Supracondylar humerus fractures are the most common elbow in pediatric population. Type I managed nonsurgically, but displaced injuries (types II, III, and IV) require surgical intervention. Closed reduction percutaneous pinning remains mainstay of management. Numerous studies have reported recent alterations important aspects managing these fractures. Currently, many surgeons wait until 12 to 18 hours after injury perform surgery provided child's neurovascular soft-tissue statuses permit....

The anterior humeral line is used to assess displacement and the adequacy of reduction supracondylar fractures in children. It said pass through middle third capitellum elbow a normal child. Few reports published literature have discussed this measurement, intra-rater inter-rater reliability measurement not known. purposes present study were define position normal, skeletally immature elbows determine parameter.On two occasions, three observers (a pediatric orthopaedic surgeon, senior...

Prader-Willi Syndrome (PWS) is a chromosome 15 disorder characterized by hypotonia, hypogonadism, hyperphagia, and obesity. Musculoskeletal manifestations, including scoliosis, hip dysplasia, lower limb alignment abnormalities, are well described in the orthopaedic literature. However, care of this patient population from surgeon's perspective complicated other clinical manifestations PWS. Osteopenia, psychiatric disorders, diminished pain sensitivity frequently noted PWS but not discussed...

Torticollis is often characterized by a unilateral head tilt and rotation of the chin to opposite side. This pathology believed arise from contracted, shortened, or deformed sternocleidomastoid muscle. However, torticollis not formal diagnosis but clinically viewed as sequela many other conditions. can be categorized acquired congenital; latter presents shortly after birth, while at any age. For this article’s purpose, we will focus on relevant clinical approaches Congenital Muscular (CMT)....

The modified Gartland classification system for pediatric supracondylar fractures is often utilized as a communication tool to aid in determining whether or not fracture warrants operative intervention. This study sought determine the interobserver and intraobserver reliability of system, well there was agreement that warranted intervention regardless system.A total 200 anteroposterior lateral radiographs humerus were retrospectively reviewed by 3 fellowship-trained orthopaedic surgeons 2...

This study investigates the hypothesis that integrity of cartilage hinge at distal humeral epiphysis determines stability fractures lateral condyle. Sixteen patients with condyle were studied radiographs and magnetic resonance imaging (MRI). The clinical course each patient was compared using these studies to determine whether initial fracture displacement correlated stability. Radiographically, 4 considered unstable (with >3 mm) 12 stable (initial < or =3 mm). On MRI, 6 complete disruption...

From 1987 to 1992, 161 children were treated at The Children's Hospital of Philadelphia for slipped capital femoral epiphysis. Of these, 23 patients (23 hips) had Grade III slips (>50%). Fixation was achieved by 1 or 2 screws in all patients. Twenty-one available followup (average followup, 2.8 years). Four acute, 11 acute-on-chronic, and 6 chronic. At the most recent radiographs taken a Harris Hip Score assigned each patient. Stabilization without progression slip Screw placement...

The authors conducted a retrospective review at their level I trauma center to assess the outcomes of closed vs open pediatric tibial fractures treated with titanium elastic nails. study group included 38 patients (median age, 12 years) nails for during 5-year period. Patient demographics, or injury, Gustilo-Anderson type fractures, fracture location, skeletal maturity, time union, hospital length stay, number procedures performed per patient, and complications were recorded. main outcome...

Postoperative pain control in pediatric patients has become a priority for all institutions. There is paucity of literature on after orthopedic procedures the population. The purpose this study to compare efficacy acetaminophen with narcotic analgesics, specifically, acetaminophen/codeine and morphine, management closed reduction percutaneous pinning displaced supracondylar humerus fractures children.We retrospectively evaluated 217 who received type II or III at our institution from 2003...

The majority of pediatric fractures are treated in casts due to the child's ability heal rapidly and remodel. Unplanned cast changes a time economic burden with potentially adverse effects on fracture management. purpose this study is document incidence, etiology, complications related unplanned changes.A prospective was conducted over 6-month period determine incidence changes. All applied were nonwaterproof. Data collected include reason for placement, type placed, duration wear before...

Mobile imaging, such as viewing radiographs text messages, is increasingly prevalent in clinical settings. The purpose of this study was to determine whether remote diagnosis pediatric elbow fractures using smartphone technology reliable. In addition, aimed the assessment regarding decision for operative treatment affected by evaluation images on a mobile device opposed standard picture archiving and communication system (PACS).Standard anteroposterior lateral 50 trauma cases were evaluated...

Background: Management of pediatric femoral shaft fractures remains controversial, particularly in children between the ages 6 and 10. In current push toward cost containment, hospital type, surgeon subspecialization have emerged as important factors influencing this treatment decision. Thus, present study, we use a nationwide inpatient database to compare the: (a) incidence; (b) demographic characteristics; (c) costs; (d) length stay; (e) method closed admitted general versus children’s...