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forearm fractures in children

Bibek K Rai, Raju Vaishya, Amit Kumar Agarwal
Open segmental fractures of both bones of the forearm with the loss of the middle segment of the radius is a rare injury in children. An eight-year-old boy presented to our clinic four days following a road traffic accident. The child's mother was carrying a 12-cm long extruded and soiled segment of the radius bone. The extruded bone segment seemed necrotic, and we decided not to use it for replantation. The wound over the forearm fracture was infected. It was debrided and regularly dressed until it became healthy...
September 8, 2016: Curēus
Joshua M Abzug, Christine Ann Ho, Todd F Ritzman, Brian Brighton
Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed...
February 15, 2016: Instructional Course Lectures
Yuwei Zhou, Uygar Teomete, Ozgur Dandin, Onur Osman, Taner Dandinoglu, Ulas Bagci, Weizhao Zhao
Bowing fractures are incomplete fractures of tubular long bones, often observed in pediatric patients, where plain radiographic film is the non-invasive imaging modality of choice in routine radiological workflow. Due to weak association between bent bone and distinct cortex disruption, bowing fractures may not be diagnosed properly while reading plain radiography. Missed fractures and dislocations are common in accidents and emergency practice, particularly in children. These missed injuries can result in more complicated treatment or even long-term disability...
September 17, 2016: Computers in Biology and Medicine
Jonas Esche, Simone Johner, Lijie Shi, Eckhard Schönau, Thomas Remer
CONTEXT: Diet can impact on bone strength via metabolic shifts in acid-base status. In contrast to the strongly diet-dependent biomarker urinary potential renal acid load (uPRAL), the amount of renally excreted citrate integrates nutritional and systemic influences on acid-base homeostasis with high citrate indicating preferential alkalization. OBJECTIVE: To examine the association between urinary citrate excretion and bone strength as well as long-term fracture risk...
September 27, 2016: Journal of Clinical Endocrinology and Metabolism
Abeer El-Sakka, Cristina Penon, Adham Hegazy, Salwa Elbatrawy, Amr Gobashy, Alvaro Moreira
Objective. To determine the likelihood of vitamin D deficiency and low bone mineral density in Egyptian children with forearm fractures. Methods. A case control study of 46 children aged 3 to 10 years with or without forearm fractures. Validated questionnaires were used to assess calcium and vitamin D intake as well as sun exposure. Serum calcium, phosphorus, alkaline phosphatase, and 25-hydroxy-vitamin D were collected. Bone mineral density was evaluated using dual-energy X-ray absorptiometry. Results. Compared to the Control group, calcium and vitamin D intake was lower in the Cases group (p = 0...
2016: International Journal of Pediatrics
Timo Rantalainen, Benjamin K Weeks, Rossana C Nogueira, Belinda R Beck
Skeletal robustness (cross-section size relative to length) is associated with stress fractures in adults, and appears to explain the high incidence of distal radius fractures in adolescents. However, little is known about the ontogeny of long bone robustness during the first three decades of life. Therefore, we explored the ontogeny of tibial, fibular, ulnar and radial robustness in a cross-sectional sample of 5 to 29year-old volunteers of both sexes. Peripheral quantitative computed tomography (pQCT) was used to evaluate cross-sections of the leg (4%, 14%, 38% and 66%), and forearm (4%, and 66%) in N=432 individuals...
September 17, 2016: Bone
J F Maempel, O D Stone, A W Murray
Introduction Surgical procedures to manage trauma to the wrist, forearm and elbow in children are very common. Image intensifiers are used routinely, yet studies/guidelines that quantify expected radiation exposure in such procedures are lacking. Methods Information on demographics, injury type, surgeon grade and dose area product (DAP) of radiation exposure per procedure was collected prospectively for 248 patients undergoing manipulation/fixation of injuries to the elbow, forearm or wrist at a paediatric hospital over 1 year...
September 2016: Annals of the Royal College of Surgeons of England
Veronique Chasle, Laurent Riffaud, Romain Longuet, Marie Martineau-Curt, Yann Collet, Luc Le Fournier, Patrick Pladys
PURPOSE: Post-concussion syndrome is a well-described complication following moderate and severe head trauma but whether it occurs after mild head injury in children remains unclear. The aim of this study was to evaluate whether exposure to mild head injury with potential additional risk factors (non-surgical lesion on computed tomographic, high kinetic trauma, or Glasgow Coma Scale <15) is associated with attention deficit hyperactivity disorder (ADHD) after the head trauma. METHODS: This study was performed in an emergency department on children admitted between 2009 and 2013...
August 27, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
G Büchele, C Becker, I D Cameron, R Auer, D Rothenbacher, H H König, K Rapp
: Age- and sex-specific fracture rates of 18,000 people with developmental disabilities aged 0-69 years were compared to the general population. Age-standardized incidence of femoral fracture was 4.8- and 7.1-fold higher in women and men, respectively. Comparable fracture risks to the general population occurred 10-15 years earlier in females and 20-40 years earlier in males. INTRODUCTION: Previous studies suggested that fracture risks in people with developmental disabilities (DD) may be higher than in people in the general population...
August 24, 2016: Osteoporosis International
Harsh Raval, J B Panse, Prakash Amin, Jyotindra Pandit
INTRODUCTION: Diaphyseal fractures of both bones of the forearm are commonly encountered in clinical practice. Segmental radius shaft fractures are, however, less commonly seen. We hereby report two cases of segmental complex radius fracture with mid-shaft ulna fracture. Such type of cases are reported previously in children but rarely in adults. CASE REPORT: In case-1, comminuted radius shaft fracture was fixed with square nails and ulna was fixed with Recon plate...
July 2015: Journal of Orthopaedic Case Reports
Tamir Bloom, Daniel A Seigerman, Caixia Zhao, Sanjeev Sabharwal
We sought to determine the diagnostic utility of additional full-length radiographs of the forearm and humerus for pediatric supracondylar humerus fractures. A pediatric orthopedic surgeon and a senior orthopedic resident individually reviewed the initial humerus, forearm, and elbow radiographs of 55 children with a supracondylar humerus fracture and recommended definitive treatment (operative vs. nonoperative) on the basis of the modified Gartland classification. Interobserver agreements for classification and the recommended treatment were highest for the elbow radiographs (weighted κ=0...
September 2016: Journal of Pediatric Orthopedics. Part B
Pooya Hosseinzadeh, Christopher B Hayes
Compartment syndrome in children can present differently than adults. Increased analgesic need should be considered the first sign of evolving compartment syndrome in children. Children with supracondylar humerus fractures, floating elbow injuries, operatively treated forearm fractures, and tibia fractures are at high risk for developing compartment syndrome. Elbow flexion beyond 90° in supracondylar humerus fractures and closed treatment of forearm fractures in floating elbow injuries are associated with increased risk of compartment syndrome...
July 2016: Orthopedic Clinics of North America
Djoke Douma-den Hamer, Marco H Blanker, Mireille A Edens, Lonneke N Buijteweg, Martijn F Boomsma, Sven H van Helden, Gert-Jan Mauritz
STUDY OBJECTIVE: To determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures. METHODS: A systematic review and diagnostic meta-analysis was performed according to the PRISMA statement. We searched MEDLINE, Web of Science and the Cochrane Library from inception to September 2015. All prospective studies of the diagnostic accuracy of ultrasound versus radiography as the reference standard were included. We excluded studies with a retrospective design and those with evidence of verification bias...
2016: PloS One
Derek M Kelly
Most proximal and diaphyseal pediatric humeral fractures can be treated successfully by closed means; however, certain patient factors or fracture characteristics may make surgical stabilization with flexible intramedullary nails (FIN) a better choice. Common indications for FIN of pediatric humeral fractures include unstable proximal-third fractures in children nearing skeletal maturity, unstable distal metaphyseal-diaphyseal junction fractures, shaft fractures in polytraumatized patients or patients with ipsilateral both-bone forearm fractures (floating elbow), and prophylactic stabilization of benign diaphyseal bone cysts or surgical stabilization of pathologic fractures...
June 2016: Journal of Pediatric Orthopedics
Michael Elvey, S Patel, Erez Avisar, W J White, E Sorene
PURPOSE: The nonspecific terms "wrist sprain" and "suspected occult bony injury" are frequently documented as diagnoses in occult paediatric wrist injuries. To date, however, no one has accurately defined their true underlying pathology. The primary objective of this study was to identify the true pathoanatomy of occult acute paediatric wrist injuries. Our secondary objective was to compare our findings with existing adult data in order to determine any population differences that might be clinically relevant...
June 2016: Journal of Children's Orthopaedics
Yongzeng Feng, Xiaolong Shui, Jianshun Wang, Leyi Cai, Gang Wang, Jianjun Hong
OBJECTIVE: The aim of the present study was to compare the clinical outcomes of hybrid fixation using elastic stable intramedullary nailing (ESIN) for the radius and plate screw fixation for the ulna (Hybrid group) with dual ESIN fixation (D-ESIN group) for both-bone forearm fractures in children between 10 and 16 years of age. METHODS: Fifty patients with both-bone forearm fractures (28 patients in the Hybrid group and 22 patients in the D-ESIN group) were reviewed...
April 7, 2016: International Journal of Surgery
Shizhan Wei, Yujin Tang, Peng Weibo, Huadeng Ban
OBJECTIVE: To investigate the effectiveness of a modified surgical treatment of old Monteggia fracture. METHODS: Between March 2006 and December 2013, 40 cases of old Monteggia fracture were treated with modified operation. Modified operation procedure included expanding excision of pedicled forearm fascia flap for reconstruction of the annular ligament and repair of elbow radial lateral collateral ligament complex and extending osteotomy of the ulna, callus replantation, and internal fixation with steel plate...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Joshua Abzug, Christine Ann Ho, Todd F Ritzman, Brian Brighton
Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed...
2016: Instructional Course Lectures
Yujing Cao, Yang Li, Xinwu Ming, Xinyue Ming, Keda Fu, Huijuan Lian, Shouren Shen, Hailiang Dong
OBJECTIVE: To explore the effectiveness of modified Ilizarov semi-ring external fixator combined with an ulnar osteotomy lengthening in the treatment of old dislocation of the radial head in children. METHODS: A retrospective analysis was made on the data of 14 patients with old dislocation of the radial head treated by the modified Ilizarov semi-ring external fixator combined with ulnar osteotomy lengthening between March 2012 and January 2015. The age ranged from 2 to 13 years (mean, 7...
December 2015: Chinese Journal of Reparative and Reconstructive Surgery
S Menachem, Z T Sharfman, I Perets, A Arami, G Eyal, M Drexler, O Chechik
AIM: To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery. MATERIALS AND METHODS: A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B...
June 2016: Clinical Radiology
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