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https://www.readbyqxmd.com/read/29062211/outcomes-of-fracture-shaft-femur-in-pediatric-population-managed-at-emergency
#1
Sourabh Kumar Sinha, Vineet Kumar, Ajai Singh
BACKGROUND: Fracture shaft of femur is amongst one of the commonest major diaphyseal injuries in school going children presenting to us at emergency rooms of our hospitals. The presence of a growing proximal and distal physes imposes a real challenge in management of these fractures. The use of titanium elastic nails has gained wide acceptance for stabilizing these fractures. MATERIALS AND METHODS: A sample of 53 children of age group 6 to 12 years were included in the study according to the inclusion and exclusion criteria...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#2
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29019753/imaging-of-pediatric-growth-plate-disturbances
#3
Jie C Nguyen, B Keegan Markhardt, Arnold C Merrow, Jerry R Dwek
The growth plates, or physes, are visible on virtually all images obtained in skeletally immature children. The proper function of these growth plates depends on an intricate balance between chondrocyte proliferation, which requires nourishment from the epiphyseal vessels, and chondrocyte death, which requires the integrity of the metaphyseal vessels. Therefore, injury to the growth plate (ie, direct insult) or vascular compromise on either side of the growth plate (ie, indirect insult) can cause growth plate dysfunction...
October 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28983218/percutaneous-epiphysiodesis-using-transphyseal-screws-a-case-series-demonstrating-high-efficacy
#4
Emily R Dodwell, Matthew R Garner, Elise Bixby, Eva M Luderowski, Daniel W Green, John S Blanco, Roger F Widmann
BACKGROUND: Percutaneous epiphysiodesis using transphyseal screws (PETS) has been associated with implant failure, implant prominence, angular deformities, and delayed growth inhibition. QUESTIONS/PURPOSES: The aim of this study was to assess the complication rate and efficacy (defined as actual growth inhibition divided by expected growth inhibition) of PETS and to identify factors associated with improved efficacy. METHODS: Patients who underwent distal femoral and/or proximal tibial PETS between January 2007 and June 2014 were identified...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28975131/multiligament-knee-injuries-in-older-adolescents-a-2-year-minimum-follow-up-study
#5
Jonathan A Godin, Mark E Cinque, Jonas Pogorzelski, Gilbert Moatshe, Jorge Chahla, Robert F LaPrade
BACKGROUND: Multiligament knee injuries cause significant functional impairment. Adults undergoing anatomic reconstruction of multiligament knee injuries have excellent outcomes postoperatively. However, less is known about the outcomes in adolescent patients following multiligament reconstruction. PURPOSE/HYPOTHESIS: We aimed to assess patient outcomes and failure rates following unstaged multiligament reconstruction in an adolescent population at a minimum 2-year follow-up...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28917547/growth-of-the-new-thumb-metacarpal-after-pollicization-for-thumb-hypoplasia
#6
Michael A Tonkin, Nathan D Trist, Dirk J van der Spuy, Albert Yoon, Harvinder P Singh, Richard D Lawson
PURPOSE: To investigate the radiographic length and width of the new thumb metacarpal in relation to the middle finger proximal phalanx; to assess the incidence of premature physeal closure of the new metacarpal; and to consider whether there is a relationship between growth characteristics and the presence of union or nonunion of the new trapezium to the retained index finger metacarpal base. MATERIALS AND METHODS: Forty pollicizations were assessed with preoperative or immediate postoperative radiographs and follow-up radiographs to establish the growth characteristics of the new thumb metacarpal...
September 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28904629/reliability-of-patellar-height-indices-in-children-with-cerebral-palsy-and-spina-bifida
#7
S A Rethlefsen, K K Barrett, T A L Wren, G Blumstein, D Gargiulo, D D Ryan, R M Kay
BACKGROUND: The Koshino (KI) and Caton-Deschamps (CDI) indices are used to measure patellar height in children, with the CDI showing excellent reliability in typically developing (TD) children. Reliability of such measures in children with cerebral palsy (CP) and spina bifida (SB) is unknown. METHODS: Lateral knee radiographs were reviewed retrospectively for children with TD (n = 49), CP (n = 48) and SB (n = 42). Five raters took measurements from radiographs twice, at least two weeks apart...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28799981/guided-growth-for-angular-correction-in-children-a-comparison-of-two-tension-band-plate-designs
#8
Muayad Kadhim, Luke Gauthier, Karl Logan, Ron El-Hawary, Benjamin Orlik
This retrospective cohort study examined 20 patients (48 physes), 11 boys and nine girls, who were treated with hinge-plate or eight-plate. The mean age of the patients at surgery was 11.9±2.6 years. The mean follow-up duration was 13±2.7 months. The radiographic measurement of both distal femoral and proximal tibial deformity showed significant correction, with no difference between the hinge-plate and the eight-plate. Both screw divergence angle and the hinge angle showed significant changes at the last follow-up...
August 9, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28688811/angular-deformity-correction-by-guided-growth-in-growing-children-eight-plate-versus-3-5-mm-reconstruction-plate
#9
Kyeong-Hyeon Park, Chang-Wug Oh, Joon-Woo Kim, Il-Hyung Park, Hee-June Kim, Young-Seo Choi
BACKGROUND: Guided growth using the eight-plate (8-plate) is the most commonly used method to correct angular deformities in children; however, implant failure has been reported. Recently, the 3.5-mm reconstruction plate (R-plate) has been used as an alternative option for guided growth; however, hardware prominence has been problematic. This study aimed to compare the coronal angular deformity correction results of guided growth between relatively thin 8-plates with cannulated screws and thick R-plates with solid screws...
July 6, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28639852/osteochondritis-dissecans-etiology-pathology-and-imaging-with-a-special-focus-on-the-knee-joint
#10
Juergen Bruns, Mathias Werner, Christian Habermann
This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the treatments available. OCD is seen in children and adolescents with open growth plates (juvenile OCD) and adults with closed growth plates (adult OCD). The etiology of OCD lesions remains unclear and is characterized by an aseptic necrosis in the subchondral bone area. Mechanical factors seem to play an important role...
June 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#11
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/28590374/return-to-sport-after-pediatric-anterior-cruciate-ligament-reconstruction-and-its-effect-on-subsequent-anterior-cruciate-ligament-injury
#12
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/28538286/any-cortical-bridging-predicts-healing-of-supracondylar-femur-fractures-after-treatment-with-locked-plating
#13
Patrick K Strotman, Madhav A Karunakar, Rachel Seymour, William D Lack
OBJECTIVES: To determine the accuracy and reliability of radiographic cortical bridging criteria in predicting the final healing of supracondylar femur fractures after treatment with locked plating. DESIGN: Retrospective review. SETTING: Two Level 1 trauma centers. PATIENTS/PARTICIPANTS: Patients who presented with supracondylar femur fractures (OTA/AO 33A, C) and were treated with locking plate fixation between January 1, 2004, and January 1, 2011...
October 2017: Journal of Orthopaedic Trauma
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/28455719/valgus-slipped-capital-femoral-epiphysis-with-contralateral-pre-slip
#15
Dana E Amiraian, Zahir Sarwar, William R Bireley, Elizabeth Moran
Slipped capital femoral epiphysis (SCFE) is a common hip disorder in older children and adolescents, classically with medial and posterior slippage of the proximal femoral epiphysis. However, valgus SCFE is a very rare entity, where the proximal femoral epiphysis slips laterally and posteriorly. To our knowledge, valgus SCFE with magnetic resonance imaging (MRI) features of contralateral pre-slip has not yet been reported. We present a case of a 9 year old girl with symptomatic valgus SCFE on the left and asymptomatic contralateral pre-slip on the right with concurrent radiographic, sonographic, and MRI findings...
September 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28355677/imaging-of-the-pediatric-knee
#16
REVIEW
Jessica R Leschied, Kara Gaetke Udager
The knee joint is commonly injured in the young athlete. This article discusses the common injury patterns around the knee that are unique to this patient population. Pediatric patients have relative weak points at their physes and apophyses that result in different forces on ligaments and bones during injury compared with adults. Common pathologic findings seen on imaging include patellar and patellar tendon injury, physeal fractures, osteochondral abnormality, ligament tears, and meniscal injury. Imaging studies are also performed to evaluate pediatric patients after surgical knee injury repair, and radiologists should be familiar with certain pediatric-specific knee repair techniques and their imaging appearances...
April 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28302429/does-bony-regrowth-occur-after-arthroscopic-femoroplasty-in-a-group-of-young-adolescents
#17
Itay Perets, Asheesh Gupta, Edwin O Chaharbakhshi, Lyall Ashberg, David E Hartigan, Mary R Close, Benjamin G Domb
PURPOSE: To evaluate femoral head-neck bone regrowth and PROs in skeletally immature patients that underwent arthroscopic femoroplasties over a minimum 2-year period. METHODS: Eleven skeletally immature hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum 2-year follow-up with patient-reported outcomes (PROs) and radiographs preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively...
May 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28288078/idiopathic-genu-valgum-and-its-association-with-obesity-in-children-and-adolescents
#18
Janet L Walker, Pooya Hosseinzadeh, Hank White, Kevin Murr, Todd A Milbrandt, Vishwas J Talwalkar, Henry Iwinski, Ryan Muchow
BACKGROUND: Obesity as a cause of lower extremity deformity in children has been well established. This deformity is most often seen as tibia vara, however, at our institution we have observed more obese children and adolescents over age 7 years with excessive or progressive idiopathic genu valgum. Our hypothesis is that children with idiopathic genu valgum have high rates of obesity which impact the severity of their disease. METHODS: Retrospective review of existing data was performed on 66 consecutive children/112 limbs over age 7 years with idiopathic genu valgum, seen from 2010 to 2013...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28188335/posterior-cruciate-ligament-reconstruction-in-skeletal-immature-children
#19
Ole Gade Sørensen, Peter Faunø, Svend Erik Christiansen, Martin Lind
PURPOSE: Rupture of the posterior cruciate ligament (PCL) is a rare knee injury in children with open growth plates. The follow-up results of six patients with open physes treated with PCL reconstruction are presented. The objective is to evaluate the clinical outcomes of PCL reconstruction for six skeletally immature patients. METHODS: Between 2006 and 2010, six skeletally immature patients were treated with PCL reconstruction. At the time of surgery, the median age was 9 years (range 6-14)...
February 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28184364/tibial-lengthening-using-a-fixator-assisted-lengthening-plate-a-new-technique
#20
Haci Bayram Tosun, Ismail Agir, Seyitali Gumustas, Sancar Serbest, Abuzer Uludag, Suat Celik
BACKGROUND: There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult. OBJECTIVES: In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate. MATERIALS AND METHODS: For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially...
November 2016: Trauma Monthly
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