Journal of pediatric orthopedics
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Case Reports
Heterotopic ossification of the hip after non-accidental injury in a child: case report.
Heterotopic ossification is bone formation that occurs in an abnormal soft tissue location, most commonly after trauma, head injury, and surgical procedures such as joint arthroplasty. We report a rare case of severe heterotopic ossification caused by nonaccidental injury in a 3-year-old child. To our knowledge, heterotopic ossification as a result of nonaccidental injury in children has been reported in only 2 other patients. Physicians should be aware of this rare presentation of nonaccidental injury, and nonaccidental injury should be considered in the differential diagnosis in children who present with heterotopic ossification.
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Supracondylar distal humerus fractures are one of the most common skeletal injuries in children. The current treatment of choice in North America is closed reduction and percutaneous pin fixation. Often surgeons leave the pins exposed beneath a cast but outside the skin. Great variation exists with respect to preoperative skin preparation, and perioperative antibiotic administration. Few data exist regarding the rate of infection and other complications. The purpose of this study is to review a large series of children to evaluate the rate of infection and other complications. ⋯ Level III retrospective comparative study.
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Randomized Controlled Trial Comparative Study
A prospective, randomized clinical study of osteochondral autologous transplantation versus microfracture for the treatment of osteochondritis dissecans in the knee joint in children.
The aim of this study was to compare the outcomes of the arthroscopic mosaic-type osteochondral autologous transplantation (OAT) and microfracture (MF) procedures for the treatment of osteochondritis dissecans (OCD) defects of the femoral condyles of the knee joint in children under the age of 18 years. ⋯ Level 1: randomized controlled trial, significant difference.
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Burst fractures are rare in the pediatric population. There is limited information available on the best treatment for these injuries. The aims of our study were to evaluate the risk of spinal cord injury (SCI) and the potential for neurologic recovery associated with pediatric burst fractures; to compare sagittal alignment between nonoperative and operative treatment; and to determine whether functional outcomes are improved after surgery. ⋯ Prognostic level 2.
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Spondylolisthesis is often diagnosed and treated on the basis of measurements obtained from radiographs. Many physicians will perform surgery regardless of the patient's symptoms above a specific slip percentage. However, current methods used to assess slip percentage are vague and lack appropriate standardization, leaving physicians to devise personal evaluation techniques. This study presents a defined method to calculate slip percentage that takes advantage of modern technology, is fast and simple to perform, and shows excellent intraobserver/interobserver reliability. ⋯ Diagnostic level III.