Journal of pediatric orthopedics. Part B
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This study sought to evaluate the incidence of neurologic injury in children referred for manipulation in our hospital. A retrospective chart analysis of the first 100 children to be referred with a fracture of any segment of the radius and/or ulna was performed. ⋯ Clinicians require a high index of suspicion when evaluating forearm fractures. If neurologic injury is missed at initial assessment, the child may not receive a prompt reduction, thus increasing the likelihood of long-term sequelae.
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Case Reports
Delayed ulnar nerve palsy after open reduction and internal fixation of medial epicondylar fractures.
We present two cases of patients with delayed ulnar nerve palsies after operative fixation of displaced medial epicondyle fractures. These fractures are common childhood injuries and the optimal management for the ulnar nerve is not universally agreed. The ulnar nerve is at risk of compression distal to the elbow and where surgical decompression is selected, care must be taken to ensure that this is complete.
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Review Case Reports
A rare case of infantile myofibromatosis and review of literature.
Infantile myofibromatosis is a rare benign tumor-disease (1/400,000). Four different types have been reported in literature. The most commonly affected body areas are the head, the neck, and the trunk. ⋯ The data of the literature review underline that a wait-and-see-policy should be considered as the first treatment of choice as in most instances the bony lesions regress spontaneously. However, a thorough examination has to be carried out to exclude lesion in other organs like gastro-intestinal or cardio-pulmonary nodular tumor masses. In conclusion, the present case report and the literature review support the notion that infantile myofibromatosis should be considered as a possible differential diagnosis for soft tissue expansions and/or osteolytic lesions in a newborn.
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The neuromuscular sequaelae of Guillain-Barré syndrome are well documented in the literature. Persistent distal muscular weakness and loss of peripheral limb reflexes are common in those affected. We report a case of a 14-year-old boy who developed the Miller-Fisher variant of Guillain-Barré syndrome at the age of 8 years. ⋯ The scoliosis was successfully treated with posterior instrumentation and fusion surgery. Neuromuscular scoliosis is rare following Guillain-Barré syndrome, with no previous reports associated with the Miller-Fisher variant that we are aware of. When evaluating patients post Guillain-Barré syndrome, structural spinal examination is essential to identify rare deformity that may need surgical correction.
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Localized, bilateral, painless, nonpruritic and symmetric papuloid lesions in the posteromedial part of the foot are the clinical features of benign plantar nodules of the heel in children. They are probably congenital; they are asymptomatic and benign. We present 18 children with posteromedial nodules of the heel, 15 bilateral. ⋯ At the end of follow-up, all the patients are asymptomatic with normal functional outcome and with the lump persisting in all but one. In conclusion, a sonographic study is sufficient to diagnose this type of mass, without the need for biopsy and/or surgical exeresis to distinguish fatty tissue from another type of consistency. Subsequent studies should aim at showing piezogenic, hamartomatous or congenital fat herniation aetiology of these typical lumps, probably normal variant of normality.