The Pediatric Orthopaedic Society of North America (POSNA) Adopts a Member Health and Wellness Charter.
J Pediatr Orthop
Apr, 2019
The Pediatric Orthopaedic Society of North America took actions to address the well-being of its members. The epidemic of physician burnout interferes with the delivery of high-quality care that our patients and families need and deserve, and at the same time places the care-providers at an increased risk of depression and suicide. The actions taken by Pediatric Orthopaedic Society of North America serve as a model for other professional medical societies to emulate.
Intermediate to Long-term Results of Femoral Neck Lengthening (Morscher Osteotomy).
J Pediatr Orthop
Apr, 2019
Morscher osteotomy can be effective for the treatment of patients with short femoral neck and overgrowth of the greater trochanter with a positive Trendelenburg test and mild leg length discrepancy. A congruent nonarthritic hip joint is a prerequisite for the success of the operation.
Optimization of Casting in Early-onset Scoliosis.
J Pediatr Orthop
Apr, 2019
The children in group A demonstrated results very similar to the children of group B. Thus, the extra burden of shoulder straps and frequent radiographs are unnecessary.
Posttraumatic Subfibular Ossicle Formation in Children: Experience in a Single Primary Care Unit: Erratum.
J Pediatr Orthop
Apr, 2019
Outcome following olecranon osteotomy versus paratricipital approach for complex intra-articular (AO 13-C) fracture of distal humerus: a prospective comparative study.
J Shoulder Elbow Surg
Apr, 2019
The PT approach and the OO approach can be used alternatively for AO 13-C1 and -C2 fractures with similar outcomes. However, in type C3, the PT approach yields a poor outcome in comparison with the OO approach.
Morphology of the Posterior Malleolar Fracture Associated With a Spiral Distal Tibia Fracture.
J Orthop Trauma
Apr, 2019
Intra-articular extension was present in 84 patients (68.9%), with posterior malleolus fractures occurring most commonly (n = 59, 48.4%). Other fractures included plafond fractures (n = 8), medial malleolus fractures (n = 7), anterior-inferior tibiofibular ligament avulsions (n = 5), and other anterior fractures (n = 5). Forty-one of 44 (93%) posterior malleolus fractures with cross-sectional imaging were Haraguchi type I (posterolateral-oblique type) with an average angle of 24 degrees off the bimalleolar axis. The remaining 3 were type II (transverse-medial extension type) fractures. Posterior malleolus fractures were visible 61% of the time on preoperative radiographs.
Ultrasound-Guided Nerve Blocks as Analgesia for Nonoperative Management of Distal Radius Fractures-Two Consecutive Randomized Controlled Trials.
J Orthop Trauma
Apr, 2019
Although participating clinicians had minimal expertise using ultrasound-guided peripheral nerve blocks, nonoperative management of distal radius fracture using an ANB was less painful. These block types are expected to completely eradicate sensation the best. Future studies should address technical factors including adequate placement and time to let the block set up, as well as issues such as resource utilization including time and clinician availability to better determine the relative advantages and disadvantages to other analgesia techniques such as the FHB.
Is Bone Loss or Devascularization Associated With Recurrence of Osteomyelitis in Wartime Open Tibia Fractures?
Clin. Orthop. Relat. Res.
Apr, 2019
Recurrent osteomyelitis after open tibia fractures is common. In a univariate model, patients with an intermediate amount of bone loss and those treated with antibiotics for 22 to 56 days were more likely to experience osteomyelitis recurrence. Because only univariate analysis was possible, these findings should be considered preliminary. Osteomyelitis recurrence rates were similar, regardless of initial osteomyelitis classification, indicating that diagnoses of possible osteomyelitis should be treated aggressively.
Osteonecrosis of the Femoral Head.
Orthop. Clin. North Am.
Apr, 2019
Osteonecrosis of the femoral head most commonly arises from trauma or corticosteroid and alcohol use but is also associated with blood dyscrasias and metabolic and coagulation disorders. Initial evaluation includes a history and physical examination and plain radiographs. Early-stage osteonecrosis is best evaluated by MRI. The Ficat and Arlet classification system is the most widely used. Nonoperative treatment has been studied using bisphosphonates, anticoagulants, vasodilators, statins, and biophysical modalities. Operative treatment includes core decompression with or without adjuvants, such as autologous bone marrow, whereas total hip arthroplasty is reserved for advanced-stage osteonecrosis in older patients or those who have failed ...
Osteogenesis Imperfecta: A Pediatric Orthopedic Perspective.
Orthop. Clin. North Am.
Apr, 2019
Osteogenesis imperfecta is a genetically and phenotypically heterogeneous disorder related to a defect or deficiency in the production of type I collagen. It is characterized by brittle bones, fractures, spine and extremity deformity, and a host of extraskeletal manifestations. Type I collagen is present in bone, tendons, ligaments, skin, dentin, and the sclera of the eye and other connective tissues. Osteogenesis imperfecta includes a multitude of disease manifestations that may be present at birth or develop over time and vary depending on the severity of the disease. This article describes the disease presentation and management considerations from a pediatric orthopedic ...
Surgical Considerations in the Treatment of Osteoporotic Proximal Humerus Fractures.
Orthop. Clin. North Am.
Apr, 2019
Proximal humerus fractures in the setting of osteoporosis can be technically challenging. Intraoperative challenges include comminution, thin cortical bone, and crushed cancellous bone that lead to difficulties in obtaining and maintaining a reduction and hardware fixation. Loss of fixation and varus collapse continue to be problems despite the utilization of modern locking plate fixation. A clearer understanding of predictors of fixation failure and the encouraging early results of reverse total shoulder arthroplasty (RTSA) have resulted in increased utilization of RTSA for the primary treatment of proximal humerus fractures.