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https://www.readbyqxmd.com/read/29237543/diagnosis-and-management-of-mcfarland-fractures-a-case-report-and-review-of-the-literature
#1
M Birt, B Vopat, P Schroeppel, A Tarakemeh, B Everist, S Mullen
BACKGROUND: McFarland fracture is the eponym for a rare Salter Harris III or IV fracture involving the medial distal tibia. These fractures can be difficult to diagnose without a high index suspicion and appropriate radiographic imaging. These fractures may result in significant growth disturbances to the pediatric patient. When diagnosed and treated acutely, these fractures can be managed with cast immobilization and close follow up. If diagnoses in a delayed fashion they can result in significant morbidity including prolonged casting and possible surgical treatment...
December 9, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29226207/open-anterior-hip-dislocation-in-a-child-a-rare-mechanism-of-injury
#2
Ali A Esmailiejah, Mohammadreza Abbasian, Farshad Safdari, Sufian S Ahmad
Traumatic anterior dislocation of the hip is an extremely rare condition in children and open dislocation is even rarer. This isusually caused by high-energy trauma. In the current study, we present a case of an eight-year-old child suffering from an open anterior-inferior dislocation of the right hip concomitant with pelvic ring disruption and an ipsilateral open distal femoral fracture (Salter-Harris type 4, Gustilo type IIIA) caused by a traffic accident. The patient underwent successful emergent open reduction due to the buttonholed femoral head after appropriate irrigation and debridement...
September 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29183896/paediatric-salter-harris-type-iv-injury-of-distal-tibia-with-talus-fracture
#3
Swapnil Kothadia, Umesh Birole, Ashish Ranade
Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning...
November 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29182123/angular-deformity-development-after-the-distal-tibial-physeal-fractures
#4
B Özkul, M S Saygılı, E Çetinkaya, F Arslanoğlu, I A Bayhan, B Demir, A C Tekin
Several clinical and radiological factors can be prognostic in the development of angular deformity following physeal injuries of the distal tibia. One of the radiological parameters, premature physeal closure (PPC), can be detected during postoperative follow-ups. Aim of our study was to identify the prognostic factors in development of angular deformity and its relationship with PPC. One hundred and four patients treated due to physeal injuries of the distal tibia were included in our study. Patients were divided into three groups based on Salter-Harris (SH) classification...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29170353/56%C3%A2-manipulation-and-reduction-of-paediatric-forearm-fractures-using-es-ketamine-in-a-paediatric-emergency-department-a-5-year-study
#5
Shirley Mulvaney
BACKGROUND: Forearm fractures are the most common paediatric injury presenting to A+E.1,2 Literature supports safe and effective treatment of these injuries in A+E using a variety of sedation methods, including ketamine.3,4 The Paediatric Orthopaedic Trauma Snapshot (POTS) study showed that only 35% of A+Es nationally allow manipulation of these injuries in the department. METHODS: A retrospective analysis was undertaken of all patients presenting with fractures of the forearm between January 2012 to December 2016 who were treated with reduction and manipulation in the Alder Hey A+E department using Es-ketamine...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29107133/physeal-fractures-of-the-lower-leg-in-children-and-adolescents-therapeutic-results-pitfalls-and-suggested-management-protocol-based-on-the-experience-of-the-authors-and-contemporary-literature
#6
Marcin Karlikowski, Jerzy Sułko
INTRODUCTION: Physeal fractures in children frequently give rise to concerns about the condition of the growth plate. Our observations have proven that the dysfunction of the growth plate is less frequent complication in those cases than misdiagnosed interposition of the periosteum. The aim of this paper is to familiarize the readers with the issue of treatment of physeal fractures of the distal tibia and fibula in the growing skeleton. MATERIALS AND METHODS: We analyzed the group of 75 patients - children and adolescents - with surgically treated physeal fractures of the lower leg...
October 26, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29070026/a-biomechanical-comparison-of-kirschner-wire-fixation-on-fracture-stability-in-salter-harris-type-i-fractures-of-the-proximal-humeral-physis-in-a-porcine-cadaveric-model
#7
Jiawen Ma, Tian Wang, Vedran Lovric, Kenneth A Johnson, William R Walsh
BACKGROUND: The physis is the weakest component of immature long bones, and physeal fractures constitute about 30% of fractures in growing dogs. Fractures of the proximal humeral physis typically have a Salter Harris type I or II configuration. These fractures require accurate reduction and adequate stabilization to allow for any potential continued longitudinal bone growth, in conjunction with physeal fracture healing. Conventional internal fixation of these fractures involves insertion of two parallel Kirschner wires, although other methods described include tension band wiring, Rush pinning, and lag screws...
October 25, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29052010/open-versus-closed-treatment-of-distal-tibia-physeal-fractures-a-systematic-review-and-meta-analysis
#8
Waleed A Asad, Manaf H S Younis, Abdulaziz F Ahmed, Talal Ibrahim
AIMS: Distal tibia physeal fractures can lead to growth complications such as premature physeal closure (PPC), angular deformity and leg length discrepancy. The aim of our study was to systematically review the literature to assess whether open reduction and internal fixation (ORIF) is associated with lower rates of PPC compared to closed treatment. MATERIALS AND METHODS: We searched several databases from 1966 to 2016 for studies that evaluated ORIF versus closed treatment of distal tibia physeal fractures...
October 19, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29051906/intra-articular-physeal-fractures-of-the-distal-femur-a-frequently-missed-diagnosis-in-adolescent-athletes
#9
Andrew T Pennock, Henry B Ellis, Samuel C Willimon, Charles Wyatt, Samuel E Broida, M Morgan Dennis, Tracey Bastrom
BACKGROUND: Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature. PURPOSE: To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29039128/distal-femoral-flexion-deformity-from-growth-disturbance-treated-with-a-two-level-osteotomy-and-internal-lengthening-nail
#10
Austin T Fragomen, Fiona R Fragomen
Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3) of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#11
Fabio D'Angelo, Giuseppe Solarino, Davide Tanas, Alessia Zani, Paolo Cherubino, Biagio Moretti
INTRODUCTION: The physeal fractures represent the 20-30% of all fractures of the child. The distal tibial physis is the third most frequently injured. The most important complication is the premature physeal closure (PPC). Aim of this study is to evaluate risk factors that can influence the outcome like fracture pattern, fracture displacement, mechanism of injury and treatment method. MATERIAL AND METHODS: The records of 46 patients treated for distal tibia physeal fractures between 2003 and 2013 were reviewed...
October 2017: Injury
https://www.readbyqxmd.com/read/29023275/proximal-radial-head-fractures-in-young-gymnasts-a-case-series-of-newly-described-overuse-injuries
#12
Jaron Santelli, Teri M McCambridge, Amy E Valasek, Kathleen Standiford
We report a case series of unilateral Salter-Harris IV fractures of the proximal radial heads in young female gymnasts. To date, there are no previous reports of such injuries in gymnastics. In all 3 athletes, no significant injury preceded presentation or diagnosis. Radiographs and magnetic resonance imaging showed fractures and associated bone marrow edema of the proximal radial head, respectively. All but 1 was treated nonoperatively with success. Given the lack of acute trauma, lack of large effusion, and good range of motion at presentation, these injuries are believed to be chronic in nature and related to overuse...
October 11, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29019753/imaging-of-pediatric-growth-plate-disturbances
#13
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/28984686/intraobserver-and-interobserver-reliability-of-radiographic-analysis-of-proximal-humerus-fractures-in-adolescents
#14
Michelle C Burke, Christopher Minnock, Christopher B Robbins, Matthew D Abbott, Michelle S Caird, Frances A Farley, Jacob Kirsch, Jared Thomas, Ying Li
BACKGROUND: Multiple studies have shown low intrarater and interrater agreement of radiographic classification systems for proximal humerus fractures (PHFs) in adults. There is no standardized method of measuring angulation of pediatric PHFs, nor is there consensus as to the amount of angulation and displacement that require operative fixation of adolescent PHFs. We propose a new standardized method to measure fracture angulation that is similar to the method used to measure the epiphyseal-shaft angle for slipped capital femoral epiphysis...
October 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28984680/pan-tibial-avascular-necrosis-in-a-12-year-old-boy-a-case-report
#15
Nirmal R Gopinathan, Balaji Saibaba, Siva S Santhanam, Kevin Syam
We report a unique case of post-traumatic avascular necrosis of tibia in a 12-year-old boy following a Salter-Harris type II physeal injury of the proximal tibia. The diagnosis was made on the basis of classical radiological findings. The only clinical symptom was diffuse shin pain. The patient was managed conservatively. At our 2-year follow-up, there was clinical and radiological evidence of spontaneous resolution of avascular necrosis, but with sequelae. The child developed a limb-length discrepancy and genu valgum...
October 3, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28928921/an-unusual-cause-of-genu-valgum-and-persistent-instability
#16
Edward Holloway, Paul Sutton, Robert Cooper
We present the case of a professional adolescent footballer who attended our clinic with ongoing instability symptoms and valgus knee deformity after conservative management of an medial collateral ligament injury. The patient was found to have sustained a contra-coup Salter Harris Type V injury to his lateral distal femur physis resulting in premature growth arrest and deformity. Salter Harris Type V injuries are rare, and often not diagnosed until growth has arrest has occurred due to lack of identifiable features on initial plain radiographs...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28925312/what-is-the-best-treatment-for-displaced-salter-harris-ii-physeal-fractures-of-the-distal-tibia
#17
Hoon Park, Dong Hoon Lee, Seung Hwan Han, Sungmin Kim, Nam Kyu Eom, Hyun Woo Kim
Background and purpose - The optimal treatment of displaced Salter-Harris (SH) II fractures of the distal tibia is controversial. We compared the outcomes of operative and nonoperative treatment of SH II distal tibial fractures with residual gap of >3 mm. Factors that may be associated with the incidence of premature physeal closure (PPC) were analyzed. Patients and methods - We retrospectively reviewed 95 patients who were treated for SH II distal tibial fractures with residual gap of >3 mm after closed reduction...
September 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28864264/a-self-reported-needs-assessment-survey-of-pediatric-orthopaedic-education-in-haiti
#18
Rameez A Qudsi, Heather J Roberts, Abhiram R Bhashyam, Elena Losina, Donald S Bae, Francel Alexis, George S Dyer
OBJECTIVE: The burden of musculoskeletal disease remains high in low-income countries, with a high rate of pediatric disease. Efforts continue for orthopedic education, but there is little guidance on local needs and desires. Our aim was to determine the specific content and modalities that would be most useful for pediatric orthopedic educational programs abroad, and we demonstrate a practical method of identifying country-specific educational deficits through a self-reported needs survey in Haiti...
August 29, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28828129/salter-harris-i-fracture-of-the-distal-humerus-in-a-neonate-imaging-appearance-of-radiographs-ultrasound-and-arthrography
#19
Nicholas M Beckmann, Lindsay Crawford
Neonatal Salter-Harris I fractures of the distal humerus are a rare injury. This injury can be easily mistaken for a posterior elbow dislocation, creating a delay in diagnosis. We present a case of a neonate with a distal humerus Salter-Harris I fracture secondary to trauma during delivery. The patient presented with pseudoparesis of the left arm following birth. Posterior displacement of the elbow was identified on radiographs. Ultrasound of the elbow was performed after a gentle closed reduction of the left elbow was unsuccessful...
September 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/28735839/epidemiology-of-proximal-humeral-fractures-a-detailed-survey-of-711-patients-in-a-metropolitan-area
#20
Daniele Passaretti, Vittorio Candela, Pasquale Sessa, Stefano Gumina
BACKGROUND: Literature lacks data concerning several epidemiologic aspects of proximal humeral fractures (PHFs). METHODS: This retrospective study included 711 consecutive patients (209 men, 502 women) who sustained a PHF in the last 3 years. Participants were divided into 2 groups, adults and children. Data regarding age, sex, date, and fracture side were collected. According to the mechanism of injury, we arbitrarily distinguished 7 subgroups. PHFs were classified according to the head-greater-lesser-shaft (HGLS)-Hertel classification and to the Salter-Harris classification using x-ray and computed tomography imaging...
July 20, 2017: Journal of Shoulder and Elbow Surgery
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