Journal of Pediatric Orthopaedics B最新文献_第7页

Physeal fractures of the distal femur: does a lower threshold for surgery lead to better outcomes? 股骨远端骨骺骨折:手术门槛越低，治疗效果越好吗?

Journal of Pediatric Orthopaedics B Pub Date : 2019-01-01 DOI: 10.1097/BPB.0000000000000664

Alexander J. Adams, Mahmoud A. H. Mahmoud, L. Wells, J. Flynn, A. Arkader

{"title":"Physeal fractures of the distal femur: does a lower threshold for surgery lead to better outcomes?","authors":"Alexander J. Adams, Mahmoud A. H. Mahmoud, L. Wells, J. Flynn, A. Arkader","doi":"10.1097/BPB.0000000000000664","DOIUrl":"https://doi.org/10.1097/BPB.0000000000000664","url":null,"abstract":"Distal femur physeal fractures are known to have a high incidence of complications. Our previous reported experience (pre-2007) showed a 40% complication risk, which prompted changes in our approach. The purpose of this study was to evaluate and compare the complication rate and outcome after implementation of these changes. This is a retrospective study of children with distal femur physeal fractures treated at a level 1 pediatric trauma center between 2007 and 2016. Patient demographics, fracture patterns, treatment and outcomes including complications and its risk factors were recorded and analyzed. We compared current results with our previously reported multicenter cohort (n = 73). Patients were male in majority (57/70) with a mean age of 13 ± 4 years. Fractures were most commonly Salter-Harris Type 2 (49/70) and displaced (59/70) on presentation, although neither characteristic was associated with complications. Most patients (63/70) were treated surgically, and the overall complication incidence was 36% (25/70), including growth arrest in 20 patients. The pre-2007 cohort was statistically significantly younger (P < 0.001) and was more commonly treated nonoperatively (P < 0.001). However, there was no statistically significant difference in complication incidence between studies (36% versus 40%, respectively, P = 0.751). Despite a lower threshold for surgery for distal femur physeal fractures in the past decade, the complication rate is still high and unchanged at 40%, and presenting patients are older. There were no new prognostic factors that showed statistically significant association with subsequent complications; however, patients with high-energy injury mechanisms and greater fracture displacements did have higher complication rates. These results demonstrate the inherent high complication risk for these injuries. Level of Evidence: III.","PeriodicalId":16709,"journal":{"name":"Journal of Pediatric Orthopaedics B","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76366543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Comparison of two different methods in preoperative planning of the amount of lengthening in Z achilloplasty technique. 两种不同方法在腋窝成形术术前规划延长量的比较。

Journal of Pediatric Orthopaedics B Pub Date : 2019-01-01 DOI: 10.1097/BPB.0000000000000666

O. Ozyalvac, E. Akpınar

{"title":"Comparison of two different methods in preoperative planning of the amount of lengthening in Z achilloplasty technique.","authors":"O. Ozyalvac, E. Akpınar","doi":"10.1097/BPB.0000000000000666","DOIUrl":"https://doi.org/10.1097/BPB.0000000000000666","url":null,"abstract":"Achilles tendon lengthening (ATL) surgery is a technique that is frequently used in the surgical treatment of contracture of the Achilles tendon seen in many pediatric orthopedic problems such as cerebral palsy, clubfoot, pes planovalgus and myelomeningocele. It is important to appropriately adjust the amount of ATL. However, the literature on the preoperative calculation of the required amount of tendon lengthening is limited. The aim of the study was to compare the reliability of the two different methods of predicting the amount of ATL. Eighteen feet of 16 patients who underwent ATL with Z-plasty technique were included in the study. The required amount of ATL was calculated as double blind according to the Cosine theorem and a method that was described by Garbarino et al. in 1985 and compared with the amounts of ATL applied during the operation. The mean amount of lengthening was 25.24 mm during surgery. The required amount of lengthening was 41.55 ± 11.0 mm, according to the Garbarino's method. The required amount of lengthening was 23.93 ± 9.03 mm, according to the Cosine theorem. The quantities calculated according to the Cosine theorem showed excellent agreement with the amount of lengthening during surgery. The quantities calculated according to the Garbarino's method showed poor agreement with the amount of lengthening during surgery. The calculation of the amount of ATL required in the treatment of the equinus deformity before surgery is possible by Cosine Theorem. The method of Cosine theorem is more reliable than the previous method described by Garbarino et al.","PeriodicalId":16709,"journal":{"name":"Journal of Pediatric Orthopaedics B","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84773205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Chronic lateral epiphyseal separation of the proximal tibia causes late-onset tibia vara. 胫骨近端慢性外侧骨骺分离引起迟发性胫骨内翻。

Journal of Pediatric Orthopaedics B Pub Date : 2018-01-01 DOI: 10.1097/BPB.0000000000000430

S. Hasegawa, H. Kitoh, M. Matsushita, K. Mishima, Izumi Kadono, H. Sugiura, Akiko Kitamura, N. Ishiguro

引用次数: 1

Treatment of syndrome-associated congenital talipes equinovarus using the Ponseti method: 4–12 years of follow-up Ponseti法治疗综合征相关先天性马蹄内翻:4-12年随访

Journal of Pediatric Orthopaedics B Pub Date : 2018-01-01 DOI: 10.1097/BPB.0000000000000434

H. Matar, D. Makki, N. Garg

引用次数: 10

Venous thromboembolism among pediatric orthopedic trauma patients: a database analysis 儿科骨科创伤患者的静脉血栓栓塞:数据库分析

Journal of Pediatric Orthopaedics B Pub Date : 2018-01-01 DOI: 10.1097/BPB.0000000000000424

D. Guzman, Samir Sabharwal, Caixia Zhao, S. Sabharwal

引用次数: 19

Management of pediatric open tibia fractures with supracutaneous locked plates 皮上锁定钢板治疗小儿开放性胫骨骨折

Journal of Pediatric Orthopaedics B Pub Date : 2018-01-01 DOI: 10.1097/BPB.0000000000000425

V. N. Radhakrishna, V. Madhuri

引用次数: 8

Minimal invasive intralesional excision of extremity-located osteoid osteomas in children 儿童四肢骨样骨瘤的病灶内微创切除

Journal of Pediatric Orthopaedics B Pub Date : 2017-11-01 DOI: 10.1097/BPB.0000000000000294

B. Erol, M. Topkar, Abbas Tokyay, Omer Sofulu, E. Çaliskan, E. Okay

{"title":"Minimal invasive intralesional excision of extremity-located osteoid osteomas in children","authors":"B. Erol, M. Topkar, Abbas Tokyay, Omer Sofulu, E. Çaliskan, E. Okay","doi":"10.1097/BPB.0000000000000294","DOIUrl":"https://doi.org/10.1097/BPB.0000000000000294","url":null,"abstract":"In this retrospective study, we evaluated the efficiency of minimal invasive intralesional extended curettage in the treatment of osteoid osteomas of the extremities in children. Forty-seven children (29 males, 18 females; mean age 10.5 years; range 4–19 years) with osteoid osteoma of the extremities underwent minimal invasive intralesional extended curettage. The exact localization of the nidus was determined preoperatively by thin-section (1–1.5 mm) computed tomography scans, and complete excision of the nidus was performed using a modified burr-down technique. None of the procedures required bone grafting or internal fixation. The median follow-up duration was 59 months (range, 12–136 months). Histopathological confirmation of osteoid osteoma was achieved in all procedures. All patients experienced immediate and complete relief of lesional pain after surgery. Preoperative (a day before surgery) and postoperative (at the time of discharge) mean visual analogue scale scores, questioning the pain derived from osteoid osteoma, were 7.7±1.2 and 0.3±0.6, respectively, confirming complete removal of the nidus. Early motion of the involved extremities and mobilization of the patients were achieved within 2 days. The children resumed normal function within 3 weeks. Postoperative complication or recurrence was not encountered in any of the patients. Even though percutaneous radiofrequency thermoablation is accepted as the treatment of choice for extraspinal osteoid osteomas, this technique requires a regional reference institution. Minimal invasive intralesional extended curettage can be performed in conventional institutions, even those not specialized in bone tumor surgery, by orthopedic surgeons with high success and low morbidity rates, in addition to rapid functional recovery.","PeriodicalId":16709,"journal":{"name":"Journal of Pediatric Orthopaedics B","volume":"14 1","pages":"552–559"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81856096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Suppurative complications of acute hematogenous osteomyelitis in children 儿童急性血液性骨髓炎的化脓性并发症

Journal of Pediatric Orthopaedics B Pub Date : 2017-11-01 DOI: 10.1097/BPB.0000000000000437

J. Johnston, C. Murray-Krezan, W. Dehority

引用次数: 14

The prevalence of the complications and their associated factors in humeral lengthening for achondroplasia: retrospective study of 54 cases 54例软骨发育不全肱骨延长术并发症及相关因素的回顾性分析

Journal of Pediatric Orthopaedics B Pub Date : 2017-11-01 DOI: 10.1097/BPB.0000000000000428

Natsuko Nakano-Matsuoka, K. Fukiage, Y. Harada, N. Kashiwagi, T. Futami

引用次数: 12

Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications 弹性稳定髓内钉治疗小儿前臂骨折:切开复位率及并发症

Journal of Pediatric Orthopaedics B Pub Date : 2017-09-01 DOI: 10.1097/BPB.0000000000000408

D. Makki, H. Matar, M. Webb, D. Wright, L. James, D. Ricketts

{"title":"Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications","authors":"D. Makki, H. Matar, M. Webb, D. Wright, L. James, D. Ricketts","doi":"10.1097/BPB.0000000000000408","DOIUrl":"https://doi.org/10.1097/BPB.0000000000000408","url":null,"abstract":"The aim of this study was to evaluate the rate of open reduction and complications of elastic stable intramedullary nailing (ESIN) in treating unstable diaphyseal forearm fractures in children. We performed a retrospective review of a consecutive series of 102 paediatric patients with a mean age of 9 years (range: 7–14 years) who underwent ESIN of unstable closed forearm fractures at three different centres. Closed reduction of one or both bones was achieved in 68 (67%) patients and open reduction was required in 34 (33%) patients. The rate of open reduction in single-bone fractures (52.2%) was significantly higher than that in both-bone fractures (27.8%) (P=0.04, Fisher’s exact test). All the fractures united within 3 months. There were six refractures following nail removal. Five patients had superficial wound infections. Seven patients developed neuropraxia of the sensory branch of the radial nerve. All resolved spontaneously within 3 months of the surgery. ESIN is an effective technique in treating unstable diaphyseal forearm fractures. The need for open reduction should be decided promptly following failed attempts of closed reduction. Single-bone fractures are more likely to require open reduction than both-bone fractures. The radius should be reduced and stabilized first. If open reduction is required, this should be performed through a volar approach rather than a dorsal one.","PeriodicalId":16709,"journal":{"name":"Journal of Pediatric Orthopaedics B","volume":"39 1","pages":"412–416"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78523374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33