Journal of pediatric orthopedics
-
Multicenter Study
Derotational casting for progressive infantile scoliosis.
Serial cast correction by using the Cotrel derotation technique is one of several potential treatments for progressive infantile scoliosis. This study reviews our early experience to identify which, if any, patients are likely to benefit from or fail this technique. ⋯ Level 4, therapeutic study.
-
Randomized Controlled Trial Comparative Study
Epidural analgesia compared with intravenous analgesia after pediatric posterior spinal fusion.
Pain management remains challenging for pediatric patients after posterior spinal fusion (PSF). This study compares the effectiveness of hydromorphone and bupivacaine administered through patient-controlled epidural analgesia (PCEA) with hydromorphone patient-controlled intravenous analgesia (IV-PCA) in this population. ⋯ Level 2, randomized, controlled trial.
-
The most commonly cited classification system for lateral condyle fractures (Milch) has not been shown to be predictive of outcome or recommend treatment. ⋯ This is the largest series of operatively treated lateral condyle fractures reported in the literature. This classification system and treatment based on fracture displacement and articular congruity predicts the risk of complications, which were more than 3 times as likely to occur in type 3 fractures as type 2 fractures.
-
Comparative Study
Skeletal versus skin traction before definitive management of pediatric femur fractures: a comparison of patient narcotic requirements.
Pediatric patients with femoral shaft fractures are often placed in traction as a temporizing measure before definitive management. The purpose of our study was to compare narcotic use in pediatric patients with isolated femoral shaft fractures that were initially treated with skeletal traction with similar patients that were initially treated with skin traction. The hypothesis was that narcotic use would not be significantly different between the groups. ⋯ Retrospective comparative study, level III.
-
Child abuse is a serious threat to the physical and psychosocial well-being of the pediatric population. Musculoskeletal injuries are common manifestations of child abuse. There have been multiple studies that have attempted to identify the factors associated with, and the specific injury patterns seen with musculoskeletal trauma from child abuse, yet there have been no large studies that have used prospectively collected data and controlled comparisons. The purpose of our study was to describe the patterns of orthopaedic injury for child abuse cases detected in the large urban area that our institution serves, and to compare the injury profiles of these victims of child abuse to that of general (accidental) trauma patients seen in the emergency room and/or hospitalized during the same time period. ⋯ level III, prognostic study.