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Pediatric extremity fractures

Camille Aubin-Lemay, Philippe Acar, Nayif Alnaif, Abdulrahman Alamri, Alain Joe Azzi, Sabrina Cugno
The authors present a rare case of nontraumatic medial orbital wall fracture in an 11-year-old girl. Fractures of the orbital wall secondary to nose blowing have not been previously described in the pediatric population. The patient reported a history of chronic forceful nose blowing, followed by periorbital swelling after an episode of vigorous nose blowing. Erroneous diagnoses of sinusitis and periorbital cellulitis lead to unnecessary antibiotic treatment. The authors hypothesize that repeated and aggressive nose blowing is analogous to stress fractures, leading to weakening and eventual fracture of the medial orbital wall...
March 8, 2018: Journal of Craniofacial Surgery
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
Clint Rathje, Ashley Venegas, Stephen D Helmer, Rachel M Drake, Jeanette G Ward, James M Haan
Background: Agriculture is an industry where family members often live and work on the same premises. This study evaluated injury patterns and outcomes in children from farm-related accidents. Methods: A 10-year retrospective review of farm-accident related injuries was conducted of patients 17 years and younger. Data collected included demographics, injury mechanism, accident details, injury severity and patterns, treatments required, hospitalization details, and discharge disposition...
November 2017: Kansas Journal of Medicine
William Cody Sessions, Matthew Herring, Walter H Truong
The extensor mechanism of the knee-consisting of the four muscles of the quadriceps, the quadriceps tendon, the patella, and the patellar ligament-is essential for lower extremity function during both standing and ambulation. The presence of articular cartilage and growing physes in the pediatric knee, coupled with the generation of significant tensile force, creates an opportunity for pathology unique to the pediatric population.Tibial tubercle fractures and patella injuries are quite rare, and even pediatric-trained orthopaedic surgeons may not be exposed to these injuries on a regular basis...
February 6, 2018: Journal of Knee Surgery
Chiara Zanchi, Manuela Giangreco, Luca Ronfani, Claudio Germani, Rita Giorgi, Lorenzo Calligaris, Stefania Norbedo, Giulio Liccari, Giorgio Cozzi, Egidio Barbi
OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture. METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children's hospital in Italy, with an accidental extremity injury, between May and December 2015...
January 23, 2018: Pediatric Emergency Care
Itai Gross, Daniel J Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BACKGROUND: Electric bike (e-bike) usage is growing worldwide, and so is the e-bike-related injury rate. OBJECTIVE: This study was undertaken to characterize e-bike-related injuries. METHODS: Data of all e-bike-related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike-related injuries were then analyzed separately and compared. RESULTS: Forty-eight patients suffering from e-bike-related injuries presented to our trauma center between January 1, 2014 and December 31, 2016...
January 15, 2018: Journal of Emergency Medicine
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
February 2018: Pediatric Emergency Care
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
Anne Drury, Craig Cunningham
Radiographic fracture date estimation is a critical component of skeletal trauma analysis in the living. Several timetables have been proposed for how the appearance of radiographic features can be interpreted to provide a likely time frame for fracture occurrence. This study compares three such timetables for pediatric fractures, by Islam et al. (2000), Malone et al. (2011), and Prosser et al. (2012), in order to determine whether the fracture date ranges produced by using these methods are in agreement with one another...
January 2018: Journal of Forensic and Legal Medicine
Brian T Sullivan, Adam Margalit, Vaibhav S Garg, Dolores B Njoku, Paul D Sponseller
BACKGROUND: Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI. METHODS: We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center...
November 16, 2017: Journal of Pediatric Orthopedics
Patrick J Smith, Anthony M Hollins, Jeffrey R Sawyer, David D Spence, Shane Outlaw, Derek M Kelly
BACKGROUND: As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern. METHODS: Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014...
February 2018: Journal of Pediatric Orthopedics
John S Murray
The purpose of this article was to describe the phenomenon of toxic stress and its impact on the physical and mental health of child refugees. Almost two decades ago, researchers found that recurring adverse childhood events (ACEs; e.g., physical, psychological, and sexual abuse, neglect, and household dysfunction such as substance abuse, mental illness, and criminal behavior) were associated with a significant increase in serious illnesses during adulthood. Illnesses include heart, lung, and liver disease, cancer, and bone fractures...
November 20, 2017: Journal for Specialists in Pediatric Nursing: JSPN
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
Jennifer J Beck, Connor G Richmond, Marc A Tompkins, Ann Heyer, Kevin G Shea, Aristides I Cruz
BACKGROUND: Sports injuries are common in pediatric and adolescent patients and the evaluation and treatment of these injuries continues to evolve. The purpose of this review is to provide a comprehensive appraisal of the most recent literature, highlighting updates on sports-related upper extremity injuries in pediatric patients. METHODS: An electronic search of the PubMed, EMBASE, and Google Scholar databases was performed for keywords related to pediatric overhead athletes, osteochondritis dissecans (OCD) of the capitellum, medial epicondyle fractures, shoulder instability, and clavicle fractures...
November 7, 2017: Journal of Pediatric Orthopedics
Guy Rubin, Kobi Peleg, Adi Givon, Nimrod Rozen
BACKGROUND: Fractures in pediatrics show epidemiological characteristics which are different from fractures in adults. The objective of this study was to examine the injury profiles of open upper extremity fractures (UEFs) in all modes of injury related to road traffic accidents (RTAs) in adult and pediatric hospitalized patients. METHODS: Data on 103,465 RTA patients between 1997 and 2013 whose records were entered in a centralized country trauma database were reviewed...
October 24, 2017: Journal of Orthopaedic Surgery and Research
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
Sara Saleh, Kyle I Swanson, Taryn Bragg
Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma-induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient's birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury...
October 20, 2017: Journal of Neurosurgery. Pediatrics
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed and the fracture was seen on the post-operative radiographs...
May 2017: Journal of Orthopaedic Case Reports
Aristides I Cruz, Steven F DeFroda, Joseph A Gil, Heather Hansen, Alexandre Bolous, Michaela Procaccini, Mark R Zonfrillo
BACKGROUND: Long arm cast immobilization after operative and nonoperative treatment of pediatric upper extremity fractures is common. The use of a sling to aid in carrying the casted extremity as well as provide further immobilization is also common practice. Off-the-shelf slings vary in quality and fit, can be confusing for parents/patients to apply, and lead to frustration and dissatisfaction with its use. The purpose of this investigation was to compare patient/parent centered outcomes after the use of a customized sling compared with a standard sling by utilizing a prospective, randomized-controlled trial...
October 18, 2017: Journal of Pediatric Orthopedics
Meghan Hughes, Karan Dua, Nathan N O'Hara, Brian K Brighton, Theodore J Ganley, William L Hennrikus, Martin J Herman, Joshua E Hyman, J Todd Lawrence, Charles T Mehlman, Kenneth J Noonan, Norman Y Otsuka, Richard M Schwend, M Wade Shrader, Brian G Smith, Paul D Sponseller, Joshua M Abzug
BACKGROUND: Medial epicondyle fractures are a common pediatric and adolescent injury accounting for 11% to 20% of elbow fractures in this population. This purpose of this study was to determine the variability among pediatric orthopaedic surgeons when treating pediatric medial epicondyle fractures. METHODS: A discrete choice experiment was conducted to determine which patient and injury attributes influence the management of medial epicondyle fractures by pediatric orthopaedic surgeons...
October 18, 2017: Journal of Pediatric Orthopedics
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