Retrospective cohort analysis.To establish if drain levels exceed the minimum inhibitory concentrations for common pathogens (methicillin-resistant Staphylococcus aureus, methicillin-sensitive and Propionibacterium acnes-2 μg/mL; epidermidis, Enterococcus faecalis-4 μg/mL). Evaluate safety of topical vancomycin in pediatric patients undergoing spinal deformity surgery determine postoperative serum approach toxicity (25 μg/mL).The application powder has decreased wound infections...

Flexible intramedullary nailing (IMN) has become a popular technique for the management of unstable or open forearm fractures. Recent publications have suggested an increased incidence delayed union and poor outcomes in older children adolescents. The objective this study was to review fractures treated with IMN, comparing rate complications between 2 age groups. Our hypothesis that IMN is effective similar both groups.An Institutional Review Board-approved retrospective conducted pediatric...

There recently has been a resurgence in the utilization of ketamine, unique anesthetic, for emergency-department procedures requiring sedation. The purpose present study was to examine safety and efficacy ketamine sedation treatment children's fractures emergency department.One hundred fourteen children (average age, 5.3 years; range, twelve months ten years months) who underwent closed reduction an isolated fracture or dislocation department at level-I trauma center were prospectively...

The choice of upper-instrumented vertebrae (UIV) for posterior spinal fusion (PSF) constructs is influenced by guidelines where UIV T4 or more cephalad. In a cohort patients with adolescent idiopathic scoliosis (AIS) thoracic curves, we sought to (a) compare postoperative shoulder balance T5-T6 versus T2-T4 and (b) evaluate curve operative characteristics that lead caudal UIV. A single-institution AIS registry was queried undergoing PSF from 2000 2017. Included were AIS, Lenke 1 2 minimum...

Study Design. A retrospective review of patient outcomes after lumbar spinal fusion. Objective. To determine whether patients with a fusion ending adjacent to "degenerated disc" (DDD group) had worse clinical than fusions "normal" discs (NL group). Summary Background Data. Although it has been suggested that creating rigid motion segment degenerated may negatively impact fusion, this question not addressed our knowledge in the English literature. Methods. Twenty-five consecutive treated for...

Summary Twenty-six skeletally immature patients with 27 displaced, diaphyseal forearm fractures treated by open reduction and internal fixation were reviewed. The mean age of the at time injury was 11.5 years (range, 4-15). Indications for surgery included (10), unacceptable closed (14), loss (three). Anatomic or near anatomic achieved either compression plates intramedullary wires. average to union 3.5 months. length follow-up 39 months 9-98). All but three regained full range motion equal...

To determine the feasibility of using diffusion tensor MRI (DT-MRI) -based muscle fiber tracking to create biomechanical models quadriceps mechanism in healthy subjects and those with chronic lateral patellar dislocation (LPD).Four (average 14.5 years old; BMI 21.8) four LPD 17.3 22.4) females underwent DT axial T1W thighs. The anatomical physiologic cross-sectional areas (ACSA PCSA, respectively) pennation angle were calculated vastus lateralis oblique (VLO) medialis (VMO) muscles....

Background: The yield of synovial fluid cultures in patients meeting clinical criteria for septic hip arthritis remains low. In the presence positive blood cultures, these are diagnosed and treated as “presumed arthritis.” We hypothesized that some may instead have an extra-articular infection, such pericapsular pyomyositis. Methods: An IRB-approved prospective study children with suspected at a tertiary care children’s hospital over 2-year time period was conducted. Children were evaluated...

Slipped capital femoral epiphysis (SCFE) is strongly associated with childhood obesity, yet the prevalence of obesity orders magnitude greater than SCFE. Therefore, it hypothesized that not, by itself, a sufficient condition for SCFE, but rather one component multifactorial process requiring preexisting physeal pathology. Leptin elevation seen to varying degrees in patients and as leptin has been shown cause pathology similar changes we propose may be factor distinguishing between SCFE...

Twenty-six skeletally immature patients with 27 displaced, diaphyseal forearm fractures treated by open reduction and internal fixation were reviewed. The mean age of the at time injury was 11.5 years (range, 4-15). Indications for surgery included (10), unacceptable closed (14), loss (three). Anatomic or near anatomic achieved either compression plates intramedullary wires. average to union 3.5 months. length follow-up 39 months 9-98). All but three regained full range motion equal that...

Haemophilus influenzae has been a major cause of infectious diseases in children and attributed as significant septic arthritis osteomyelitis children. With the advent widespread vaccination, incidence meningitis other infections well documented. This is thought to be first report that documents effect vaccination on bone joint infections. One hundred sixty-five cases acute hematogenous or treated at Department Orthopaedics Vanderbilt University years before after vaccine assess whether...

The purpose of this study was to compare hemiepiphysiodesis implants for late-onset tibia vara and evaluate patient characteristics that may predict surgical failure.This is a retrospective review patients treated with temporary from 1998 2012. Mechanical axis deviation (MAD), mechanical angle, lateral distal femoral medial proximal tibial angle were measured on standing bone length radiographs. Surgical failure defined as residual deformity requiring osteotomy, revision surgery, or MAD...

Background: Musculoskeletal infections (MSKIs) are a common cause of pediatric hospitalization. Children affected by MSKI have highly variable hospital courses, which seem to depend on infection severity. Early stratification severity would therefore help maximize resource utilization and improve patient care. Currently, MSKIs classified according primary diagnoses such as osteomyelitis, pyomyositis, etc. These diagnoses, however, do not often occur in isolation may differ widely On the...

Genu valgum is a common orthopaedic problem in children. The vast majority of cases are physiologic variants, which resolve normally. However, there pathologic entities due to both focal and systemic processes the deformity often progresses usually requires treatment. Differentiating between two forms facilitated by thorough understanding natural history development tibiofemoral angle In this review, an approach evaluation diagnosis genu presented, therapeutic alternatives discussed.

Immediate spica casting for pediatric femur fractures is well described as a standard treatment in the literature. The purpose of this study to evaluate application cast emergency department (ED) versus operating room (OR) with regard quality reduction, complications, and hospital charges at an academic institution.An institutional review board-approved retrospective identified 100 children aged 6 months 5 years between January 2003 October 2008 isolated fracture treated hip cast. Patients...

Background: Debate exists over the safety of rigid intramedullary nailing femoral shaft fractures in skeletally immature patients. The goal this study was to describe functional outcomes and complication rates pediatric Methods: A retrospective review performed patients treated with trochanteric from 1987 2009. Radiographs made at initial injury, immediately postoperatively, latest follow-up were reviewed. Patients administered Nonarthritic Hip Score a survey. Results: population 241 246...

Displaced pediatric supracondylar humeral fractures (SCHFs) are stabilized after reduction by smooth pins. Although some SCHFs biomechanically stable lateral-only entry pinning (lateral pinning), an additional medial pin (cross-pinning) confers superior stabilization in SCHFs. There is a recognized risk of iatrogenic ulnar nerve injury with pinning. The best existing evidence has estimated rate approximately 3.4% cross-pinning. In similar studies, the (all nerves) lateral at 1.9%. This study...

The efficacy of a popliteal fossa block (PFB) was evaluated after foot and ankle surgery in children. With the child still anesthetized, PFB performed with 0.75 ml/kg 0.2% ropivacaine. Postoperative analgesia assessed by using an objective pain score, assigned at 2-h intervals. Patients scores ≥3 received intravenous nalbuphine. PFBs were 20 children ranging age from 0.5 to 12 years weight 6 41 kg. In five patients, supplemented saphenous nerve ankle. unsuccessful one patient. remaining 19...

Objective: There are currently no algorithms for early stratification of pediatric musculoskeletal infection (MSKI) severity that applicable to all types tissue involvement. In this study, the authors sought develop a clinical prediction algorithm accurately stratifies based on and laboratory data at presentation emergency department. Methods: An IRB-approved retrospective review was conducted identify patients aged 0 18 who presented department tertiary care children’s hospital with concern...

The rate of venous thromboembolism in children with musculoskeletal infections (MSKIs) is markedly elevated compared hospitalized general. Predictive biomarkers to identify high-risk patients are needed prevent the significant morbidity and rare mortality associated thrombotic complications. We hypothesize that overactivation acute phase response development pathologic thrombi we aim determine whether elevations C-reactive protein (CRP) increased rates thrombosis pediatric MSKI.A...