Journal of pediatric orthopedics
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Adolescent tibial tubercle fractures are uncommon, complex, high-energy injuries. The use of lateral radiographs in isolation to diagnose and treat these injuries is the standard of practice. However, with a single 2-dimensional (2D) view, there may be a risk that the degree of injury can be underestimated. This study was performed to report on the outcomes of tibial tubercle fractures operatively treated, determine the utility of a single lateral x-ray to accurately document injury severity and pattern, delineate the role of advanced imaging and intraoperative arthroscopy/arthrotomy in injury treatment, and propose a new classification system of tibial tubercle fractures that accounts for the complex 3D nature of proximal tibial physeal closure, and recognizes the importance of intra-articular extension, providing guidance for intervention. ⋯ Level III--diagnostic study.
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Comparative Study
Preoperative templating before spinal fusion using a fluoroscopic multiplanar imaging system is as accurate as CT scan and uses substantially less radiation.
Many surgeons utilize preoperative multiplanar imaging for surgical planning before fusion surgery using pedicle screw instrumentation. Computed tomographic (CT) scan is often used but limited by non-weight-bearing images and high-ionizing radiation. The purpose of this study was to compare pedicle length and width measurements using a multiplanar fluoroscopic imaging system and CT with gross measurements to validate the accuracy of multiplanar fluoroscopic imaging and compare relative radiation exposure between techniques. ⋯ This study demonstrates similar results from simulated preoperative templating using fluoroscopic imaging compared with CT scan but with less radiation exposure.
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Flexible nailing has become the preferred implant for pediatric patients with tibial shaft fractures that require operative fixation. Immediate definitive fracture fixation with flexible nails in patients with high-energy, open fractures has not been examined. The purpose of our study was to determine if immediate flexible nailing of open pediatric tibial shaft fractures is safe and efficacious from a bone healing, wound, and infectious standpoint. ⋯ Level III, therapeutic study, retrospective cohort.
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Comparative Study
Validation of a scoliometer smartphone app to assess scoliosis.
Surgeons and software developers recognize that apps can improve patient care by replicating the function of existing medical devices. However, the incorporation of new tools requires that the clinical data being recorded is accurate and valid. This study attempts to validate a new iPhone app to measure scoliotic rotation. The objective of this study was to validate the scoliogauge iPhone application by comparing the results to simultaneous readings from a standard Scoliometer. ⋯ Validation of this new device demonstrates the potential to increase the distribution of cost-effective scoliosis screening tools to a broad population of medical providers.
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Physical examination may be inconclusive in adolescents presenting with an acute traumatic knee effusion because of pain and guarding. The purpose of this study was to describe the magnetic resonance imaging (MRI) findings in adolescents with traumatic knee effusions and to compare injuries based on age, sex, and physeal maturity. ⋯ Level III.