Journal of pediatric orthopedics
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Comparative Study
Comparative analysis of hook, hybrid, and pedicle screw instrumentation in the posterior treatment of adolescent idiopathic scoliosis.
Spinal instrumentation in adolescent idiopathic scoliosis (AIS) aims to correct spinal deformity and maintain long-term spinal stability until bony healing is ensured. The purpose of this study was to compare the minimum 2-year postoperative radiographic and clinical results of posterior spine correction and fusion with all-hook instrumentation versus hybrid segmental instrumentation versus pedicle screw instrumentation for AIS from a single institution. ⋯ Therapeutic level III retrospective comparative study.
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A nursemaid's elbow most frequently occurs with transient longitudinal traction of the pronated forearm and extended elbow, which can be reduced by manipulation without sedation. There are circumstances in which the history is atypical and reduction of the elbow is unsuccessful. Imaging may be helpful in these cases. ⋯ IV.
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With increases in use and power of all-terrain vehicles (ATVs), there have been dramatic increases in both the number and severity of ATV-related injuries. The KIDS database showed a 240% increase in the number of children admitted to a hospital for an ATV-related injury between 1997 and 2006. Over the same time period, there was a 476% increase in the number of children with ATV-related spine injuries. To better understand the nature of these injuries, a series of pediatric ATV-related spine fractures at a regional pediatric trauma center were analyzed. ⋯ ATV-related spine injuries in children and adolescents are high-energy injuries with a high rate of associated spine and nonspine injuries. ATV-related spine injuries are different from other ATV-related injuries in children in that they are more common in older children and in females. As musculoskeletal injuries are the most common ATV-related injuries in children, orthopaedic surgeons need to be aware of these differences, and have a high index of suspicion for associated injuries, including additional and often noncontiguous spine injuries.
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Medial humeral epicondyle fracture displacement in children is difficult to quantify, as current methods suffer from significant intraobserver and interobserver variability. The aim of this study was to create a systematic approach to determine medial epicondyle fracture displacement based upon easily identifiable radiographic landmarks of the elbow. ⋯ This study may be helpful in assessing fracture displacement in pediatric medial epicondyle fractures.
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Adolescent clavicle fractures have traditionally been treated nonoperatively; however, recent literature in adults has shown improved outcomes with operative treatment of displaced and shortened clavicle fractures. It has been suggested that these results may translate to adolescents. This study presents an initial look at outcomes for operative treatment of displaced midshaft clavicle fractures in adolescents using an intramedullary clavicle pin. ⋯ Therapeutic level IV.