European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Elastic stable intramedullary nailing (ESIN) is the first-choice surgical technique for stabilizing various pediatric diaphyseal and selected metaphyseal fractures of the long bones. This technique has increasingly been applied in fractures of the small bones. Here, we report experiences with ESIN in displaced fractures of the metacarpals in children. ⋯ ESIN of the metacarpals is a safe, minimally invasive, and technically easy option in displaced fractures that warrant surgical intervention achieving excellent long-term results. Complications occurred when technical aspects to obtain stability were neglected or tendons and nerves of the hand had been injured. Stabilizing fractures of metacarpal 1 is technically challenging when compared with fractures of metacarpals 2 to 5.
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Successful treatment of tuberculosis relies on microbiological diagnosis and drug sensitivities. Due to the pauci-bacillary nature of childhood infection, this is often not possible. We describe the successful microbiological diagnosis of tuberculosis using thoracoscopic pleural nodule biopsy. ⋯ Thoracoscopic pleural biopsy is a sensitive aid to the diagnosis of pleural tuberculosis in children.
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The surgical management of multifocal necrotizing enterocolitis (NEC) remains a major challenge. The "clip-and-drop" strategy with a second-look laparotomy permits re-assessment of bowel viability after optimization, thus offering the potential of both improving survival and conserving bowel length. This study reviews the outcome of this strategy in a single regional center. ⋯ The "clip-and-drop" strategy, when used in selected patients with multifocal NEC, may help bowel conservation in survivors.
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We recently showed that fast-track pathways could be applied to only one third of patients undergoing routine pediatric surgery. The aim of this study was to investigate various fast-track elements in various procedure types irrespective of the applicability of a whole fast-track pathway. ⋯ Fast-track elements in pediatric surgery increase patient comfort, reduce hospital stay, and achieve a high patient satisfaction. We wish to emphasize the benefits of using fast-track elements irrespective of whether a whole fast-track protocol is applicable.