ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to compare prospectively the distributions, validity, and discriminative ability of three pediatric outcome questionnaires. Consecutive patients completed the Activities Scales for Kids (ASK), the Child Health Questionnaire Parent Form (CHQ-PF-28), and the Pediatrics Outcomes Data Collection Instrument (PODCI). The scores of the three instruments were compared with each other and with parents' and clinicians' ratings. Of 210 patients, 166 (79%) completed the three questionnaires. The CHQ-PF-28 had a different distribution than the other two questionnaires and showed both floor and ceiling effects. The ASK and PODCI instruments were highly correlated and discriminated better than the CHQ-PF-28, with fewer floor and ceiling effects. Each questionnaire, however, seemed to be measuring slightly different things.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A standing anteroposterior pelvic radiograph with gonadal shielding is used as a screening tool for all patients evaluated for intoeing at our institution. Sixty-two normal consecutive screening pelvic radiographs obtained in 61 female patients between the ages of 4 and 6 years were evaluated. Radiographs were evaluated for the adequacy to assess the hips as well as the protection afforded the ovaries from radiation exposure. Radiographs were judged to be inadequate because the shield covered essential landmarks in at least one hip in eight radiographs (13%). Five radiographs (8%) covered >50% of the area of both ovaries, and only one radiograph covered >75% of the area of both ovaries. Standard techniques of positioning gonadal shields in preadolescent girls are inadequate and provide minimal protection with a high rate of interference with vital landmarks. We no longer advocate using gonadal shields on initial screening radiographs of preadolescent girls.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This study aimed to determine treatment preference of various femoral fracture patterns in children by pediatric orthopedists and whether it is practice dependent. In September 1998, members of the Pediatric Orthopedic Society of North America were surveyed to determine their current preferences in treating each of four middle one-third femoral fracture patterns in four age groups. Forty-four percent (286/656) of those surveyed responded. For each fracture pattern, operative treatment was increasingly preferred over nonoperative as patient age increased, and the preferred treatments within the operative and nonoperative categories changed significantly as patient age increased. Fourteen specific cases of femoral head avascular necrosis were noted after rigid reamed and unreamed rodding. There is a statistically significant trend by pediatric orthopedists to treat older children's femur fractures operatively and younger children's nonoperatively. The consensus treatment is age dependent. The numerous cases of avascular necrosis after rigid rodding are a concern.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Biomechanical testing was performed to determine the effects of flexible intramedullary nail fixation on simulated transverse and comminuted midshaft femur fractures using two Ender nails. A synthetic adolescent-size femur model was used. The axial and rotational stiffness values for the simulated comminuted fracture were equivalent to those of the transverse fracture under “touch-down weight-bearing” loads. These data suggest that length and rotational control of comminuted midshaft femur fractures with two divergent Ender nails may be sufficient for early mobilization.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Pediatric pelvic fractures are serious injuries. Anatomical differences exist between pediatric and adult populations, leading to different causes and rates of death, fracture patterns, and associated injuries. This study is the largest consecutive series of pediatric pelvic fractures from one institution emphasizing the unique aspects seen in pediatrics. One hundred sixty-six children were included. Plain radiography and computed tomography scans were used to classify pelvic fractures. Multisystem injuries occurred in 60%, and 50% sustained additional skeletal injuries. The death rate was 3.6%. Head and/or visceral injuries were the causes of all deaths. Life-threatening hemorrhage did not occur. Urethral injury was not seen as often as in adults. Anterior ring fractures were the most common type, dominated by pedestrian versus motor vehicle trauma. Anatomical differences and mechanism of injury may play a role in these contrasting findings.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A comminuted coronal split fracture of the proximal tibial epiphysis is an uncommon injury in children. The authors evaluated and treated two patients who sustained an epiphyseal fracture through a partially closed proximal tibial epiphysis. Plain radiography and computed tomography with three-dimensional reconstruction showed a comminuted coronal split fracture of the proximal tibial epiphysis. Each patient underwent definitive operative fixation of the fracture and was followed at least 1 year after clinical union. A mechanism consisting of three-point bending on the tibial plateau is proposed.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A retrospective review of 16 patients with floating elbow injuries over a 9-year period at a tertiary care children's hospital confirms that these injuries are associated with substantial swelling and the potential to develop compartment syndrome, particularly when circumferential cast immobilization is used. Among 10 patients in whom the forearm was treated with closed reduction and plaster immobilization, a compartment syndrome developed in 2, and 4 patients had incipient compartment syndrome that responded to splitting of the cast; 3 of these subsequently required remanipulation of the distal radius. One patient with compartment syndrome had Volkmann ischemic contracture. Six patients underwent stabilization of both the distal humeral and forearm fractures with percutaneously inserted Kirschner wires, thereby allowing postreduction immobilization in a split cast. None of these patients had problems with excessive swelling or compartment syndrome. Percutaneous Kirschner wire fixation of both the humeral and forearm fractures in pediatric floating elbow injuries allows noncircumferential immobilization, thereby reducing the risk of compartment syndrome.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Flexion-type supracondylar elbow fractures are uncommon in children. Minimally displaced fractures were treated in plaster cast in 7 children, and 22 children with a displaced fracture were treated by closed reduction and percutaneous pinning. Results after an average follow-up of 6.3 years showed that the treatment of choice yielded excellent or good results in 86.2% of the patients. All patients were satisfied with the end result and had normal use of their elbow.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to determine the normal ranges of scapholunate distance (SLD) applicable to children. Bone age radiographs of 85 children (36 boys, 49 girls) 6 to 14 years of age were used to establish the normal ranges. Repeated-measures analysis of variance revealed significant age and gender differences. Therefore, linear regression was used to determine normal SLD ranges separately for girls and boys based on chronologic age and bone age. SLD normal ranges were similar for chronologic age and bone age. Interobserver and intraobserver agreement was excellent. There was no significant age by gender interaction found, indicating that although boys had significantly longer distances than girls, both showed a similar rate of decreasing SLD distance with age. These results provide age-and gender-based normal ranges of SLD in young children. These results may be useful in assessing traumatic soft tissue injuries about the pediatric wrist. Of note, only three girls and two boys (all 12 years or older) met the adult criterion of normal SLD of ≤2 mm.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID