In Brief Study Design. Retrospective analysis of patients treated with single and dual growing rods who had completed their course treatment, definitive fusion, a minimum 2 years follow-up. Objectives. To determine which technique was the most effective in management severe spinal deformity young children: control deformity, growth, incidence complications. Summary Background Data. Growing rod techniques provide proximal distal segmental “claw” foundations, but overall results through fusion...

Retrospective, case series.To determine the prevalence of major complications and to identify factors that increase risk in patients undergoing surgery for neuromuscular scoliosis.Complications after scoliosis are more prevalent than idiopathic scoliosis. However, associated have not been statistically significant.Our computerized Pediatric Orthopedic Spine Database identified 131 consecutive with scoliosis, excluding those myelodysplasia, who underwent had a minimum 2 years follow-up....

Older adult health is often defined in clinical terms. Research has demonstrated that many older adults self-report aging successfully regardless of status. This qualitative study used claims data to identify on three levels status: healthy and active, managing diseases, or very sick, better understand how maintained. In total, 32 participants from two cities were interviewed. Interviews audio- video-recorded then transcribed. Thematic analysis identified five themes: disconnectedness...

This study evaluated forearm compartment pressures in 29 children with supracondylar humerus fractures. Pressures were measured before and after reduction the dorsal, superficial volar, deep volar compartments at proximal 1/6th 1/3rd forearm. significantly elevated compared other compartments. There also higher closer to elbow within each compartment. Fracture did not have a consistent immediate effect on pressures. The of flexion post-reduction was evaluated; beyond 90 degrees produced...

Various methods of cast immobilization have been recommended for the treatment distal forearm fractures in children. The purpose this study was to determine if short arm casts are as effective long displaced third these patients.In a prospective randomized trial, consecutive patients, four years age or older, who presented Women's and Children's Hospital Buffalo with fracture were plaster cast. Radiographs analyzed displacement, angulation, deviation at time injury, after reduction,...

This is a retrospective cohort study comparing the effectiveness of thoracolumbosacral orthosis (TLSO) and Providence in treatment adolescent idiopathic scoliosis (AIS) using new Scoliosis Research Society (SRS) Committee on Bracing Nonoperative Management inclusion assessment criteria for bracing studies. These will make future studies comparable more valid accurate.We have used custom TLSO (duration, 22 hours/day) 8-10 hours/night) to control progressive AIS curves. Only 83 160 patients...

Retrospective, case-control study.Determine risk factors for postoperative wound infections after surgery neuromuscular scoliosis as well the causative organisms and results of treatment.Wound infection is more common than that idiopathic scoliosis. A variety potential have been identified, but few demonstrated statistical significance.The Pediatric Orthopedic Spine Database identified 151 patients with who underwent had a follow-up minimum 2 years. total eight (5.3% prevalence) developed...

Background: It has been proposed that the epiphyseal tubercle on inferior surface of capital femoral epiphysis may be responsible for clinical distinction between a stable and an unstable slipped (SCFE). The anatomy its relationship to lateral vessels have not previously rigorously defined. Methods: Twenty-two cadaveric epiphyses from donors who had three seventeen years age were analyzed then digitized with use high-resolution laser scanner. height, location, approximate area measured...

Background Fluoroscopy during fracture reduction allows a physician to assess fractures and immediately treat pediatric patient. However, concern regarding the effects of radiation exposure has led us find ways keep exposures as low reasonably achievable. One potentially simple way, which our knowledge not been explored, decrease is through formal education before mini C-arm use. Questions/purposes We questioned whether safety educational program decreases (1) time (2) among residents...

In Brief Study Design. A prospective study comparing supine bending, push-prone, and traction under general anesthesia (UGA) radiographs in adolescent idiopathic scoliosis. Objective. To compare the effectiveness of 3 different flexibility methods on structural nonstructural main thoracic (MT) thoracolumbar/lumbar (TL/L) curves. Summary Background Data. Supine side bending are major method for determining curve reducibility. Push-prone show compensatory curves same radiograph, but have not...

Osteopetrosis or Albers-Schonberg disease is a rare hereditary disorder of osteoclast function in which resorption bone diminished, resulting abnormally dense bones. The condition known to occur at least four recognizable clinical patterns, each variable. optimal treatment fractures and deformity these patients has not previously been made clear. To determine appropriate orthopedic management the condition, we conducted survey membership Pediatric Orthopedic Society North America. combined...

The following finite element study was conducted to determine whether increased body weight, femoral retroversion, and varus hip loading could sufficiently raise physeal shear strains stresses above the yield point predispose an adolescent a slip. A computer tomography scan of 13-year-old child with slipped capital epiphysis used generate solid model proximal femur physis. parameterized using 3-dimensional software three difference angles neck version-neutral, 15° anteversion. Loads 2.7...

Background: Cast room procedures, such as cast application and removal, pin suture removal can cause significant anxiety in young children. The use of music therapy the to decrease has not been previously reported. Methods: We performed a randomized, prospective study soft lullaby compared with no 69 children 10 years or younger undergoing procedures. Heart rates (beats per minute) were recorded waiting using pulse oximeter. Results: A total 28 randomized 41 music. mean rise heart rate...

The anatomy of the undulating distal femoral physis may be relevant to growth disturbance after physeal fractures and screw fixation about physis. surface this has not been well described.We performed an anatomic study on 26 cadaveric epiphyses in specimens 3 18 years age. High-resolution 3-dimensional scans were obtained analyzed determine heights, approximate areas, locations major undulations.Gross examination revealed lateral anteromedial peripheral notches at metaphyseal-epiphyseal...

To establish the incidence, mortality rate, and fracture location of pediatric patients injured while using an all-terrain vehicle (ATV) over 11-year period.A retrospective study a state trauma database for ages 0 to 17 years who sustained injuries ATV. Thirty-two adult centers within were evaluated from January 1, 2004, December 31, 2014.The inclusion criteria met by 1912 patients. The estimated mean annual incidence during period was 6.2 per 100 000 children in population <18 age. There...

Thirty-four consecutive patients with displaced supracondylar humerus fractures were treated reduction and percutaneous pinning. The precise location of the ulnar nerve to medial pin was determined by intraoperative stimulation. In 22 34 patients, authors attempted predict palpation placing a mark on skin. They also recorded ability feel anatomic landmarks for fixation, including epicondyle nerve. average distance from predicted 9.3 mm, whereas actual measured 7.6 significant difference 1.7...

A retrospective case-control study.Evaluate the effectiveness of Amicar in decreasing perioperative blood loss patients with neuromuscular scoliosis undergoing posterior spinal fusion (PSF) and segmental instrumentation (SSI).Previously, a preliminary prospective; prospective randomized double-blind; same-day anterior fusion; fibrinogen studies have demonstrated to be effective total transfusion requirements surgery for idiopathic scoliosis. Increased secretion is possible explanation. We...

Thirty-four consecutive patients with displaced supracondylar humerus fractures were treated reduction and percutaneous pinning. The precise location of the ulnar nerve to medial pin was determined by intraoperative stimulation. In 22 34 patients, authors attempted predict palpation placing a mark on skin. They also recorded ability feel anatomic landmarks for fixation, including epicondyle nerve. average distance from predicted 9.3 mm, whereas actual measured 7.6 significant difference 1.7...

A retrospective study of the effectiveness Amicar (epsilon aminocaproic acid).Evaluate in decreasing perioperative blood loss and transfusion requirements same-day anterior (ASF) posterior spinal fusion (PSF) with segmental instrumentation (SSI) for idiopathic scoliosis.Preliminary prospective, prospective randomized double-blind, fibrinogen studies have demonstrated to be effective patients scoliosis undergoing PSF SSI. Increased secretion is a possible explanation.There were 73 consecutive...

Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions accredited Levels 1 4 trauma centers state. annual rates admission for children our state and severity subsequent introduction safety have not been reported, knowledge. Ride-on associated more severe children.We asked: (1) What was...

In Brief Study Design. Prospective evaluation of fibrinogen levels before surgery and after in patients with idiopathic scoliosis undergoing posterior spinal fusion (PSF) segmental instrumentation (SSI) who received Amicar to decrease perioperative blood loss. Objectives. To assess a possible association between postoperative administration. Summary Background Data. Our previous randomized, double-blind (Amicar control) study demonstrated rise on the first day group, but not control group....

Fractures of the proximal humerus with concomitant vascular injury are rare in children. We describe presentation, diagnosis, and treatment a fracture association an axillary artery child.

In Brief Study Design. A retrospective assessment of fusion rates using either morselized allograft bone or demineralized matrix (DBM) following video-assisted thoracoscopic surgery (VATS) in idiopathic scoliosis. Objective. To compare between and (Grafton DBM Flex) VATS on standard standing lateral spine radiographs. Summary Background Data. Both graft substitutes are accepted surgical techniques. However, their concomitant use spinal deformity has not been previously reported. Bone...