Journal of pediatric orthopedics
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Tibial tuberosity fractures have been described as uncommon injuries, but their frequency appears to be increasing. Because of the relatively few cases reported in the literature, little is known regarding risk factors for complications. In a large group of adolescents with tibial tuberosity fractures, we noted more frequent complications in patients who had posterior metaphyseal fractures in addition to tibial tuberosity avulsion fractures. The purpose of this study was to examine the outcomes associated with this fracture pattern and compare them with tibial tuberosity fractures without the posterior component. ⋯ Level IV (case study).
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Developmental dysplasia of the hip (DDH) is a familial condition with a wide phenotypic expression. Families with high rates of DDH may have individuals with subtle phenotypic expression that can progress to osteoarthritis and require total hip arthroplasty (THA). This study compares the rates of THA in relatives of individuals with DDH with individuals in control families. ⋯ Level III.
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Supracondylar humerus fractures are widely considered the most common fracture of the elbow in children. Fractures can range from a less severe, nondisplaced type I fracture to a more severe, displaced type III fracture with no cortical contact. Type III fractures can lead to adverse physical, social, and emotional consequences if they are not treated effectively. The American Academy of Orthopaedic Surgeons recently carried out a systematic review of the literature to develop a clinical practice guideline. The guidelines provided answers for the following questions regarding the treatment for type III supracondylar fractures (1) which is the preferred treatment for displaced supracondylar fractures of the humerus: reduction and casting versus closed reduction and percutaneous pinning; (2) which is the preferred method for fixing displaced supracondylar fractures of the humerus: medial (crossed) versus lateral pinning; and lastly, (3) does open reduction cause increased stiffness or have a high rate of complication? The purpose of this paper is to summarize and highlight the major findings from this systematic review. ⋯ Level II.
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Comparative Study
Biomechanical analysis comparing titanium elastic nails with locked plating in two simulated pediatric femur fracture models.
Increasing attention is being paid to the influences that the body habitus and weight of the pediatric patient impose upon the fixation methods for femur fractures. Of the widely accepted treatment options, little biomechanical or clinical data exist comparing flexible intramedullary nailing and locked plating. The aim of this study was to compare the mechanical stability of unstable pediatric diaphyseal femur fractures fixed with titanium flexible intramedullary nails or a titanium locking plate using a synthetic femur model. ⋯ : Provide biomechanical evidence supporting the use of plating techniques in the pediatric femur fracture population.
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Supracondylar humerus fractures are the most common operative fractures in children; however, no studies describe the older child with this injury. The purpose of this study was to compare Gartland type III supracondylar humerus fractures in children older than 8 years of age with those in younger children than age 8. We hypothesized that there would be more complications in older children, reflecting a higher-energy injury mechanism. ⋯ III Retrospective cohort.