Journal of pediatric orthopedics. Part B
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Paediatric wrist-buckle fractures are common distal radius fractures with inherent stability. Traditional management with complete plaster-cast immobilization necessitates follow-up visits, time off school/work and hospital treatment costs. Treatment with alternative splinting, negating the need for follow-up visits and saving time and money, has been proposed. ⋯ A systematic review was performed with eight randomized-controlled trials analysed. Alternative splinting was superior to casting in terms of function, cost and convenience, but with no significantly worse pain or fracture complication level. The evidence endorses the use alternative splinting over casting in paediatric wrist-buckle fractures.
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Case Reports
Avulsion fracture of the lesser trochanter in a skeletally immature freestyle footballer.
We report the case of a skeletally immature freestyle footballer who presented with avulsion fracture of the lesser trochanter. The patient had precursor symptom before onset during a ball juggling. ⋯ This repetitive movement might cause continuous stretching stress of the iliopsoas muscle at the apophysis of the lesser trochanter, causing disruption at this site. This new sporting activity in this age cohort may have higher prevalence of this type of injury due to its unique repetitive hip flexion movement.
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Case Reports
Posterior shoulder dislocation with ipsilateral proximal humerus type 2 physeal fracture: case report.
In pediatric patients, proximal humeral physeal fractures are uncommon injuries compared with distal physeal fractures. Usually, the growth plate is the most vulnerable site of fracture in the proximal humerus. ⋯ Here, we describe a case of posterior shoulder dislocation with ipsilateral proximal humerus type 2 physeal fracture in a 9-year-old boy. We treated the patient by closed reduction and percutaneous pinning under general anesthesia.
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Since the beginning of Operation Enduring Freedom, management of Afghan military or civilian casualties including children is a priority of the battlefield medical support. The aim of this study is to describe the features of paediatric wartime extremities injuries and to analyse their management in the Kabul International Airport Combat Support Hospital. A retrospective review was carried out using the French surgical database OPEX (Service de Santé des Armées) from June 2009 to January 2013. ⋯ There were four deaths, yielding a global mortality rate of 2.6%. This study is the first to analyse specifically paediatric extremities trauma and their management at level 3 of battlefield medical facilities in recent conflicts. Except for severe burns and polytrauma, treatment of paediatric extremities injuries can be readily performed in Combat Support Hospitals by orthopaedic surgeons trained in paediatric trauma.
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This work aimed to study the pattern and epidemiology of pediatric musculoskeletal trauma and consequent morbidity in Kashmir Valley and compare the results with other studies and to formulate preventive measures and devise management strategies. This was a retrospective study of 1467 pediatric orthopedic trauma patients who presented to our hospital over a 3-year period between September 2005 and August 2008. Information was recorded in a prescribed proforma including the following: age, sex, mode of trauma, type of fracture/injury, radiological study, final diagnosis, intervention performed, and complications. ⋯ Enhanced supervision at home and school is recommended. A safer environment and better playing conditions may decrease the high frequency of trauma in pediatric patients. Dedicated trauma centers with such facilities as orthopedics, neurosurgery, and plastic surgery need to be established for the proper management of pediatric trauma.