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Pediatric orthopaedics

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https://www.readbyqxmd.com/read/29781945/appropriateness-of-pediatric-orthopaedic-transfers-to-a-level-1-hospital
#1
Jaclyn McKenna, David Novikov, Amanda Pawlak, Jihye Park, Jie Yang, Hariharan Iyer, James Barsi
OBJECTIVE: The purpose of this study was to compare a cohort of transferred pediatric orthopaedic patients with orthopaedic patients who primarily presented to a Level 1 pediatric emergency department to identify risk factors for transfer. DESIGN: Retrospective cohort study. SETTING: This study was performed at a level one trauma center in New York. PATIENTS: The cohort consisted of patients under age 18 who presented to one level 1 pediatric trauma center between January 1, 2013 - December 31, 2013 with an orthopaedic fracture diagnosis code (ICD-9 805...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29778751/cortical-erosion-after-elastic-stable-intramedullary-nail-fixation-for-pediatric-long-bone-fractures-case-series-according-to-the-site
#2
Kun-Bo Park, Je-Hyun Yoo, Seok-Woo Kim, Yoon Hae Kwak
BACKGROUND: Elastic stable intramedullary nail (ESIN) is widely used for treatment of long bone fractures in children. However, migration of the nail or cortical bone erosion in children has been reported. This study was conducted to investigate the incidence of cortical erosion according to the site and cortical erosion type. MATERIALS AND METHODS: A total of 221 normally developing children (223 fractures) who were treated with ESIN for fractures of the long bones without cortical breakage at immediate postoperative radiography and with the ESIN in position for more than 6 months were included...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#3
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29762118/pediatric-orthopaedic-consults-from-chiropractic-care
#4
Andy B Awwad, William L Hennrikus, Douglas G Armstrong
Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Data collected included chiropractic diagnosis, orthopaedic diagnosis, imaging studies, treatments, and complications...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29727412/evidence-based-medicine-in-pediatric-orthopaedics-evidence-based-practice-committee-summary-of-levels-of-evidence-clinical-practice-guidelines-appropriate-use-criteria-and-best-practice-guidelines
#5
Jigar S Gandhi, Kevin G Shea, Paul D Sponseller, Brian K Brighton, Theodore J Ganley
The concept of evidence-based medicine has evolved over the past 2 decades, and has become a cornerstone to clinical decision-making in virtually every aspect of medicine. With a commitment to providing its members with high-quality evidence-based guidelines, the American Academy of Orthopaedic Surgeons has instituted concerted efforts since 2006 to develop clinical practice guidelines (CPGs) and appropriate use criteria (AUCs) for certain orthopaedic conditions. Many of these CPGs and AUCs detail the management of pediatric orthopaedic conditions...
April 30, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29727409/how-much-will-my-child-s-operation-cost-availability-of-consumer-prices-from-us-hospitals-for-a-common-pediatric-orthopaedic-surgical-procedure
#6
Allison R Racimo, Nakul S Talathi, Nicole A Zelenski, Lawrence Wells, Apurva S Shah
BACKGROUND: Price transparency allows patients to make value-based health care decisions and is particularly important for individuals who are uninsured or enrolled in high-deductible health care plans. The availability of consumer prices for children undergoing orthopaedic surgery has not been previously investigated. We aimed to determine the availability of price estimates from hospitals in the United States for an archetypal pediatric orthopaedic surgical procedure (closed reduction and percutaneous pinning of a distal radius fracture) and identify variations in price estimates across hospitals...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29698303/closed-reduction-osteotomy-and-fibular-graft-are-effective-in-treating-pediatric-femoral-neck-pseudarthrosis-after-infection
#7
Rajesh Kumar Kanojia, Sumit Gupta, Ajay Kumar, Bachha Kanakeya Reddy
BACKGROUND: When treatment of acute septic arthritis of the hip is delayed, severe sequelae can occur. This may take the form of coxa breva, vara, or valga. Pseudoarthrosis of the femoral neck is a rare complication with only a few studies to guide treatment. QUESTION/PURPOSES: In a small series of patients with pseudarthrosis of the femoral neck after acute septic arthritis, we wanted to determine (1) whether femoral neck union can be achieved using a variety of surgical approaches; (2) whether these patients satisfied criteria outlined by Hunka and Choi, defined as a stable hip, a flexion arc ≥ 70° and no fixed adduction or abduction contractures, fixed flexion deformity not more than 20°, pain relief, and restoration of activities of daily living after surgery; and (3) any treatment-related complications if observed...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29698292/does-the-watson-jones-or-modified-smith-petersen-approach-provide-superior-exposure-for-femoral-neck-fracture-fixation
#8
Paul M Lichstein, John P Kleimeyer, Michael Githens, John S Vorhies, Michael J Gardner, Michael Bellino, Julius Bishop
BACKGROUND: A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated. QUESTIONS/PURPOSES: (1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches? METHODS: Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29683858/the-effect-of-booster-seat-use-on-pediatric-injuries-in-motor-vehicle-frontal-crashes
#9
Sean Caskey, Joshua Hammond, Jeffery Peck, Matthew Sardelli, Theresa Atkinson
BACKGROUND: Motor vehicle crashes are a significant source of pediatric mortality and morbidity. Studies indicate that booster seats significantly improve seat belt fit for children who have not attained a height of 145 cm (4' 9"). This study examined injuries occurring in booster age children up to age 12, as the majority of children do not attain 145 cm until this age. The purpose of the study was to identify differences in injuries due to the type of restraint used, with attention to musculoskeletal injuries...
April 20, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29683814/radiographic-resource-utilization-in-the-initial-referral-and-evaluation-of-patients-with-adolescent-idiopathic-scoliosis
#10
Matthew E Oetgen, Allison L Matthews, Benjamin D Martin, Jeffrey Hanway, Shannon Kelly, Laurel Blakemore
INTRODUCTION: The dangers of radiation exposure in children have been well studied, with assessment of adolescent idiopathic scoliosis (AIS) documented as having the potential for notable patient exposure. The purposes of this study were to evaluate a consecutive series of patients referred to a tertiary care pediatric hospital for AIS and to assess the type and quality of imaging obtained before referral for specialist evaluation. METHODS: We performed a prospective study of consecutive patients referred over a 6-month period to a pediatric orthopaedic practice at a large, free-standing, urban children's hospital for evaluation of AIS...
April 19, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29679411/the-use-of-a-logistic-regression-model-to-develop-a-risk-assessment-of-intraoperatively-acquired-pressure-ulcer
#11
Ling Gao, Lina Yang, Xiaoqin Li, Jin Chen, Juan Du, Xiaoxia Bai, Xianjun Yang
AIMS AND OBJECTIVES: To screen the factors of intraoperatively acquired pressure ulcer (IAPU) and establish a new risk assessment model of IAPU. DESIGN: This is a prospective study. METHODS: A total of 1963 patients who received neurosurgery, orthopaedics, pediatric surgery and cardiac surgery therapy in Sichuan Academy of Medical Science and Provincial People's Hospital in China from October 2015 to October 2016 were enrolled in the study and their clinical parameters were collected...
April 20, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29664879/surgical-treatment-of-supracondylar-humeral-fractures-in-a-freestanding-ambulatory-surgery-center-is-as-safe-as-and-faster-and-more-cost-effective-than-in-a-children-s-hospital
#12
Carson M Rider, Victor Y Hong, Timothy J Westbrooks, Jiajing Wang, Benjamin W Sheffer, Derek M Kelly, David D Spence, John M Flynn, Jeffrey R Sawyer
BACKGROUND: Despite an 88% increase in the number of pediatric fractures treated in ambulatory surgery centers (ASCs) over a 10-year period, few studies have compared outcomes of fracture treatment performed in a freestanding ASC compared with those performed in the hospital (HOSP) or hospital outpatient department (HOPD). The purpose of this study was to compare clinical and radiographic outcomes, treatment times, and costs for treatment of Gartland type II supracondylar humeral (SCH) fracture in the ASC, HOSP, and HOPD...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29664878/c2-translaminar-screw-fixation-in-children
#13
Brian W Yang, Michael P Glotzbecker, Michael Troy, Mark R Proctor, Michael T Hresko, Daniel J Hedequist
BACKGROUND: Axis (C2) screw fixation has been shown to be effective in treating disorders that necessitate cervical stabilization. Although translaminar C2 screws have demonstrated clinical efficacy in adults, this technique has not yet been thoroughly investigated in children. This study describes the indications, technique, and results of translaminar C2 screw fixation in a case series of pediatric cervical spine disorders. METHODS: We searched the orthopaedic database at our institution for patients who had undergone a cervical spinal fusion that encompassed C2 between 2007 and 2017...
April 16, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29664850/idiopathic-toe-walking-prevalence-and-natural-history-from-birth-to-ten-years-of-age
#14
Pähr Engström, Kristina Tedroff
BACKGROUND: Children with idiopathic toe-walking, a common pediatric condition, walk some or all of the time on their toes. This condition often causes parental concern, with repeated medical contacts and a range of interventions including stretching, casts, injection of botulinum toxin A, and surgical procedures. The purpose of this cohort study was to document the natural history of this condition. METHODS: In a population-based cohort of 1,401 healthy 5.5-year-old Swedish children, we found the prevalence of idiopathic toe-walking to be approximately 5% (63 of 1,401)...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#15
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29613930/operative-experience-during-orthopaedic-residency-compared-with-early-practice-in-the-u-s
#16
Jessica M Kohring, Michael O Bishop, Angela P Presson, John J Harrast, J Lawrence Marsh, Theodore W Parsons, Charles L Saltzman
BACKGROUND: The goal of surgical education is to prepare the trainee for independent practice; however, the relevance of the current residency experience to practice remains uncertain. The purpose of this study was to identify the surgical procedures most frequently performed in orthopaedic residency and in early surgical practice and to identify surgical procedures performed more often or less often in orthopaedic residency compared with early surgical practice. METHODS: This retrospective cohort study included American Medical Association (AMA) Current Procedural Terminology (CPT) codes (n = 4,329,561 procedures) reported by all U...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29594177/2018-international-olympic-committee-consensus-statement-on-prevention-diagnosis-and-management-of-pediatric-anterior-cruciate-ligament-injuries
#17
Clare L Ardern, Guri Ekås, Hege Grindem, Håvard Moksnes, Allen F Anderson, Franck Chotel, Moises Cohen, Magnus Forssblad, Theodore J Ganley, Julian A Feller, Jón Karlsson, Mininder S Kocher, Robert F LaPrade, Mike McNamee, Bert Mandelbaum, Lyle Micheli, Nicholas G H Mohtadi, Bruce Reider, Justin P Roe, Romain Seil, Rainer Siebold, Holly J Silvers-Granelli, Torbjørn Soligard, Erik Witvrouw, Lars Engebretsen
In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte...
March 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29589456/-laparoscopy-at-the-pediatric-surgery-department-for-a-five-year-period
#18
D Starý, J Tůma, R Doušek, R Macháček, J Škvařil, L Plánka
INTRODUCTION: Laparoscopy in small children was developed only after the adoption and verification of basic principles in adult patients and is mostly concentrated in specialized facilities due to the possible complications and necessity of follow-up specialized anesthesiological and post-operative care. In the 1990s, the Clinic of Paediatric Surgery, Orthopaedics and Traumatology at University Hospital Brno was one of the first in the Czech Republic to begin operating on children laparoscopically...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29581924/distinguishing-pediatric-lyme-arthritis-of-the-hip-from-transient-synovitis-and-acute-bacterial-septic-arthritis-a-systematic-review-and-meta-analysis
#19
Aristides I Cruz, Jason B Anari, Jose M Ramirez, Wudbhav N Sankar, Keith D Baldwin
Objective Lyme arthritis is an increasingly recognized clinical entity that often prompts orthopaedic evaluation in pediatric patients. While Lyme arthritis is most common in the knee, the clinical presentation of Lyme arthritis of the hip can be similar to both acute bacterial septic arthritis and transient synovitis. Accurately distinguishing these clinical entities is important since the definitive treatment of each is distinct. Because there is limited literature on monoarticular Lyme arthritis of the hip, the purpose of this study was to perform a systematic review and meta-analysis of clinical and laboratory parameters associated with Lyme arthritis (LA) of the hip and compare them to septic arthritis (SA) and transient synovitis (TS)...
January 25, 2018: Curēus
https://www.readbyqxmd.com/read/29580094/outcomes-of-noninvasively-treated-idiopathic-toe-walkers
#20
Kerstin Radtke, Nataliia Karch, Fabian Goede, Bernhard Vaske, Gabriela von Lewinski, Yvonne Noll, Anneke Thren
Idiopathic toe walking (ITW) causes a common problem in pediatric orthopaedics. In the literature, numerous treatment options have been reported, but consensus about the management of ITW is still missing. The aim of the current study was to evaluate conservative treatment with pyramidal insoles. A total of 193 patients underwent conservative treatment between January 2010 and June 2013. Mean age at the beginning of the treatment was 7.75 ± 0.23 years (range 2.0-17.0 years). For all patients, demographic data, comorbid diseases, passive range of motion (ROM), persistent toe walking, and performed operations were retrospectively evaluated...
March 1, 2018: Foot & Ankle Specialist
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