Journal of pediatric orthopedics
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Clinical Trial
Popliteal fossa block for postoperative analgesia after foot surgery in infants and children.
The efficacy of a popliteal fossa block (PFB) was evaluated after foot and ankle surgery in children. With the child still anesthetized, a PFB was performed with 0.75 ml/kg of 0.2% ropivacaine. Postoperative analgesia was assessed by using an objective pain score, assigned at 2-h intervals. ⋯ Eight patients required no analgesic agents during the first 12 postoperative hours. The duration of the analgesia varied from 8 to 12 hours. PFB provides effective analgesia after foot and ankle surgery in children.
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The diagnosis of traumatic dislocation of the radial head, either isolated or as part of a Monteggia fracture-dislocation, was delayed in 10 of the 110 children treated with these injuries during the study period. In eight children, the dislocation was overlooked on the initial radiographs. ⋯ The most likely explanation is that the radial head dislocated at the time of impact, spontaneously reduced by the time the first radiographs were obtained, and redislocated while the arm was in a cast. We conclude that radiographic assessments of the radiocapitellar joint, by using the radiocapitellar line, are required in children with elbow and forearm injuries at presentation and when the cast is removed.