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Missed fractures in children

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https://www.readbyqxmd.com/read/28540998/impact-of-open-reduction-on-surgical-strategies-for-missed-monteggia-fracture-in-children
#1
Hoon Park, Kwang Won Park, Kun Bo Park, Hyun Woo Kim, Nam Kyu Eom, Dong Hoon Lee
PURPOSE: The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture. MATERIALS AND METHODS: We retrospectively reviewed 22 patients who presented with missed Monteggia fracture. The patients' mean age at the time of surgery was 7.6 years. The mean interval from injury to surgery was 16...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28536766/pediatric-radiology-malpractice-claims-characteristics-and-comparison-to-adult-radiology-claims
#2
REVIEW
Micheál A Breen, Kathy Dwyer, Winnie Yu-Moe, George A Taylor
Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation...
June 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#3
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28363615/retrospective-comparison-of-the-low-risk-ankle-rules-and-the-ottawa-ankle-rules-in-a-pediatric-population
#4
Amy L Ellenbogen, Amy L Rice, Pranav Vyas
BACKGROUND: A recent multicenter prospective Canadian study presented prospective evidence supporting the Low Risk Ankle Rules (LRAR) as a means of reducing the number of ankle radiographs ordered for children presenting with an ankle injury while maintaining nearly 100% sensitivity. This is in contrast to a previous prospective study which showed that this rule yielded only 87% sensitivity. OBJECTIVE: It is important to further investigate the LRAR and compare them with the already validated Ottawa Ankle Rules (OAR) to potentially curb healthcare costs and decrease unnecessary radiation exposure without compromising diagnostic accuracy...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28246898/external-validation-of-clinical-decision-rules-for-children-with-wrist-trauma
#5
Marjolein A M Mulders, Monique M J Walenkamp, Bente F H Dubois, Annelie Slaar, J Carel Goslings, Niels W L Schep
BACKGROUND: Clinical decision rules help to avoid potentially unnecessary radiographs of the wrist, reduce waiting times and save costs. OBJECTIVE: The primary aim of this study was to provide an overview of all existing non-validated clinical decision rules for wrist trauma in children and to externally validate these rules in a different cohort of patients. Secondarily, we aimed to compare the performance of these rules with the validated Amsterdam Pediatric Wrist Rules...
May 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28236132/double-read-of-skeletal-surveys-in-suspected-non-accidental-trauma-what-we-learned
#6
Boaz Karmazyn, Elise M Miller, Sara E Lay, James M Massey, Matthew R Wanner, Megan B Marine, S Gregory Jennings, Fangqian Ouyang, Roberta A Hibbard
BACKGROUND: Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. OBJECTIVE: To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. MATERIALS AND METHODS: The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours...
February 24, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28141693/time-to-return-to-school-after-10-common-orthopaedic-surgeries-among-children-and-adolescents
#7
Samuel C Willimon, Marjorie M Johnson, Mackenzie M Herzog, Michael T Busch
BACKGROUND: Return to school among adolescents is often overlooked in orthopaedic outcome studies. The purpose was to measure the time missed from school after 10 common orthopedic surgeries. METHODS: Patients, 5 to 19 years old enrolled in elementary, middle, or high school, who underwent treatment for fixation of type III supracondylar humerus fracture, midshaft femur fracture fixation, isolated anterior cruciate ligament reconstruction, isolated partial menisectomy, adolescent idiopathic scoliosis fusion, closed reduction of both-bone forearm fracture, arthroscopic Bankart repair, hip arthroscopy with femoroacetabular impingement correction, limb length discrepancy correction, or surgical fixation of slipped capital femoral epiphysis during the 2014/2015 and 2015/2016 school years were identified for this Institutional Review Board-approved study...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28105733/vitamin-d-supplementation-for-sickle-cell-disease
#8
REVIEW
Htoo Htoo Kyaw Soe, Adinegara Bl Abas, Nan Nitra Than, Han Ni, Jaspal Singh, Abdul Razzak Bin Mohd Said, Ifeyinwa Osunkwo
BACKGROUND: Sickle cell disease is a genetic chronic haemolytic and pro-inflammatory disorder. The clinical manifestations of sickle cell disease result from the presence of mutations on the beta globin genes that generate an abnormal haemoglobin product (called haemoglobin S) within the red blood cell. Sickle cell disease can lead to many complications such as acute chest syndrome, stroke, acute and chronic bone complications (including painful vaso-occlusive crisis, osteomyelitis, osteonecrosis and osteoporosis)...
January 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28018066/femoral-fracture-acting-as-an-ominous-masquerade-in-a-7-year-old-child
#9
Amit Srivastava, Aditya N Aggarwal, Puneet Mishra, Dheeraj Bhateja
A pathological fracture is one which occurs in diseased bone with trivial trauma or even without it. However, fracture occurring as a result of significant injury can masquerade underlying ominous bone pathology, which is highly likely to be missed in the garb of overwhelming traumatic aetiology. Pathological fracture as the manifestation of tumour in children less than 10 years of age is rare.1, 2 Fracture following significant trauma masquerading as underlying malignancy is even rarer. We report a case of 7-year-old male child, he had history of significant trauma with fracture shaft of femur, pathology was "missed" initially in the outset of trauma and on subsequent follow up it was found to be osteosarcoma...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27908536/the-sensitivity-and-negative-predictive-value-of-a-pediatric-cervical-spine-clearance-algorithm-that-minimizes-computerized-tomography
#10
Mary Arbuthnot, David P Mooney
BACKGROUND: It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm. METHODS: We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our institution's cervical spine clearance algorithm over a 10-year period. Age, gender, International Classification of Diseases 9th Edition diagnosis codes, presence or absence of cervical collar on arrival, Injury Severity Score, and type of cervical spine imaging obtained were extracted from the trauma registry and electronic medical record...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27857985/emergency-physicians-performed-point-of-care-ultrasonography-for-detecting-distal-forearm-fracture
#11
Semra Sivrikaya, Ersin Aksay, Basak Bayram, Nese Colak Oray, Ahmet Karakasli, Emel Altintas
OBJECTIVES: Several studies focusing diagnosis of forearm fracture using Point-of-Care-Ultrasonography (POCUS) had been carried out in children. There is a lack of evidence for the utility of sonographic (US) examination for detecting of distal forearm fracture in adults. We aim to determine the diagnostic sensitivity and specificity of POCUS examination for the fracture of the distal radius and ulna in adult patients presenting with blunt forearm trauma. MATERIAL AND METHODS: Adult patients presenting with acute distal forearm trauma and suspicion of fracture were enrolled into study...
September 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27805890/dental-treatment-needs-among-children-and-adolescents-residing-in-an-ugandan-orphanage
#12
Pessia Friedman Rubin, Ephraim Winocur, Assaf Erez, Ravit Birenboim-Wilensky, Benjamin Peretz
BACKGROUND: Previous studies focused on the dental caries status of East African children and not on their overall dental needs. Urban children consume more sugar-rich foods. OBJECTIVES: To assess overall dental treatment needs of children living in an orphanage in Uganda. STUDY DESIGN: Teeth were diagnosed as needing treatment by obvious frank carious lesions (WHO criteria), temporary fillings, staining, or very deep pit and/or fissures possibly requiring sealants...
2016: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/27777920/bilateral-femoral-neck-stress-fracture-in-child-a-case-report
#13
Gun-Woo Lee, Kyung-Soon Park, Taek-Rim Yoon, Eshnazarov Kamolhuja Eshnazarovich
A femoral neck stress fracture in child is rare, particularly in bilateral case. It is easy to miss initially or may be misdiagnosed. The authors experienced a case of bilateral femoral neck stress fracture in a 10-year-old boy with bilateral hip. The patient was successfully healed by conservative treatment. We report this rare case with a review of the literature. A femoral neck stress fracture should be included in the differential diagnosis in children who present with sustained hip or groin pain.
September 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/27741076/useful-plain-radiographic-findings-in-diagnosis-of-pediatric-olecranon-fracture-complicated-with-proximal-radial-fracture
#14
Yuki Fujihara, Masahiro Tatebe, Nasa Fujihara, Hiromasa Tanaka, Hitoshi Hirata
OBJECTIVE: The aim of this study was to verify the use of initial plain radiographs, specifically the presence of a longitudinal crack on the olecranon, for diagnosing olecranon occult fractures in children. METHODS: We retrospectively reviewed all patients younger than 16 years who were diagnosed with proximal radial fractures treated at our hospital between April 1, 2006 and September 31, 2014. We included 22 patients (9 boys and 13 girls) with a mean age of 8...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27709870/avoiding-errors-in-the-management-of-pediatric-polytrauma-patients
#15
Kenneth Chin, Joshua M Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
February 15, 2016: Instructional Course Lectures
https://www.readbyqxmd.com/read/27684324/computer-aided-detection-cadx-for-plastic-deformation-fractures-in-pediatric-forearm
#16
Yuwei Zhou, Uygar Teomete, Ozgur Dandin, Onur Osman, Taner Dandinoglu, Ulas Bagci, Weizhao Zhao
Bowing fractures are incomplete fractures of tubular long bones, often observed in pediatric patients, where plain radiographic film is the non-invasive imaging modality of choice in routine radiological workflow. Due to weak association between bent bone and distinct cortex disruption, bowing fractures may not be diagnosed properly while reading plain radiography. Missed fractures and dislocations are common in accidents and emergency practice, particularly in children. These missed injuries can result in more complicated treatment or even long-term disability...
September 17, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27603195/femoral-neck-aspiration-aids-in-the-diagnosis-of-osteomyelitis-in-children-with-septic-hip
#17
Jedidiah E Schlung, Tracey P Bastrom, Joanna H Roocroft, Peter O Newton, Scott J Mubarak, Vidyadhar V Upasani
BACKGROUND: The role of femoral aspiration (FA) in the treatment of septic arthritis of the hip is controversial. The purpose of this study was to determine if FA conducted concomitantly with irrigation and debridement (I&D) of the septic hip aids in microorganism and osteomyelitis identification and alters the treatment plan, or if the risks of the procedure outweigh its potential benefit. We also compare preoperative magnetic resonance imaging (MRI) with FA for diagnosis of osteomyelitis cooccurring with septic arthritis...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27470953/-classification-and-imaging-diagnosis-of-lisfranc-joint-injuries
#18
Y Xi, D J Hu, W W Yao, M Li
OBJECTIVE: To accelerate the detection rate and accuracy of diagnosis in damage imaging of Lisfranc joint through research on the information of X-ray, CT, and MR imaging of tarsometatarsus joint (also called Lisfranc joint) damage. METHODS: A total of 153 cases of tarsometratisus damage or Lisfranc ligamentous injury patients were chosen during November 2012 to November 2015. Lisfranc injuries were classified according to the Myerson fracture displacements classification and Nunley-Vertullo low-grade injury classification...
July 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27432464/clinical-significance-of-anterior-humeral-line-in-supracondylar-humeral-fractures-in-children
#19
Hsuan-Kai Kao, Wei-Chun Lee, Wen-E Yang, Chia-Hsieh Chang
INTRODUCTION: Anterior humeral line (AHL) location is commonly used to evaluate sagittal alignment after fracture reduction in children with supracondylar humeral fractures. However, the position of the AHL for acceptable fracture reduction has not been validated by clinical outcome. The purpose of this study was to investigate the relationship between the location of AHL and range of elbow motion. PATIENTS AND METHODS: We retrospectively reviewed 101 children who underwent closed reduction and percutaneous pinning for Gartland type III supracondylar humeral fractures between January 2009 and June 2014...
October 2016: Injury
https://www.readbyqxmd.com/read/27314506/geometry-reconstruction-method-for-patient-specific-finite-element-models-for-the-assessment-of-tibia-fracture-risk-in-osteogenesis-imperfecta
#20
Christiane Caouette, Nicole Ikin, Isabelle Villemure, Pierre-Jean Arnoux, Frank Rauch, Carl-Éric Aubin
Lower limb deformation in children with osteogenesis imperfecta (OI) impairs ambulation and may lead to fracture. Corrective surgery is based on empirical assessment criteria. The objective was to develop a reconstruction method of the tibia for OI patients that could be used as input of a comprehensive finite element model to assess fracture risks. Data were obtained from three children with OI and tibia deformities. Four pQCT scans were registered to biplanar radiographs, and a template mesh was deformed to fit the bone outline...
June 17, 2016: Medical & Biological Engineering & Computing
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