Tammy Wong, Frank Ferlisi, Sydney Todorovich, Kyle Canton, Michael Miller, Julia Younan, Sharlene Elsie, Naveen Poonai
Introduction Over 80% of children experience compromise in functioning following a fracture. Digital media may improve caregiver knowledge of managing fracture pain at home. OBJECTIVES: To determine whether an educational video was superior to an interactive web-based module (WBM) and verbal instructions, the standard of care (SOC). METHODS: This randomized trial included caregivers of children 0-17 years presenting to the emergency department (ED) with non-operative fractures...
October 18, 2017: CJEM
https://www.readbyqxmd.com/read/29040247/use-of-ondansetron-for-vomiting-after-head-trauma-does-it-mask-clinically-significant-traumatic-brain-injury
#13
Israel Green-Hopkins, Michael C Monuteaux, Lois Lee, Lise Nigrovic, Rebekah Mannix, Sara Schutzman
OBJECTIVES: We describe ondansetron use in children with head injury evaluated in pediatric emergency departments and its association with return visits and late diagnoses of intracranial injuries requiring intervention. METHODS: Children ages 6 months to 18 years discharged without neuroimaging from 35 pediatric emergency departments with a diagnosis of head injury from 2009 to 2013 were identified retrospectively from the Pediatric Health Information System. We evaluated the rates of ondansetron use during the study period and of the association of ondansetron treatment with the diagnosis of intracranial injury, skull fracture, and return visits within 72 hours requiring admission or operative intervention...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28965519/accuracy-of-the-ottawa-ankle-rules-applied-by-non-physician-providers-in-a-pediatric-emergency-department
#14
Joe MacLellan, Teya Smith, Jason Baserman, Shawn Dowling
OBJECTIVE: The Ottawa Ankle Rules (OAR) are a clinical decision tool used to minimize unnecessary radiographs in ankle and foot injuries. The OAR are a reliable tool to exclude fractures in children over 5 years of age when applied by physicians. Limited data support its use by other health care workers in children. Our objective was to determine the accuracy of the OAR when applied by non-physician providers (NPP). METHODS: Children aged 5 to 17 years presenting with an acute ankle or foot injury were enrolled...
October 2, 2017: CJEM
https://www.readbyqxmd.com/read/28956988/recognition-and-nursing-management-of-abusive-head-trauma-in-children
#15
Francesca Louise Payne, Daphin Nazareth Fernandez, Lucy Jenner, Siba Prosad Paul
Abusive head trauma (AHT) describes an injury to the head caused by a deliberate impact or shaking by a parent or carer. It can cause significant morbidity and mortality in infants, and is most commonly seen in those aged under 2 years. The initial presentation of AHT can include vague symptoms and the correct diagnosis may be missed by health professionals. Subdural haematoma, brain oedema and retinal haemorrhages are well-known features associated with AHT. However, other conditions such as birth trauma, accidental falls in infants and bleeding disorders can all mimic AHT, thus making its recognition difficult...
September 28, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28956182/combined-avulsion-fracture-of-the-tibial-tubercle-and-patellar-tendon-rupture-in-pediatric-population-case-series-and-review-of-literature
#16
Mohamed Abdelhamid Ali Yousef
Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion with double-hit injury of the knee extensor mechanism is an extremely rare condition. However, they become more frequent due to increased participation in sports and high-energy recreational activities at younger age. It represents a frequently missed diagnosis; therefore, high index of suspicion is required for the diagnosis of such injuries to avoid delays in the treatment which would lead to possible suboptimal functional outcome...
February 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28889364/open-complete-anterior-dislocation-of-the-sacro-iliac-joint-in-a-4-year-old-boy-a-case-report-of-a-rare-injury-with-5-year-follow-up
#17
Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya
Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh...
April 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28677512/-a-toddler-with-a-mandibular-fracture
#18
E L van der Linden, R J Bun, E van Os
BACKGROUND: Mandibular fractures are rare in children. Symptoms of these fractures include preauricular pain and swelling, trismus and pain when opening the mouth, and they are often preceded by a fall on the chin. If the diagnosis is missed they may have serious consequences for the growth and development of the jaw. CASE DESCRIPTION: A 3-year-old boy was referred with a swelling in his left cheek, fever and vomiting. Two days earlier he had fallen on his chin...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#19
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVIs) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US), and the Denver criteria (DC) have been advocated for pediatric BCVI screening, although direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005 to 2015 with radiographically confirmed BCVI...
January 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28604072/-ultrasonographic-diagnosis-of-distal-pediatric-forearm-fractures
#20
Marcell Varga, Nikolett Gáti, Erika Kalóz, Zsuzsanna Bíró, Csenge Szeverényi, Dániel Kardos, Gergő Józsa
INTRODUCTION AND AIM: The aim of our prospective study was to evaluate the effectivity of sonographic diagnosis of pediatric wrist fractures and analyzing the results of two pediatric musculoskeletal centers. METHOD: Between 2011 January and 2015 December 467 children aged 0-15 with closed wrist injuries and open growth plates were sonographically and radiologically evaluated by an orthopaedic surgeon or a resident in trainee. Sonography was performed immediately after physical examination with linear probes of 7-14 Mhz frequency...
June 2017: Orvosi Hetilap
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