Journal of pediatric orthopedics. Part B
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Comparative Study
Intraoperative radiation exposure in displaced supracondylar humeral fractures: a comparison of surgical methods.
Crossed K-wires, descending elastic stable intramedullary nailing and radial external fixator are alternatives in the operative treatment of displaced supracondylar humeral fractures. Only little knowledge of intraoperative radiation exposure exists in those procedures. ⋯ Extensively increased fluoroscopy times was seen in cases switched from closed to open reduction intraoperatively. To avoid unnecessary intraoperative radiation exposure for patient, surgeon and staff, limits of radiation time are recommended as an additional indicator to change the surgical procedure to another fixation method or open reduction.
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A total of 154 children admitted with septic arthritis (n=81) or transient synovitis (n=73) were studied retrospectively. Ultrasound findings for 127 patients were correlated with the final diagnosis. Sensitivity, specificity and positive predictive value of ultrasound for the diagnosis of pediatric septic hip were 86.4, 89.7 and 87.9%, respectively. ⋯ Ultrasound cannot be used safely to distinguish between pediatric septic hip and transient synovitis. It may be a method of value to detect minimal hip effusion. A predictive algorithm using clinical, laboratory and ultrasound findings could be beneficial.
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Botulinum toxin acts at neuromuscular junctions close to muscle motor points and is used to help manage spastic upper-limb deformities. To develop a system allowing clinicians to identify optimal injection sites by an easily reproducible technique, forearm flexor muscles were dissected in 20 formalin-preserved human limbs. Motor points for flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis and pronator teres were (1) identified, (2) related to a reference grid based on lines (proximal, distal, lateral, medial and diagonals) drawn between forearm anatomical landmarks, and (3) defined in terms of their percentage distances along the established grid lines.
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We describe our experience with a novel surgical exsanguination tourniquet (S-MART; OHK Medical Devices, Haifa, Israel) in clinical pediatric orthopedics. We evaluated the surgical exsanguination tourniquet's properties and clinical use in 51 patients and compared our observations with our long-standing experience with the Esmarch bandage, pneumatic tourniquet and sterile stockinet. ⋯ After removal, the skin under the ring was intact in all cases. We conclude that the surgical exsanguination tourniquet is safe and valuable in our practice.
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Growth velocities, curve magnitudes, curve patterns and Risser signs of 80 consecutive untreated boys with adolescent idiopathic scoliosis were studied retrospectively and compared with the progression velocity of the curves. Growth velocity >or=4 cm/year with curves >or=25 degrees increased progression velocity of curves significantly (P<0.001). Growth velocity was fastest at skeletal ages 12-13 years but continued moderately after the age of 16 years. The major right thoracic curves were the most progressive.