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tibial fractures in children

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https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#1
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/28988680/macroscopic-anisotropic-bone-material-properties-in-children-with-severe-osteogenesis-imperfecta
#2
Carolyne Albert, John Jameson, Sergey Tarima, Peter Smith, Gerald Harris
Children with severe osteogenesis imperfecta (OI) typically experience numerous fractures and progressive skeletal deformities over their lifetime. Recent studies proposed finite element models to assess fracture risk and guide clinicians in determining appropriate intervention in children with OI, but lack of appropriate material property inputs remains a challenge. This study aimed to characterize macroscopic anisotropic cortical bone material properties and investigate relationships with bone density measures in children with severe OI...
September 14, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28956182/combined-avulsion-fracture-of-the-tibial-tubercle-and-patellar-tendon-rupture-in-pediatric-population-case-series-and-review-of-literature
#3
Mohamed Abdelhamid Ali Yousef
Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion with double-hit injury of the knee extensor mechanism is an extremely rare condition. However, they become more frequent due to increased participation in sports and high-energy recreational activities at younger age. It represents a frequently missed diagnosis; therefore, high index of suspicion is required for the diagnosis of such injuries to avoid delays in the treatment which would lead to possible suboptimal functional outcome...
September 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28945692/the-surgical-management-of-tibial-spine-fractures-in-children-a-survey-of-the-pediatric-orthopaedic-society-of-north-america-posna
#4
Taylor J Jackson, Eileen P Storey, Theodore J Ganley
BACKGROUND: Tibial spine fractures are rare, complex injuries. Management remains varied given a lack of consensus about the optimal approach. Thus, the purpose of this study is to determine prevailing strategies among pediatric orthopaedists and establish areas of agreement and ongoing controversy in the management of tibial spine fractures. METHODS: An electronic survey was distributed to the Pediatric Orthopaedic Society of North America (POSNA) membership. Surgeon demographics, experience, and responses to clinical vignettes were collected...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28925312/what-is-the-best-treatment-for-displaced-salter-harris-ii-physeal-fractures-of-the-distal-tibia
#5
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/28918873/use-of-ganga-hospital-open-injury-severity-scoring-for-determination-of-salvage-versus-amputation-in-open-type-iiib-injuries-of-lower-limbs-in-children-an-analysis-of-52-type-iiib-open-fractures
#6
K Venkatadass, Tarani Sai Prasanth Grandhi, S Rajasekaran
INTRODUCTION AND AIMS: Open injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score)...
September 12, 2017: Injury
https://www.readbyqxmd.com/read/28904628/tibial-derotational-osteotomies-in-two-neuromuscular-populations-comparing-cerebral-palsy-with-myelomeningocele
#7
R M Thompson, S Ihnow, L Dias, V Swaroop
PURPOSE: To review the outcomes of tibial derotational osteotomies (TDOs) as a function of complication and revision surgery rates comparing a cohort of children with myelodysplasia to a cohort with cerebral palsy (CP). METHODS: A chart review was completed on TDOs performed in a tertiary referral centre on patients with myelodysplasia or CP between 1985 and 2013 in patients aged > 5 years with > 2 years follow-up. Charts were reviewed for demographics, direction/degree of derotation, complications and need for re-derotation...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28856026/acute-traumatic-patellar-tendon-rupture-at-the-tibial-tuberosity-attachment-without-avulsion-fracture
#8
Shuichi Miyamoto, Makoto Otsuka, Fumio Hasue, Takayuki Fujiyoshi, Koushirou Kamiya, Hitoshi Kiuchi, Ken Ohara, Atsushi Yunde, Yasunori Toki, Tadashi Tanaka, Junichi Nakamura, Seiji Ohtori
Patellar tendon rupture in children is especially rare. The fact that the area of traumatic rupture has wide variations makes surgical treatment difficult. We present an 11-year-old boy with acute traumatic patellar tendon rupture at the tibial tuberosity attachment without avulsion fracture. Primary end-to-end repair and reinforcement using 1.5 mm stainless steel wires as a surgical strategy were undertaken. Early range of motion began with a functional knee brace and the reinforced stainless wire was removed 3 months after surgery...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28840195/pediatric-posterior-cruciate-ligament-avulsion-fracture-of-the-tibial-insertion-case-report-and-review-of-the-literature
#9
Yannick Hurni, Vincenzo De Rosa, Jorge Gabriel Gonzalez, Mario Mendoza-Sagaon, Flurim Hamitaga, Giorgia Pellanda
Background  Posterior cruciate ligament (PCL) avulsion fracture of the tibial insertion is a very rare injury in children. In addition to performing an attentive clinical examination, radiologic studies are fundamental for its correct diagnosis and treatment. Its management may be either conservative or operative. So far, only a few cases treated conservatively have been reported in the pediatric population, with controversial results. Methods  We prospectively collected and reviewed clinical and radiographic data of an 11-year-old boy with avulsion fracture of the tibial insertion of the PCL...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28795206/children-and-adolescents-with-cystic-fibrosis-display-moderate-bone-microarchitecture-abnormalities-data-from-high-resolution-peripheral-quantitative-computed-tomography
#10
C Braun, J Bacchetta, P Braillon, R Chapurlat, J Drai, P Reix
We investigated whether bone microstructure assessed by high-resolution peripheral quantitative tomography (HR-pQCT) could be altered in children and teenagers with cystic fibrosis (CF). In comparison to their healthy counterparts, bone microstructure was mildly affected at the tibial level only. INTRODUCTION: Cystic fibrosis-related bone disease (CFBD) may alter bone health, ultimately predisposing patients to bone fractures. Our aim was to assess bone microstructure using high-resolution peripheral quantitative tomography (HR-pQCT) in a cohort of children and teenagers with CF in comparison to age-, puberty-, and gender-matched healthy volunteers (HVs)...
August 9, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28791436/musculoskeletal-health-in-newly-diagnosed-children-with-crohn-s-disease
#11
L M Ward, J Ma, F Rauch, E I Benchimol, J Hay, M B Leonard, M A Matzinger, N Shenouda, B Lentle, H Cosgrove, M Scharke, V N Konji, D R Mack
We evaluated the impact of Crohn's disease on muscle and bone strength, mass, density, and geometry in children with newly diagnosed CD and found profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low. INTRODUCTION: Crohn's disease (CD) is an inflammatory condition of the gastrointestinal tract that can affect the musculoskeletal system. The objective of this study was to determine the prevalence of vertebral fractures and the impact of CD on muscle and bone mass, strength, density, and geometry in children with newly diagnosed CD...
August 8, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28774257/a-case-of-non-union-of-ulna-fracture-managed-with-tibial-strut-cortico-cancellous-bone-grafting-in-a-paediatric-patient
#12
Collin S K Looi, Roohi S A, Ranjit Singh Gill
Forearm fractures in children complicated with non-union are uncommon. Various methods have previously been reported to manage this condition. Well documented techniques would include iliac crest grafting, cancellous insert grafting, ulnar segment grafting, cortical tibial grafting, vascularized fibular grafting and bone transport by ring fixation. The authors present a case of a child with an atrophic non-union of the ulna who was successfully treated with a cortico-cancellous tibial strut bone graft.
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28743319/nationwide-survey-on-current-management-strategies-of-toddler-s-fractures
#13
Jade Seguin, Daniel Brody, Patricia Li
BACKGROUND: Tibial fractures are common in children less than 3 years old. The traditional management involves immobilization in an above knee cast for both confirmed (positive x-ray) and presumed (normal x-ray) toddler's fractures. This carries health care implications and causes unnecessary burden for patients and their families. There is a paucity of literature describing the ideal immobilization strategy for this injury. OBJECTIVES: To determine: 1) the variation between Canadian emergency departments in management of toddler's fractures; 2) the variation in management between confirmed and presumed toddler's fractures; 3) the association between demographic variables and immobilization strategies...
July 26, 2017: CJEM
https://www.readbyqxmd.com/read/28742679/delayed-treatment-of-a-posterior-cruciate-ligament-tibial-insertion-avulsion-fracture-in-a-child-with-open-physis-a-case-report-with-a-4-year-follow-up
#14
Tales M Guimarães, Paulo V P Helito, Fabio J Angelini, Marco K Demange, José R Pécora, Camilo P Helito
Posterior cruciate ligament avulsion fracture from its tibial insertion is a rare pathology in children. It is usually caused by high-energy traumas and its diagnosis is not always easy. Late diagnosis leads to late treatment, which can result in suboptimal results. We present a case of a 13-year-old boy hit by a car, who had a delay in diagnosis and treatment because of severe head trauma. The patient was treated 4 months after the trauma with open reduction and internal fixation of the avulsion fracture. After 4 years of follow-up, he has no complaints and has achieved good functional outcome...
September 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#15
Brian A Kelly, Manahil Naqvi, Emily S Rademacher, Patricia E Miller, Daniel J Hedequist, Michael P Glotzbecker, Travis H Matheney, Benjamin J Shore
BACKGROUND: Flexible elastic nails, submuscular plating, and rigid locked intramedullary nails are common methods of fixation for pediatric femur fractures (PFF) in which the fracture table is used to aid reduction. Little is known about complications associated with fracture table application in PFF. The purpose of this study was to determine the incidence and risk factors associated with adverse outcomes related to fracture table application for the treatment of PFF. METHODS: A retrospective chart review of all children (younger than 18 y) treated for a femur fracture with the use of the fracture table between 2004 and 2015 at a single tertiary pediatric hospital was performed...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28715376/a-rat-tibial-growth-plate-injury-model-to-characterize-repair-mechanisms-and-evaluate-growth-plate-regeneration-strategies
#16
Christopher B Erickson, Nichole Shaw, Nancy Hadley-Miller, Michael S Riederer, Melissa D Krebs, Karin A Payne
A third of all pediatric fractures involve the growth plate and can result in impaired bone growth. The growth plate (or physis) is cartilage tissue found at the end of all long bones in children that is responsible for longitudinal bone growth. Once damaged, cartilage tissue within the growth plate can undergo premature ossification and lead to unwanted bony repair tissue, which forms a "bony bar." In some cases, this bony bar can result in bone growth deformities, such as angular deformities, or it can completely halt longitudinal bone growth...
July 4, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28683418/tibial-impact-accelerations-in-gait-of-primary-school-children-the-effect-of-age-and-speed
#17
Oren Tirosh, Guy Orland, Alon Eliakim, Dan Nemet, Nili Steinberg
Tibial stress fractures are associated with increased lower extremity loading at initial foot-ground contact, reflected in high peak positive acceleration (>8g) of the tibia in adults. There is no reported data on peak positive acceleration of the tibia in children during walking and running. The aim of this study was to establish tibial peak positive acceleration responses in children across a range of age and gait speeds. Twenty-four children aged 8.5±1.4years with no known gait pathology comprised two age groups; Young (7-9year, n=12) and Older (10-12 years, n=12)...
June 27, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28603569/pediatric-acl-injuries-a-review-of-current-concepts
#18
Vikas Trivedi, Panna Mishra, Deepankar Verma
BACKGROUND: The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for management of these injuries to frame a dedicated age specific treatment strategy...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28458731/allograft-reconstruction-for-sarcomas-of-the-tibia
#19
Vincent Y Ng, Philip Louie, Stephanie Punt, Ernest U Conrad
BACKGROUND: Allograft reconstruction of oncologic resections involving the tibia can have unpredictable results. Prior studies have reported a high rate of complications and a long recovery period involving prolonged bracing, repeated procedures and extended periods of antibiotics. METHODS: The case details of 30 tibial allografts (12 adults, 18 children; 20 intercalary, 7 hemicortical, 3 other) were reviewed retrospectively. Based on factors including function, pain, healing and infection, clinical outcomes were stratified into three categories: excellent, moderate, and poor...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#20
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
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