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https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#1
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28423998/preexisting-lesions-associated-with-complete-diaphyseal-fractures-of-the-third-metacarpal-bone-in-12-thoroughbred-racehorses
#2
Sarah N Gray, Mathieu Spriet, Tanya C Garcia, Francisco A Uzal, Susan M Stover
We characterized features of complete diaphyseal fractures of third metacarpal bones in Thoroughbred racehorses. Given that stress fractures are known to occur in the third metacarpal bone, an additional aim was to determine if complete fractures are associated with signs of a preexisting incomplete stress fracture. Bilateral metacarpi from 12 Thoroughbred racehorses euthanized because of complete unilateral metacarpal diaphyseal fracture were examined visually and radiographically. Open, comminuted, transverse or short oblique fractures occurred in the middle of the diaphysis or supracondylar region...
April 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28419537/electromagnetic-tracking-for-femoral-derotation-osteotomy-an-in-vivo-study
#3
Andreas Geisbüsch, Christoph Auer, Hartmut Dickhaus, Cornelia Putz, Thomas Dreher
Femoral derotation osteotomy delivers good to excellent results in the treatment of rotational gait abnormalities and especially in internal rotation gait. The outcome of the procedure has been evaluated in numerous short and long term studies. Although reasons for recurrence and over-/under-correction have been unveiled in earlier studies the mechanisms are still not fully understood. False intra-operative assessment of the derotation angle may contribute to imprecise outcomes. In a recent saw-bone study we evaluated an electromagnetic tracking system in comparison to conventional goniometer measurement and a CT reference measurement and found it to be extremely accurate, whereas the use of a conventional goniometer for derotation measurement showed a high inter- and intra-rater variability...
April 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28419036/emerging-u-s-national-trends-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#4
Joshua B Holt, Natalie A Glass, Nicholas A Bedard, Stuart L Weinstein, Apurva S Shah
BACKGROUND: Understanding national trends in the treatment of pediatric supracondylar humeral fractures will provide important insight into variations in regional treatment and identify areas for improving value and quality in care delivery in the U.S. METHODS: U.S. national trends in the treatment of supracondylar humeral fractures were evaluated through query of the Humana (2007 to 2014) and ING (2007 to 2011) administrative claims databases. Geographic variation and changes in surgical and transfer rates over time were further explored through the Nationwide Emergency Department Sample (NEDS) database (2006 to 2011)...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#5
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
April 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#6
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28389820/cortical-desmoid-of-the-humerus-radiographic-and-mri-correlation
#7
Matthew Kay, Peter Counsel, David Wood, William Breidahl
Cortical desmoids are self-limiting fibro-osseous lesions commonly occurring at the medial supracondylar femur in active adolescents, at either the origin of the medial head of the gastrocnemius or at the insertion of the adductor magnus aponeurosis. Less commonly, in a similar demographic, cortical desmoids may occur in the proximal humerus medially at the insertion of the pectoralis major muscle or laterally at the insertion of the deltoid. The radiographic appearance of the proximal humerus cortical desmoid has been described previously, but not the MRI appearance...
April 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28367440/analysis-of-early-neurovascular-complications-of-pediatric-supracondylar-humerus-fractures-a-long-term-observation
#8
Ryszard Tomaszewski, Artur Wozowicz, Paulina Wysocka-Wojakiewicz
Purpose. Analysis of early vascular and nerve complications of supracondylar humerus fractures in children. Material and Methods. 220 children hospitalized in the Pediatric Trauma-Orthopedic Department in the years 2004-2014. The group consisted of 143 males and 77 females. Results. Acute neurovascular complications occurred in 16.81% of patients with displaced supracondylar fracture (37 children). Nerve damage was found in 10% of patients with displaced fracture (22 children). The most injured nerve was median nerve; this complication occurred in 15 patients (68...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28331961/-corrective-osteotomies-for-posttraumatic-elbow-deformities
#9
J Nowotny, F Thielemann, A Biewener, K D Schaser
OBJECTIVES: Correcion of elbow joint deformities that usually develop secondary to direct or indirect trauma of the arm or elbow with subsequent inadequate healing and consecutive axial/rotational malalignment and may be associated with cosmetic or functional deficits of the arm. INDICATIONS: Relevant malalignment of the arm axis with corresponding cosmetic or functional deficits for the patient. CONTRAINDICATIONS: Pre-existing degenerative and chronic inflammatory changes...
March 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28328740/comparison-of-the-lateral-and-posterior-approaches-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#10
Gökçer Uzer, Fatih Yildiz, Mehmet Elmadağ, Kerem Bilsel, Tunay Erden, Anil Pulatkan, Derya Çelik, Volkan Gürkan
This study explored the radiological, functional, and cosmetic results of treatment of supracondylar humeral fractures with open reduction and percutaneous pinning, comparing posterior triceps V-splitting (group I, n=22) and lateral (group II, n=25) approaches. The time to union, the functional and cosmetic results, and the flexor and extensor muscle strengths were measured and compared with the contralateral extremities. There were no statistical differences between the groups. The V-splitting posterior approach is as safe and effective as the lateral approach in the surgical treatment of pediatric supracondylar humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28288688/postoperative-brachial-artery-entrapment-associated-with-pediatric-supracondylar-fracture-of-the-humerus-a-case-report
#11
David Latz, Jan Grassmann, Erik Schiffner, Sebastian Gehrmann, Mansur Duran, Joachim Windolf, Pascal Jungbluth
BACKGROUND: Severely displaced supracondylar fractures of the humerus in children are frequently associated with complications including neurovascular injuries, non-union, or compartment syndrome. In the current literature, no report exists about postoperative brachial artery entrapment in combination with an inconspicuous preoperative neurovascular examination. CASE PRESENTATION: We present a case of a 6-year-old white boy with a pulseless radial and ulnar artery after open reduction and internal fixation of a severely displaced supracondylar fracture of his right humerus (Gartland type III) using four K-wires...
March 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28266698/complications-associated-with-pediatric-supracondylar-humeral-fractures
#12
Ernesto Del Valle-Hernández, Pablo A Marrero-Barrera, David Beaton, Dalibel Bravo, Sergio Santiago, Humberto Guzmán-Pérez, Nestor Ramos-Alconini
OBJECTIVE: To measure pediatric supracondylar fracture epidemiology, fracture rate, and complications in the island's pediatric population. The study aims to compare our results to the national rates reported in the literature. METHODS: In this retrospective record review we examined 330 patients who underwent open reduction internal fixation or closed reduction percutaneous pinning in pediatric supracondylar fractures at the University Pediatric Hospital of Puerto Rico Medical Center (HOPU)...
March 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28256419/evaluation-of-the-acceptability-of-a-sphygmomanometer-device-in-knee-extension-training-following-surgical-procedures-of-the-knee
#13
Hauke Horstmann, Christian Colcuc, Philipp Lobenhoffer, Christian Krettek, Thomas Sanjay Weber-Spickschen
BACKGROUND: The postoperative treatment after a standard surgical intervention such as knee arthroplasty, proximal tibial osteotomy or supracondylar osteotomy, can have an important impact on the overall treatment outcome. In most cases, outcomes are positively effected by patients receiving physiotherapy and occupational therapy. Basic movements and range of motion need to be learnt. Self-responsible behaviour, which is similar to exercise programs in sports, needs to be supported. However, in most cases the transfer of training techniques into successful and desired postoperative care is not simple...
November 4, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28251295/management-of-pin-tract-infection-in-pediatric-supracondylar-humerus-fractures-a-comparative-study-of-three-methods
#14
Di Lu, Te Wang, Hua Chen, Liao-Jun Sun
The objective of this study was to prospectively compare the incidence of pin tract infection in pediatric supracondylar humerus fractures managed with pin care daily or every other day or weekly. We hypothesized that there were some differences between these three methods. From June 2012 to May 2015, 135 children with supracondylar humerus fractures were randomized to postoperative pin care by cleaning pin tracts daily (group A, 45 cases) or cleaning every 2 days (group B, 45 cases) or cleaning weekly (group C, 45 cases)...
March 1, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28249353/ultrasound-is-a-useful-tool-to-evaluate-nerve-involvement-in-children-with-supracondylar-humerus-fractures
#15
Marina A Bellavia, Chiara Cambise, Daniele Coraci, Giulio Maccauro, Antonio Valassina, Luca Padua
No abstract text is available yet for this article.
March 1, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28208961/fracture-supracondylar-humerus-a-review
#16
REVIEW
Vineet Kumar, Ajai Singh
Fracture supracondylar humerus is one of the most common fractures encountered in pediatric age group at all levels (both rural and urban). Thus it needs a special review in its management protocol as per the changing trend. Modified Gartland classification is the most accepted classification and has its importance in decision making regarding management and prognosis. Neurovascular complications are mostly associated with Type III A, III B and Type IV variety and they most of the time need surgical intervention for stabilization, exploration of brachial artery, sometimes median nerve exploration and reduction of fracture...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28162172/-radiographic-and-clinical-assessment-of-supracondylar-humeral-fractures-resulted-from-sports-in-children
#17
Z J Liu, S N Pan, L J Zhang
Objective: To investigate the radiographic and clinical assessment for supracondylar humeral fractures resulted from sports in children. Methods: The medical records of 166 patients with displaced supracondylar humerus fractures treated in Shengjing Hospital of China Medical University from January 2015 to December 2015 were reviewed.The etiology of 56 of 166 cases was relevant to the sports.Medical records of 56 of 166 patients were reviewed, incluidng gender, the mean age of patient at the time of surgery, the mean duration of injury, radiographic assessment based on the anteroposterior (AP) and lateral radiographs of the elbow, neurologic injury, the Mayo Elbow Performance Score (MEPS) and the criteria of Flynn...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28141693/time-to-return-to-school-after-10-common-orthopaedic-surgeries-among-children-and-adolescents
#18
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/28104093/surgical-management-of-delayed-irreducible-gartland-iii-supracondylar-fractures-in-children-open-reduction-and-internal-fixation-versus-external-fixation
#19
COMPARATIVE STUDY
Jin Li, DeHao Fu, Chong Yu, ShangYu Wang, RenHao Ze, Xin Tang
BACKGROUND: Percutaneous pinning has been accepted as the "gold standard" for displaced supracondylar humeral fracture (SHF) in children. However, to secure an anatomic reduction and to reduce the rotated fragment, open reduction is often necessary when there is inadequate stabilization or a satisfactory reduction has failed to be achieved. The study aimed to compare the efficacy of the open reduction and bioabsorbable poly-d,l-lactic acid (PDLLA) pin fixation method with the closed reduction and lateral external fixation method in irreducible delayed Gartland type III SHF in children...
February 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#20
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
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