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Pediatric upper extremity

Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
February 13, 2019: Pediatric Emergency Care
Ghanshyam Das Singhal, Shakti Singhal, Gunjan Agrawal, Deepti Singhal, Vipin Arora
Objective: The objective of this study was to retrospectively study Chiari I malformation patients (<18 years) treated surgically. Materials and Methods: Chiari I malformation patients (<18 years) treated surgically at our institute were retrospectively studied. Results: During the study period between January 1999 and June 2011, fifty patients, aged ≤18 years with Chiari malformation, were treated surgically and formed the basis for this series...
January 2019: Journal of Neurosciences in Rural Practice
Jess T Randall, Osamah Aldoss, Asra Khan, Melissa Challman, Gurumurthy Hiremath, Athar M Qureshi, Manish Bansal
BACKGROUND: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper- extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. METHODS: A retrospective chart review of all patients who underwent cardiac catheterization via upper-extremity vascular access was performed...
February 15, 2019: Journal of Invasive Cardiology
Laura Rosas, Kavya Rao, Christine McGough, Ashley Becker
The authors describe a 12-year-old girl with an atypical presentation of Bartonella encephalitis. She presented with fever and altered mental status and developed flaccid paralysis of her left upper extremity a day later. An electroencephalogram showed slowing over her right hemisphere. She had mild leukocytosis and bandemia, but her imaging and cerebrospinal studies were unrevealing. After five days, her symptoms resolved and she was discharged home on doxycycline due to suspicion for Bartonella encephalitis...
2019: Child Neurology Open
Namrata Grampurohit, Mary Slavin, Pengsheng Ni, Scott Kozin, Alan Jette, MaryJane Mulcahey
PURPOSE: The Cerebral Palsy Profile of Health and Function (CP-PRO) Computerized Adaptive Tests (CAT) are quality of life measures developed specifically for use in children with cerebral palsy. This study examined the ability of the upper-extremity (UE) CP-PRO CAT to detect change in function after UE surgery compared with the Pediatric Outcomes Data Collection Instrument (PODCI), ABILHAND-Kids, and Box and Blocks test. METHODS: From 2009 to 2013, children with cerebral palsy who had UE musculoskeletal surgery completed the UE CP-PRO CAT, PODCI-UE, ABILHAND-Kids, and Box and Blocks tests before surgery (97 children) and at 3 postoperative intervals: 6 months (80 children), 12 months (73 children), and 24 months (52 children)...
February 4, 2019: Journal of Hand Surgery
Marisa Manzano Surroca, Francisco Parri, Xavier Tarrado
INTRODUCTION AND OBJECTIVES: The literature reports many variations of Poland syndrome, which is a congenital disorder and a rare condition. The associated features are extremely variable, including alterations in the ipsilateral thorax and upper extremity and other malformations. This is used to designate the condition as Poland sequence (PS) because a sequence is a primary defect with a secondary cascade of structural changes. It is generally accepted that it is characterized as pathognomonic by absence/aplasia of the sternocostal aspect of the pectoralis major muscle of one side...
February 1, 2019: Annals of Plastic Surgery
Tyler Edmond, Alexandra Laps, Alexandria L Case, Nathan O'Hara, Joshua M Abzug
BACKGROUND: Upper extremity length and circumference abnormalities are present in a number of conditions in the pediatric population. In most cases, upper limb hypoplasia and hypertrophy are diagnosed when one limb appears substantially different from the other during physical examination. However, occasionally when this discrepancy exists, it can be difficult to determine which limb is the abnormal one. The purpose of this study was to establish normal values for upper extremity length, circumference, and rate of growth in children aged 0 to 17 years...
February 1, 2019: Hand: Official Journal of the American Association for Hand Surgery
Hajar Ziaei Hezarjaribi, Mahdi Fakhar, Rezvan Yalveh, Sayed Abdollah Mousavi, Elham Sadat Banimostafavi
Leech infestation most frequently occurs in upper body cavities of children including pharynx, nose and esophagus and, more rarely, the vagina and vulva. Here we describe a 6-yr-old girl with vulvar bleeding caused by leech infestation that referred to the Emergency unit of the Booali Sina Hospital in Sari, Iran in Sep 2015. She had a history of swimming in a pond prior to the occurrence. The leech infestation particularly vulvar involvement among young girls is extremely rare and yet neglected event in the world...
October 2018: Iranian Journal of Parasitology
Rajan R Murgai, Curtis VandenBerg, Milan Stevanovic, Nina Lightdale-Miric
BACKGROUND: Conversion disorder in children presents a challenge to orthopedic surgeons. The condition is frequently associated with unnecessary diagnostic tests, treatments, and cost. The purpose of this study was to report a series of children with upper extremity conversion disorder to raise awareness for this uncommon condition and to assist with its diagnosis and management. METHODS: A retrospective review was conducted of 4 pediatric patients with upper extremity conversion disorder at a tertiary pediatric hospital from 2015 to 2017...
January 23, 2019: Journal of Shoulder and Elbow Surgery
Rachel Marchalik, Erin M Rada, Frank P Albino, Tina M Sauerhammer, Michael J Boyajian, Gary F Rogers, Albert K Oh
Background: Upper extremity friction burn due to powered home equipment is a growing problem in the pediatric population. The purpose of this study was to review the etiology, presentation, characteristics, and treatment of this particular type of pediatric mechanism of injury. Methods: A retrospective chart review using International Classification of Diseases, version 9, codes for patients treated at a large tertiary care, free-standing children's hospital was performed to identify all patients presenting with an upper extremity friction burn from 2003 to 2012...
December 2018: Plastic and Reconstructive Surgery. Global Open
Genevieve E Staudt, Susan S Eagle, Alexander K Hughes, Brian S Donahue
OBJECTIVE: To evaluate the effect of dynamic ultrasound (US) on the need for surgical intervention to achieve successful arterial cannulation in the pediatric cardiac surgery population. DESIGN: Retrospective, observational study. SETTING: Single, academic, pediatric hospital in the United States. PARTICIPANTS: The study comprised 3,569 consecutive patients who had an arterial catheter placed in the operating room before undergoing congenital heart surgery between January 2004 and September 2016...
December 1, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Balagangadhar R Totapally, Andre Raszynski, Danyal Khan, Ibrahim Amjad, Jefry Biehler
OBJECTIVES: The purpose of this study was to evaluate the prevalence, demographics, predisposing conditions, therapeutic interventions, and outcomes of extremity arterial thrombosis in hospitalized children. DESIGN: Retrospective cohort study. PATIENTS: National discharge database analysis. MEASUREMENTS AND MAIN RESULTS: Cases of extremity arterial thrombosis in children and neonates were extracted from the Kids' Inpatient Database 2012...
January 11, 2019: Pediatric Critical Care Medicine
Ahmed M Morsy, Marwa I Abdelgawad, Badawy M Ahmed, Khalid M Rezk, Amir M Aboelgheit, Islam K-A Ramadan, Hosam E M Kamel, Doaa M Fouad, Rania A Herdan, Shimaa H Shabaan, Hanan A Eltyb
AIM: To assess the outcome and determine predictors of survival in pediatric patients with osteosarcoma of the extremities treated with a unified chemotherapy protocol at a single institution over a 15-year period. MATERIALS AND METHODS: We performed a retrospective analysis of medical records of 48 pediatric patients with histologically verified osteosarcoma of the extremities diagnosed at South Egypt Cancer Institute and received treatment between January 2001 and December 2015...
January 8, 2019: Journal of Pediatric Hematology/oncology
Scott Taylor, Mina Guirguis, Ellen M Raney
BACKGROUND: Patient-reported Outcome Measures (PROMs) quantifying health-related quality of life are widely used to evaluate illness and the impact of health care interventions. The questionnaires must be comprehensible by the persons completing them. Literacy Surveys in the United States reveal nearly half of the US adult population have a literacy level below the 8th grade. Recommendations are that health-related written material directed at adults should be at a reading level of grade 6 or below...
January 2, 2019: Journal of Pediatric Orthopedics
Conor F McCarthy, James C Kyriakedes, R Justin Mistovich
CASE: A 30-month-old boy with a displaced medial condyle fracture and no history of an elbow dislocation was found to have an entrapped median nerve. CONCLUSION: Entrapment of the median nerve is a potential consequence of a displaced medial condyle fracture, even when there are no neurologic deficits on presentation. This provides additional support for open reduction of these fractures rather than percutaneous treatment or nonoperative management. Prompt identification and extraction of an interposed ulnar or median nerve is imperative to prevent the catastrophic consequences of an upper-extremity nerve palsy in children, as well as to optimize fracture-healing and elbow growth and development...
October 2018: JBJS Case Connector
Sonia Chaudhry
Hand surgeons encountering pediatric patients should be attuned to both technical and practical facets of caring for congenital and traumatic pathologies. Psychosocial aspects include engaging children in conversation and factoring in both self and external perception of deformity. Medical considerations are also unique, from including child abuse in the differential to having techniques to assess active motion and sensation in the nonverbal child. Certain universal principles, such as minimizing radiation exposure and limiting needle sticks, have higher emphasis in pediatric patients than in adults...
December 12, 2018: Journal of Hand Surgery
Robert Bogart, Kathryn Vidlock
Forearm fractures of the distal radius are one of the most common fractures seen in the upper extremity, and they represent approximately 1/6 of fractures treated in the emergency department. Forearm fractures are associated with a rare but known complication of a delayed ruptured extensor pollicis longus (EPL) tendon. This sequela is more commonly seen in adults after a nondisplaced distal radius fracture, with much variability in the incidence ranging from 0.07% to 5%. By contrast, this complication in the pediatric population is almost exclusively seen after a displaced or unstable fracture necessitating surgical correction with open reduction and internal fixation...
December 13, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Christopher A Iobst, Darvin Bunhor, David L Skaggs, Steven L Frick
Fractures of the supercondylar humerus are the most common elbow fracture in pediatrics. Management of this injury would be aided if surgeons could reliably test fracture stability intraoperatively after pinning. A transverse supracondylar humerus fracture model was created using 3 adult cadaver upper-extremity specimens with an intact soft tissue envelope. Using the lateral entry technique, three 2.0 mm pins were then drilled using lateral entry technique to create an "A" pinning. Pins were checked in anteroposterior and lateral views with the C-arm to confirm accurate placement in both planes...
December 2018: Techniques in Orthopaedics: TIO
David S Tulsky, Pamela A Kisala, Aaron J Boulton, Alan M Jette, David Thissen, Pengsheng Ni, Darren A DeWalt, I-Chan Huang, Yang Liu, M J Mulcahey, Mary Slavin, Brooke Magnus, Holly Crump, Robin Hanks, Susan Charlifue, Bryce B Reeve
PURPOSE: Having independent versions of the PROMIS® scales (for Pediatric and Adults) is problematic as scores cannot be evaluated longitudinally as individuals move from childhood into adulthood. The primary aim of this research project is to use item response theory (IRT) to develop a transitional scoring link (or "crosswalk") between the PROMIS adult and pediatric physical health measures. SETTING: Sample 1 was collected at 6 rehabilitation hospitals in the U...
December 11, 2018: Quality of Life Research
Pawel J Matusz, Alexandra P Key, Shirley Gogliotti, Jennifer Pearson, Megan L Auld, Micah M Murray, Nathalie L Maitre
Cerebral palsy (CP) is predominantly a disorder of movement, with evidence of sensory-motor dysfunction. CIMT1 is a widely used treatment for hemiplegic CP. However, effects of CIMT on somatosensory processing remain unclear. To examine potential CIMT-induced changes in cortical tactile processing, we designed a prospective study, during which 10 children with hemiplegic CP (5 to 8 years old) underwent an intensive one-week-long nonremovable hard-constraint CIMT. Before and directly after the treatment, we recorded their cortical event-related potential (ERP) responses to calibrated light touch (versus a control stimulus) at the more and less affected hand...
2018: Neural Plasticity
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