Journal of pediatric orthopedics
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Tibial shaft fractures are common injuries in the adolescent age group. Potential complications from the injury or treatment include infection, implant migration, neurovascular injury, compartment syndrome, malunion, or nonunion. ⋯ The majority of adolescent tibia shaft fractures can be successfully managed with closed reduction and cast immobilization. Unstable fractures that have failed cast treatment should be treated operatively. Flexible intramedullary nailing, rigid intramedullary nailing, plate and screw osteosynthesis, and external fixation are acceptable treatment options that may be considered for an individual patient depending upon the clinical scenario.
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Meta Analysis
Flexible Intramedullary Nailing of Femoral Shaft Fractures in Children Weighing ≥40 kg: A Systematic Review and Meta-analysis.
Pediatric femur fractures are commonly treated with flexible intramedullary nails (FIN). However, there is controversy regarding the effect of patient weight on outcomes and complications. The purpose of this meta-analysis was to review the literature and describe implant choice, analyze complication, and reoperation rates; as well as the report clinical and radiographic outcomes of FIN in pediatric patients weighing ≥40 kg with femoral shaft fractures. ⋯ Level III-systematic review of level-III studies.
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Never before has physician suffering received as much attention in the peer-reviewed medical literature and popular media as now. The purpose of this paper is to propose that the manner in which these concerns are being addressed is further complicating physician and medical family well-being due to the perpetuation of work ambivalence. ⋯ Both clinical experience and research suggest that physician well-being can be enhanced by coaching physicians to protect positive engagement in their work while practicing resilience-enhancing tactics and strategies.
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The members and leadership of the Pediatric Orthopaedic Society of North America (POSNA) continue to expand awareness of the impact of burnout on the delivery of care and on the health care professionals that are critical to delivering that care. Surgeon coaching, when appropriately defined, shows considerable promise as a method to create positive change in our team environment and practice, our organizational culture, and our own wellness. ⋯ High-performance surgeons engage in coaching to maintain or amplify that passion for performance improvement in anything and everything. It does not matter whether you are seeking coaching for juggling the many priorities in your life and practice; dealing with difficult outcomes, litigation, or personal stress; refining a technique or skill; addressing burnout; climbing to the next level of your career; training for or sustaining the marathon of a surgical career; implementing incremental steps or changes; or practicing wellness in your own way. Any way you look at it, coaching and coaching skills can be a positive influence and an avenue to even greater success for surgeons in their life and career.
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Upper extremity fractures are the most common fractures in children. Many high-quality studies have been reported regarding operative and nonoperative treatment of different upper extremity fractures in children. This review will summarize the literature on 4 major upper extremity fractures in children over the past 5 years. ⋯ Level IV.