Background: Children with cerebral palsy (CP) often undergo hip reconstruction through proximal femoral varus derotation osteotomy (VDRO), orthopaedic implants used for fixation. Posthealing, hardware may be retained or removed, either reactively due to complications prophylactically. The controversy surrounding implant removal persists. This study aimed compare the rate of fractures in children CP who their versus those had it removed after VDRO. A secondary aim was identify fracture risk...

Background: Knowledge of the relative contributions to different growth areas in proximal femur and acetabulum is limited due complex anatomy lack markers children. There increasing interest using guided improve hip joint stability decrease dysplasia children with neurological disability. Some cerebral palsy (CP) are treated bisphosphonates for bone insufficiency, which leaves a dense arrest band at time treatment. The aim this study was develop novel approach understand maturation impact on...

Few studies have investigated outcomes after adjunct botulinum toxin type A (BTX-A) injections into the shoulder internal rotator muscles during closed reduction and spica cast immobilization in children with brachial plexus birth palsy. The purpose of this study was to report success rates treatment identify pretreatment predictors success.Children palsy who underwent glenohumeral joint BTX-A casting were included. Minimum follow-up 1 year. Included patients did not receive concomitant...

Background: Acute limb ischemia (ALI) of the upper extremity is a rare yet severe condition in intensive care unit (ICU) patients that generally leads to amputation. The aim this study determine risk factors for development ICU requiring vasopressor support. Methods: This retrospective conducted from 2010 2015. Patients who received vasopressors during admission were considered study. identified via Current Procedural Terminology ( CPT) billing codes. ALI matched control based on diagnosis...

Background: Closed reduction is generally attempted on children under 18 months of age who present as older infants or fail nonoperative management for developmental dysplasia the hip (DDH). However, many these patients will not achieve concentric by closed means and ultimately require open (OR). Limited evidence exists to predict which can be adequately reduced versus those need treatment. Methods: Prospectively collected data from 4 select centers an international multicenter study group...

Background: Hip reconstruction in patients with cerebral palsy (CP) is associated with. significant postoperative pain. However, adequate analgesia can be difficult to achieve. this population due spasticity, communication barriers, and postoperative. spasticity. Recently, multimodal pain management techniques such as epidurals and. regional nerve blocks have been described for control, but it unclear if 1 technique more beneficial. The purpose of study was compare the outcomes different...

Traditional management of hand abscesses consists withholding antibiotics prior to drainage optimize bacterial culture growth and outcome. The purpose this study was determine the effect preoperative empiric on rate adverse events in patients with acute abscesses.We performed a retrospective review prospectively collected data 88 consecutive that received incision from 2012 2013 at an urban academic institution. We analyzed patient demographics, bacteriology, results, time surgery, frequency...

Background: While reconstruction of the medial patellofemoral ligament (MPFL) is one most frequently performed surgical procedures in skeletally immature patients with patellar instability, there an inherent risk to distal femoral physis during tunnel placement Methods: This case report describes a valgus deformity caused by partial lateral physeal growth arrest after MPFL reconstruction.   Results: The acquired was successfully treated varus-producing osteotomy.  Conclusion:...

The neck-shaft angle and head-shaft in children with varying levels of neurological disability were evaluated to define change over different ages.

Case: A 14-year-old adolescent girl sustained a Lisfranc fracture-dislocation with an interposed extensor hallucis brevis (EHB) tendon. Following multiple failed attempts at closed reduction in both the emergency department and operating room, patient was treated staged manner temporizing percutaneous pinning improved alignment, followed by definitive open internal fixation once soft tissues allowed. Conclusions: Anatomic stable of injuries is vital to regain stability reduce risk midfoot...

Background: Simulation-based training is one way to improve basic competence for surgical trainees and thus patient safety. Closed reduction percutaneous pinning of a supracondylar humerus fracture common procedure that encompasses many orthopaedic skills has been identified as residency milestone. Despite this, no quantitative tools exist help learners attain this skill. This study seeks validate quantitative, low-cost simulation-based tool teaching surgery the fundamentals stabilization...

Cerebral palsy (CP) is a heterogeneous group of disorders with different clinical types and underlying genetic variants. Children CP are at risk for fragility fractures secondary to low bone mineral density, although bisphosphonates prescribed the treatment children fragility, there limited information on long-term impact safety. usually present overtubulated bones, thickening cortical by pamidronate can potentially further narrow medullary canal. Our purpose was report alterations...

Many non-ambulatory children with cerebral palsy (CP) who are indicated for hip reconstruction and/or spine surgery medically complex and thus high-risk surgical candidates. A well-coordinated, multidisciplinary team approach to the care of these youth is essential reduce risk perioperative complications. This review offers an evidence-based overview covering interventions that have been shown improve safety outcomes after in CP. Specifically, this will focus on coordination goals optimizing...

Purpose: Clinical practice, including utilization of postoperative x-rays, may vary after pinning supracondylar humerus fractures in children. The purposes this study were to: (1) evaluate the frequency at which radiography resulted management changes and (2) determine risk factors for such changes, as previous studies be underpowered analyses. Methods: This retrospective cohort included skeletally immature patients that underwent a fracture four tertiary children’s hospitals. Skeletally...

Purpose: Closed reduction of the hip and spica casting is generally attempted on children under 18 months age who fail non-operative management for developmental dysplasia (DDH). However, many these patients will not achieve concentric by closed means require open reduction. Limited evidence exists to predict which can be adequately reduced versus those need treatment. Therefore, purpose this study identify factors predictive needing vs. …