Journal of pediatric orthopedics
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Comparative Study
Closed treatment of displaced diaphyseal both-bone forearm fractures in older children and adolescents.
The management of adolescent radius and ulna diaphyseal fractures is controversial. The purpose of this study was to address the residual deformity and functional outcome following closed treatment of these fractures. Twenty-five older children and adolescents (mean age 13.3 years, range 8.8-15.5) with displaced diaphyseal both-bone forearm fractures underwent closed treatment and were followed for a mean of 49.6 weeks. ⋯ All patients achieved full elbow and wrist range of motion. Loss of forearm supination and pronation averaged 4 degrees (range 0 to 20 degrees) and 6.8 degrees (0 to 40 degrees), respectively. Closed reduction and casting of displaced both-bone diaphyseal forearm fractures, despite the residual angulation, results in satisfactory functional outcome and should remain a viable treatment option in the management of this injury.
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Comparative Study
Recurrence rates of burn contracture ankle equinus and other foot deformities in children treated with Ilizarov fixation.
The purpose of this study was to determine recurrence rates of pediatric foot and ankle burn deformities treated with the Ilizarov method. A total of 19 patients with 29 foot and ankle deformities were studied. The most common deformity treated was equinus (23). ⋯ Parents and patients should anticipate adjunctive nonoperative and operative procedures to keep their feet plantigrade as they grow. In young children, the possibility of having additional surgeries, including repeat Ilizarov procedures, should be discussed. Even older children should expect additional surgeries to prevent recurrent deformities.
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Randomized Controlled Trial Comparative Study Clinical Trial
Buckle fractures of the distal radius are safely treated in a soft bandage: a randomized prospective trial of bandage versus plaster cast.
To show that the treatment of buckle fractures of the distal radius in children in a soft bandage is an effective and safe method of treatment, a randomized prospective trial was undertaken. Patients entered the trial after diagnosis in the accident and emergency department. Allocation to either plaster cast or bandage was random. ⋯ Those in bandage showed an excellent range of movement by the first week. Results were highly positive for treatment in bandage, with no reported adverse effects and a highly desirable result for the patient. The authors would suggest a change in treatment policy for such fractures.
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Review Case Reports
Posterior divergent dislocation of the elbow in children and adolescents: a report of three cases and review of the literature.
Divergent dislocation of the elbow is defined as a specific elbow dislocation in which the distal humerus is forced between the proximal radius and ulna, resulting in separation or divergence of the proximal forearm bones. This is an uncommon injury in children, with 14 cases reported in the last 23 years. ⋯ The injury predominantly occurs in younger children because joint laxity is a predisposing cause. Early recognition, followed by a closed reduction and a 3- to 4-week period of cast immobilization, should result in a full recovery for most children.