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Pediatric orthopaedics

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https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#1
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28604072/-ultrasonographic-diagnosis-of-distal-pediatric-forearm-fractures
#2
Marcell Varga, Nikolett Gáti, Erika Kalóz, Zsuzsanna Bíró, Csenge Szeverényi, Dániel Kardos, Gergő Józsa
INTRODUCTION AND AIM: The aim of our prospective study was to evaluate the effectivity of sonographic diagnosis of pediatric wrist fractures and analyzing the results of two pediatric musculoskeletal centers. METHOD: Between 2011 January and 2015 December 467 children aged 0-15 with closed wrist injuries and open growth plates were sonographically and radiologically evaluated by an orthopaedic surgeon or a resident in trainee. Sonography was performed immediately after physical examination with linear probes of 7-14 Mhz frequency...
June 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28598494/decreased-radiation-exposure-among-orthopedic-residents-is-maintained-when-using-the-mini-c-arm-after-undergoing-radiation-safety-training
#3
David Gendelberg, William L Hennrikus, Carissa Sawyer, Douglas Armstrong, Steven King
The resident curriculum of the American Board of Orthopaedic Surgery emphasizes radiation safety. Gendelberg showed that, immediately after a program on fluoroscopic safety, residents used less radiation when using the mini C-arm to reduce pediatric fractures. The current study evaluated whether this effect lasted. Residents underwent a new annual 3-hour session on mini C-arm use and radiation. Group A included 53 reductions performed before training. Group B included 45 reductions performed immediately after training...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28594521/pediatric-distal-radius-fractures
#4
Karan Dua, Joshua M Abzug, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Distal radius fractures are the most common orthopaedic injury that occur in the pediatric population. The annual incidence of distal radius fractures has increased as a result of earlier participation in sporting activities, increased body mass index, and decreased bone mineral density. Most distal radius fractures are sustained after a fall onto an outstretched arm that results in axial compression on the extremity or from direct trauma to the extremity. Physeal fractures of the distal radius are described based on the Salter-Harris classification system...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28583063/characterization-of-the-development-of-acute-on-chronic-exertional-compartment-syndrome-a-case-report-of-symmetric-compartment-syndromes-and-review-of-the-literature
#5
Andrew Schwartz, Claudette Poole, Charles Schleien
Acute-on-chronic exertional compartment syndrome is a rare and severe progression of the likely common and more benign chronic exertional compartment syndrome. This is a report of one 17-year-old male on a pediatric inpatient service with bilateral anterior leg pain of unknown origin. Because of the nonspecific nature of pain, a high level of suspicion is required for timely diagnosis to avoid compartment ischemia and irreversible soft tissue and nerve damage. While high-energy orthopaedic trauma, orthopaedic surgery, or closed reduction and casting are common preceding events for compartment syndrome, this patient presented with acute-on-chronic exertional compartment syndrome...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28569738/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections-erratum
#6
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538533/identification-and-management-of-obese-patients-in-a-pediatric-orthopaedic-clinic
#7
(no author information available yet)
No abstract text is available yet for this article.
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538532/identification-and-management-of-obese-patients-in-a-pediatric-orthopaedic-clinic
#8
Natalia Davila, Joy Vess, Emily E Johnson
BACKGROUND: Childhood obesity is a complex healthcare problem that affects all aspects of a child's health. The American Academy of Pediatrics and the Expert Committee recommends that all children be evaluated for current medical conditions including the risk for obesity by identifying elevated body mass index (BMI), physical activity habits, and diet. Childhood obesity is defined as a BMI of 95th percentile or greater on standardized age-based growth charts. Abdominal and visceral fat mass has a negative effect on bone formation during childhood and adolescence...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538051/mobius-syndrome-a-35-year-single-institution-experience
#9
Philip K McClure, Eray Kilinc, Scott Oishi, Anthony I Riccio, Lori A Karol
BACKGROUND: Mobius syndrome is a rare syndrome that is known to be associated with a variety of orthopaedic conditions including scoliosis, clubfoot, transverse limb deficiencies, Poland syndrome, and a myriad of hand conditions. To date, no large series exist to characterize the orthopaedic manifestations of Mobius syndrome. METHODS: Medical records at a single tertiary pediatric institution were reviewed for all patients diagnosed with Mobius syndrome from January 1, 1980 to December 31, 2015...
May 19, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28471915/incidence-of-delayed-diagnosis-of-orthopaedic-injury-in-pediatric-trauma-patients
#10
Jeremy D Podolnick, Daniel S Donovan, Alfred W Atanda
TITLE: Incidence of delayed diagnosis of orthopaedic injury in pediatric trauma patients OBJECTIVE:: Determine the incidence of the delayed diagnosis of orthopaedic injuries in pediatric trauma patients. DESIGN: Cross-sectional retrospective analysis. SETTING: Level I pediatric trauma center. PATIENTS/PARTICIPANTS: All patients with an orthopaedic consultation following a trauma activation with a diagnosis of fracture, dislocation, traumatic arthrotomy, neurovascular injury, amputation, and tendon or ligament injury requiring intervention...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28471818/spectrum-of-diagnosis-and-disposition-of-patients-referred-to-a-pediatric-orthopaedic-center-for-a-diagnosis-of-intoeing
#11
Shawne Faulks, Kaitlyn Brown, John G Birch
BACKGROUND: Orthopaedic surgeons frequently evaluate otherwise healthy children for concern of intoed gait. Intoeing in otherwise healthy young children due to metatarsus adductus, internal tibial torsion, and increased femoral anteversion do not typically require orthopaedic treatment. This study reviewed the actual diagnosis, management, and disposition of patients referred to a pediatric orthopaedic specialty hospital for a diagnosis of intoeing; the efficacy of an Advanced Practice Provider (APP) assessment program to screen and triage patients with a primary complaint of intoeing; and parental satisfaction with that program...
May 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28452860/osteonecrosis-of-the-shoulders-in-pediatric-patients-treated-for-leukemia-or-lymphoma-single-institutional-experience
#12
Sue C Kaste, Brian M DeFeo, Michael D Neel, Kenneth S Weiss, Israel Fernandez-Pineda, Kiri K Ness
BACKGROUND: Osteonecrosis of the hips and knees is an often debilitating adverse event in children treated with glucocorticoids for leukemia and lymphoma but the impact of shoulder involvement has been understudied. Thus, we investigated the severity and functional impairment of shoulder osteonecrosis in a well-characterized population of pediatric patients treated for acute lymphoblastic leukemia or lymphoma. METHODS: We retrospectively reviewed orthopaedic clinic and physical therapy evaluations to determine range of motion (ROM), pain, and impact of magnetic resonance-defined osteonecrosis (ON) on activities of daily living...
April 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#13
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/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#14
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...
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28374350/teaching-the-basics-development-and-validation-of-a-distal-radius-reduction-and-casting-model
#15
Mark A Seeley, Peter D Fabricant, J Todd R Lawrence
BACKGROUND: Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool. QUESTIONS/PURPOSES: Our goal was to develop and validate a realistic distal radius fracture reduction and casting simulator as determined by (1) a questionnaire regarding the "realism" of the model and (2) the quantitative assessments of reduction time, residual angulation, and displacement...
April 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28328564/variation-in-national-acgme-case-log-data-for-pediatric-orthopaedic-fellowships-are-fellow-coding-practices-responsible
#16
Philip K McClure, Marcella Woiczik, Lori Karol, Wudbhav N Sankar
BACKGROUND: The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs...
July 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28288079/evidence-based-pediatric-orthopaedics-how-safe-is-safe
#17
G Alexander Augustithis, Hannah Margaret Ensor, James S Huntley
BACKGROUND: The aim of minimizing the risks of complications and adverse events is at the center of surgical practice.This study aimed to assess the evidence on which pediatric orthopaedic surgical procedures are described as "safe." In particular, the objective was to ascertain the proportion of studies describing a procedure as "safe," which achieved a 95% upper limit confidence interval of risk of 5% or less for major adverse events. METHOD: A primary search of Journal of Paediatric Orthopaedics 2009 to 2014 for the single term "safe" returned 71 papers appropriate for analysis...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28286603/closed-reduction-with-or-without-adductor-tenotomy-for-developmental-dysplasia-of-the-hip-presenting-at-walking-age
#18
Ahmed Samir Barakat, Abou Bakr Zein, Amr Said Arafa, Mostafa Abdelmaboud Azab, Walid Reda, Mohamed Mahmoud Hegazy, Hassan Magdy Al Barbary, Mohamed Abdelhalim Kaddah
BACKGROUND: Many children with developmental dislocation of the hip especially in underdeveloped countries reach walking age and still remain undiagnosed, which can be detrimental to their growth and development. Because of the lack medical services often encountered in these regions, it would be attractive to find a cheap and effective treatment. Our work evaluated the results of treatment of these children by closed reduction with or without adductor tenotomy in a prospective study...
March 2017: Current Orthopaedic Practice
https://www.readbyqxmd.com/read/28244925/variation-among-pediatric-orthopaedic-surgeons-when-diagnosing-and-treating-pediatric-and-adolescent-distal-radius-fractures
#19
Karan Dua, Matthew K Stein, Nathan N O'Hara, Brian K Brighton, William L Hennrikus, Martin J Herman, J Todd Lawrence, Charles T Mehlman, Norman Y Otsuka, M Wade Shrader, Brian G Smith, Paul D Sponseller, Joshua M Abzug
BACKGROUND: Distal radius fractures are the most common injury in the pediatric population. The purpose of this study was to determine the variation among pediatric orthopaedic surgeons when diagnosing and treating distal radius fractures. METHODS: Nine pediatric orthopaedic surgeons reviewed 100 sets of wrist radiographs and were asked to describe the fracture, prescribe the type of treatment and length of immobilization, and determine the next follow-up visit...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28241727/-analysis-of-outcomes-of-one-stage-operation-for-treatment-of-late-diagnosed-developmental-dysplasia-of-hip
#20
Y Liu, J Sun
Objective: To evaluate and identify the middle-term results of one-stage open reduction of patients in late-diagnosed developmental dysplasia of the hip, and to explore the best age group for treatment. Methods: A total number of 311 patients (390 hips) with LDDH in Department of Pediatric Orthopaedic of Anhui Provincial Children's Hospital from June 2006 to December 2010 were retrospectively reviewed. The patients were divided into 3 groups according to age at the start of surgical treatment: 1.5-2.5 years, 2...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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