Journal of pediatric orthopedics
-
The incidence and predictors of premature physeal closure (PPC) after pediatric distal tibial fractures were investigated. PPC was defined as evidence of growth plate disturbance on the injured side compared with the uninjured side. Ninety-two fractures were reviewed with at least 1 year of follow-up, or until physiologic closure of the growth plates. ⋯ Periosteum was entrapped in the physis in all of these cases. Residual gaps in the physis following closed reduction may represent entrapped periosteum in Salter-Harris I and II fractures. This can lead to a higher incidence of PPC, suggesting that open reduction and removal of the entrapped periosteum may be beneficial.
-
The purpose of this study was to determine the test characteristics of C-reactive protein (CRP) in the diagnosis of septic arthritis in children and to compare with erythrocyte sedimentation rate (ESR). The authors reviewed patients with synovial fluid aspiration sent for culture and Gram stain for whom a CRP was drawn within 24 hours of presentation. Descriptive statistics and univariate analyses were performed. ⋯ In comparison to ESR, CRP is a better independent predictor of disease. CRP is a better negative predictor than a positive predictor of disease. Indeed, if the CRP is <1.0 mg/dL, the probability that the patient does not have septic arthritis is 87%.
-
A characteristic hand friction burn secondary to a treadmill fitness machine has been seen in fourteen pediatric patients. This retrospective review looks at mechanism of injury, digit(s) involved, depth of burn, initial treatment, time to referral and its effect on the final result, and the need and results of definitive treatment. Based on our findings, certain recommendations are made to avoid potential sequela due to this hand friction burn.
-
Children with osteogenesis imperfecta (OI) often require operative management to correct limb and spinal deformities. The authors reviewed the postoperative courses of 22 children with OI and compared the febrile responses of these children with those of matched subgroups within a published historical control ( 8). The subgroups were matched for perioperative conditions including the magnitude of surgery, estimated intraoperative blood loss, transfusion status, age, and gender. ⋯ Within the OI group, TFR correlated with estimated blood loss and magnitude of surgery. There were three fever workups in the OI group with no evidence of infection found. In children with OI, fever workups and delays in hospital discharge should be avoided if physical signs of infection are absent.