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tibial fractures in children

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https://www.readbyqxmd.com/read/29456750/paediatric-tibial-shaft-fractures-treated-by-open-reduction-and-stabilization-with-monolateral-external-fixation
#1
A-L Simon, N Apostolou, C Vidal, E Ferrero, K Mazda, B Ilharreborde
Purpose: Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods: All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed...
February 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29409477/clinical-and-radiological-outcomes-of-arthroscopically-assisted-cannulated-screw-fixation-for-tibial-eminence-fracture-in-children-and-adolescents
#2
Chang Ho Shin, Doo Jae Lee, In Ho Choi, Tae-Joon Cho, Won Joon Yoo
BACKGROUND: The purpose of this study was to determine the efficacy and complications of arthroscopically assisted reduction and fixation with cannulated screws for tibial eminence fracture in skeletally immature patients. METHODS: This was a retrospective case series study. Forty-eight patients who were skeletally immature at the time of tibial eminence fracture were treated in a tertiary children's hospital between May 2004 and August 2015. Twenty-one patients were excluded due to non-operative treatment (n = 10), other surgical treatments (n = 9), multiple fracture (n = 1), and follow-up < 1 year (n = 1)...
February 6, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29407250/comparison-of-the-outcomes-of-pediatric-tibial-shaft-fractures-treated-by-different-types-of-orthopedists-a-prospective-cohort-study
#3
Wenhao Zheng, Chunhui Chen, Zhenyu Tao, Chuanxu Zhang, Hui Zhang, Hang Li, Zhenhua Feng, Liang Cheng, Hua Chen
BACKGROUND: The objective of this study was to compare the outcomes of pediatric tibial shaft fractures treated with titanium elastic nail (TEN) by pediatric orthopedists and non-pediatric orthopedists. MATERIALS AND METHODS: We conducted a prospective cohort study of 90 children of tibial shaft fractures, who were randomized to operative stabilization either by pediatric orthopedists (Group A, 45 cases) or by non-pediatric orthopedists (Group B, 45 cases) from April 2010 to May 2015...
January 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29365222/heel-pain-diagnosis-and-management
#4
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29330745/-treatment-of-rotational-malalignment-of-the-lower-leg
#5
REVIEW
P Keppler
BACKGROUND: Rotational malalignment after intramedullary nailing of tibial shaft fractures is not uncommon. In-toeing and out-toeing conditions in children are often the reason for orthopedic and traumatological medical consultation. OBJECTIVE: Evaluation of diagnostic modalities and therapeutic options for rotational malalignment in relationship to the patient's age. Surgical indications and efficacy of specific surgical techniques. MATERIAL AND METHODS: Systematic literature search in the German Institute for Medical Documentation and Information (DIMDI) and MEDLINE and evaluation of the currently published articles...
January 12, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#6
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
BACKGROUND: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications. METHODS: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29141620/treatment-of-genu-valgum-in-children-by-means-of-temporary-hemiepiphysiodesis-using-eight-plates-short-term-findings
#7
Dirk Zajonz, Eckehard Schumann, Magdalena Wojan, Fabian B Kübler, Christoph Josten, Ulf Bühligen, Christoph E Heyde
BACKGROUND: Idiopathic genu valgum is a frequently diagnosed growth disorder in adolescence. Whenever the possibilities of conservative therapy have been exhausted, leg straightening by means of hemiepiphysiodesis has become the standard form of treatment. Because of their flexible screw-plate connection, eight-Plates have been reported in the literature to lead to lower complications regarding implant loosening and fracture compared to other implants. The aim of this retrospective survey was to analyse our own patient population who were treated for genu valgum by means of temporary hemiepiphysiodesis near the knee using eight-Plates to modulate growth...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#8
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#9
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#10
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
#11
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
#12
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
#13
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
#14
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...
February 2018: 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
#15
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)...
November 2017: Injury
https://www.readbyqxmd.com/read/28904628/tibial-derotational-osteotomies-in-two-neuromuscular-populations-comparing-cerebral-palsy-with-myelomeningocele
#16
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
#17
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
#18
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: Surgery Journal
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
#19
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)...
November 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28791436/musculoskeletal-health-in-newly-diagnosed-children-with-crohn-s-disease
#20
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...
November 2017: Osteoporosis International
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