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Pediatric + fracture + remodeling

E A Zimmermann, C Riedel, F N Schmidt, K E Stockhausen, Y Chushkin, E Schaible, B Gludovatz, E Vettorazzi, F Zontone, K Püschel, M Amling, R O Ritchie, B Busse
Bone fracture risk is influenced by bone quality, which encompasses bone's composition as well as its multi-scale organization and architecture. Aging and disease deteriorate bone quality leading to reduced mechanical properties and higher fracture incidence. Largely unexplored is how bone quality and mechanical competence progress during longitudinal bone growth. Human femoral cortical bone was acquired from fetal (n=1), infantile (n=3), and 2-14 year-old cases (n=4) at the mid-diaphysis. Bone quality was assessed in terms of bone structure, osteocyte characteristics, mineralization, and collagen orientation...
March 26, 2019: Journal of Bone and Mineral Research
Mohammad M Al-Qattan
BACKGROUND: The diaphyseal axis-metacarpal head angle (DHA) measures the angle between the axis of the proximal phalanx and the center of the metacarpal head. In unfractured fingers, the normal DHA ranges from 177.1° to 180.0°. The angle may be used to quantify the degree of lateral displacement of pediatric fractures of the base of the proximal phalanx. Previous authors have shown that if the postreduction x-rays show an angle greater than 169° remodeling with normalization of the DHA is expected to occur in children...
April 2019: Annals of Plastic Surgery
Naoyuki Nakamura, Yutaka Inaba, Yoichi Aota, Jiro Machida, Tomoyuki Saito
BACKGROUND: Pediatric Langerhans cell histiocytosis (LCH) often results in vertebral compression fracture. However, few reports have reported vertebral remodeling during the course of LCH. We aimed to investigate the longitudinal reconstitution and transformation of the affected vertebrae and the adjacent structures in young children with spinal LCH. METHODS: We recruited 13 patients, including 16 affected vertebrae, diagnosed with LCH via biopsy. The average age at first visit was 3...
April 2019: Journal of Pediatric Orthopedics
Stephanie S Pearce, Michael W Honeycutt, William A Cutchen, Mark D Tillman, Prasit Nimityongskul
BACKGROUND: This study is the first to test Friberg's equation's (Vt=V0[e]) accuracy in predicting the residual angular deformity in pediatric distal forearm fractures. METHODS: Angular deformities from distal forearm fractures in 50 children (mean age, 9 y) were retrospectively measured on follow-up radiographs once healed and compared to extrapolated angles at respective follow-up intervals from 2013 to 2015. RESULTS: The predicted and actual angulations from 120 radiographs (mean follow-up, 3mo) showed that the mean predicted angle was similar to the measured angle in the radioulnar plane and only 2 degrees greater than the measured angle in the dorsovolar plane...
January 25, 2019: Journal of Pediatric Orthopedics
Ryuji Tanaka, Yuji Yasunaga, Jiro Fujii, Takuma Yamasaki, Takeshi Shoji, Nobuo Adachi
BACKGROUND: Joint-preserving procedures should be considered as much as possible for hip disorders in pediatric and young patients. However, in patients with extensive osteonecrosis (ON) of the femoral head combined with severe collapse and advanced secondary osteoarthritis (OA), the optimal procedure has not been elucidated. This retrospective study aimed to investigate the postoperative outcomes of 11 patients who underwent transtrochanteric rotational osteotomy (TRO) alone or with a combination treatment for various hip disorders in young patients and to evaluate the usefulness of TRO...
December 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Deniz Akar, Cenk Köroğlu, Serkan Erkus, Ali Turgut, Önder Kalenderer
Introduction Distal radius fractures are the most frequent fractures seen in pediatric population and usually treated with closed reduction and casting. However, there is a risk of reduction loss and/or angulations in distal radial metaphyseal fractures. The purpose of this study is to evaluate the radiological and functional results of pediatric patients with distal radius metaphyseal fractures in which excessive displacement and/or angulations were accepted and to question upper acceptable limits in light of current literature...
September 5, 2018: Curēus
Naoyuki Nakamura, Yutaka Inaba, Yoichi Aota, Jiro Machida, Tomoyuki Saito
BACKGROUND: Pediatric Langerhans cell histiocytosis (LCH) often results in vertebral compression fracture. However, few reports have reported vertebral remodeling during the course of LCH. We aimed to investigate the longitudinal reconstitution and transformation of the affected vertebrae and the adjacent structures in young children with spinal LCH. METHODS: We recruited 13 patients, including 16 affected vertebrae, diagnosed with LCH via biopsy. The average age at first visit was 3...
November 8, 2018: Journal of Pediatric Orthopedics
Mu-Seung Park, Suk Hyung Kang, Yong Jun Cho, Jin Seo Yang
Pediatric seat-belt fracture is a rare condition, and its management has not been well defined. The authors report a case of pediatric Chance fracture that was managed conservatively and that demonstrated rapid bone healing. A 7-year-old boy presented with back pain after a motor vehicle accident. Plain lumbar spine radiography, three-dimensional computed tomography (CT), and magnetic resonance imaging revealed a seat-belt fracture type C (classified by Rumball and Jarvis), and the patient's condition was managed conservatively...
October 2018: Korean Journal of Neurotrauma
Nirav K Patel, Joanna Horstman, Victoria Kuester, Senthil Sambandam, Varatharaj Mounasamy
Tibial shaft fractures are one of the most common pediatric fractures. They require appropriate diagnosis and treatment to minimize complications and optimize outcomes. Diagnosis is clinical and radiological, which can be difficult in a young child or with minimal clinical findings. In addition to acute fracture, Toddler's and stress fractures are important entities. Child abuse must always be considered in a nonambulatory child presenting with an inconsistent history or suspicious concomitant injuries. Treatment is predominantly nonoperative with closed reduction and casting, requiring close clinical and radiological followup until union...
September 2018: Indian Journal of Orthopaedics
Diana Olvera, Rachel Stolzenfeld, Joan C Marini, Michelle S Caird, Kenneth M Kozloff
Osteogenesis imperfecta (OI) is a genetic disorder characterized by altered bone quality and imbalanced bone remodeling, leading to skeletal fractures that are most prominent during childhood. Treatments for OI have focused on restoring pediatric bone density and architecture to recover functional strength and consequently reduce fragility. Though antiresorptive agents like bisphosphonates (BPs) are currently the most common intervention for the treatment of OI, a number of studies have shown efficacy of sclerostin antibody (SclAb) in inducing gains in bone mass and reducing fragility in OI mouse models...
July 2018: Journal of Bone and Mineral Research
Karthik Shunmugavelu, Kumaravel Subramaniam
The main characteristic feature of the pediatric mandible is that of decreased dimension, which leads to compromises in the open reduction and internal fixation (ORIF). In the dental segment, the cervically bulbous short stature primary teeth might act an obstacle during the maxillomandibular fixation conventionally. An increased osteogenic potential of bones favors rapid consolidation and remodeling in the affected region. The mixed dentition of the ugly duckling stage adds more burden while stabilizing the fractured segments...
October 2017: International Journal of Clinical Pediatric Dentistry
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
Majid Reza Farrokhi, Hamid Rezaei, Farnaz Farrokhi
Odontoid fractures are among the rare cervical spine injuries in pediatric population and thus the optimal management of these injuries is controversial. The increasing trend in road traffic accidents and improvement in diagnostic modalities has led to an increased detection of odontoid fractures in pediatric population. We herein report type II odontoid fracture in an 18-month-old girl after falling off the motorcycle leading to hyperextension and flexion injury. She was successfully treated with anterior odontoid screw fixation followed by immobilization with hard collar for 2 months...
November 28, 2017: British Journal of Neurosurgery
L Kremer, M Voth, I Marzi
Fractures in children are a major challenge in everyday clinical practice. The decision about the correct treatment of fractures follows the consideration of individual factors. The age of the child and the resulting residual growth play an essential role. This article aims to facilitate a structured approach with respect to examination, diagnostics and treatment in clinical practice. This first part of this series deals with fractures of the thigh and in the proximity of the knee joint in children. The peculiarity of pediatric bone lies in its growth, which results not only in a much faster healing tendency than in adults but also possesses a greater correction potential...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Marc Leroy Guifo, Joel Noutakdie Tochie, Blondel Nana Oumarou, Jean Roger Moulion Tapouh, Aristide Guy Bang, Aurelien Ndoumbe, Bonaventure Jemea, Maurice Aurelien Sosso
INTRODUCTION: Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé. METHODS: We conducted a prospective cohort study of all consenting consecutive cases of fractures in patients younger than 16 years managed between January 2011 and June 2015 at the University Teaching Hospital, Cameroon...
2017: Pan African Medical Journal
Karan Dua, Joshua M Abzug, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Distal radius fractures are the most common orthopaedic injury that occur in the pediatric population. The annual incidence of distal radius fractures has increased as a result of earlier participation in sporting activities, increased body mass index, and decreased bone mineral density. Most distal radius fractures are sustained after a fall onto an outstretched arm that results in axial compression on the extremity or from direct trauma to the extremity. Physeal fractures of the distal radius are described based on the Salter-Harris classification system...
February 15, 2017: Instructional Course Lectures
Jenna Godfrey, Roger Cornwall
Metacarpal fractures account for 10% to 35% of all pediatric hand fractures. Pediatric metacarpal fractures commonly occur in patients aged 13 to 16 years, with most injuries sustained during sports activities. Pseudoepiphyses can be confused with metacarpal fractures; however, a careful physical examination can help physicians distinguish the two. Thumb metacarpal base fractures that involve the physis warrant special attention. Thumb metacarpal base fractures with lateral metaphyseal fragments and pediatric Bennett fracture variants (Salter-Harris type III and type IV fractures) are unstable and require surgical management...
February 15, 2017: Instructional Course Lectures
Dmitry Popkov
Autosomal dominant osteopetrosis (Albers-Schönberg disease) classically displays the radiographic signs of osteosclerosis. The main ADO complications involve the skeleton: low-impact bone fractures, scoliosis and hip osteoarthritis. Management of osteopetrosis-related orthopedic problems is a surgical challenge due to increased bone density. The healing process is very slow in these patients because of bone remodeling defects related to osteoblast function failure. In case of bone deformities, a realignment method should be appropriated to osteopetrosis conditions...
November 2017: Strategies in Trauma and Limb Reconstruction
Robert S Runyon, Shevaun M Doyle
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of common pediatric forearm fractures, clarify the descriptions used to identify and thereby appropriately treat them with a splint or cast, and explain osseous remodeling that is unique to the skeletally immature. RECENT FINDINGS: Recent literature addresses the gap in standard treatment protocols. There is variability in the management of pediatric forearm fractures because of the multiple subspecialty physicians that care for children's fractures and a lack of well established guidelines...
February 2017: Current Opinion in Pediatrics
Brandon Scott, Brandon Taylor, Joseph R Shung, Prasit Nimityongskul
Femoral neck and pelvic fractures are rarely encountered in the pediatric population secondary to the resilient nature of the immature skeleton. Both fracture types usually result from high-energy blunt trauma including motor vehicle collisions, motor vehicle-pedestrian accidents, and falls from height. Considerable studies have been published on the natural history, management, and complications of pediatric pelvis and femoral neck fractures. However, few case reports have documented both fracture types in the same patient...
July 2017: Journal of Pediatric Orthopedics. Part B
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