Search Our Scientific Publications & Authors

Microsurgery 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopaedics and Traumatology, Division of Hand Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

Introduction: Posttraumatic brachial plexus (BP) palsy was used to be treated by reconstruction with nerve grafts. For the last two decades, nerve transfers have gained popularity and believed to be more effective than nerve grafting. The aim of this systematic review was to compare elbow flexion restoration with nerve transfers or nerve grafting after traumatic BP injury. Read More

Unfallchirurg 2019 Feb 6. Epub 2019 Feb 6.

Abt. für Kinder- und Jugendtraumatologie, Altonaer Kinderkrankenhaus gGmbH, Bleickenallee 38, 22763, Hamburg, Deutschland.

Evidence-based literature on counseling and treatment of pediatric and adolescent patients with posttraumatic deformities is scarce; however, especially around the elbow with its low remodeling potential, the number of patients with malunions presenting in outpatient clinics is not rare at all. In this review the more frequent indications for corrective surgery around the pediatric elbow are described and treatment proposals are made from the perspective of an interregional reference center for pediatric and adolescent trauma. Read More

Orthop Surg 2019 Feb 4. Epub 2019 Feb 4.

Department of Pediatric Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Objective: The treatment of missed Monteggia fracture remains a challenge, despite the various surgical methods described. The purpose of this study was to explore a new surgical technique utilizing external fixator-assisted ulnar osteotomy and to assess the surgical results in a case series.

Methods: Thirteen patients with missed Monteggia fractures were treated at our institution using this new surgical technique from August 2012 to January 2016. Read More

AJR Am J Roentgenol 2019 Jan 30:1-7. Epub 2019 Jan 30.

1 Department of Radiology, New York-Presbyterian Hospital-Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032.

Objective: The purpose of this study was to determine whether ulnar collateral ligament (UCL) insertion below the articular margin (so-called T sign) exists in the pediatric population and whether MRI features can be used to identify insertional UCL injuries in overhead athletes that are symptomatic or require surgery.

Materials And Methods: Retrospective review of elbow MR images of patients younger than 21 years from 2011 to 2017 yielded 26 control subjects who were not overhead athletes and 97 overhead athletes. According to the clinical diagnosis, 50 of the overhead athletes had symptoms. Read More

J Am Acad Orthop Surg Glob Res Rev 2018 Dec 13;2(12):e080. Epub 2018 Dec 13.

Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH (Dr. Wera), Aon Corporation, Chicago, IL (Mrs. Eisinger), American Orthopaedic Foot & Ankle Society, Chicago, IL (Mrs. Oreluk), and Department of Orthopaedic Surgery, University of Florida, Jacksonville, FL (Dr. Cannada).

Introduction: This study describes trends in the postgraduate orthopaedic surgery fellowship match from 2013 to 2017.

Methods: We determined the numbers of applicants and positions in Adult Reconstruction/Oncology, Foot and Ankle, Pediatrics, Shoulder and Elbow, Spine, Sports Medicine, and Trauma. We also defined the odds of matching in each subspecialty. Read More

J Hand Ther 2019 Jan 21. Epub 2019 Jan 21.

Department of Occupational Therapy, School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada.

Introduction: Contractures are the most common complication after traumatic injury to the elbow. Although evidence supporting the use of static progressive and serial static orthoses to help recover range of motion after these complex injuries is growing, there is currently a paucity of literature exploring its efficacy in pediatric populations.

Case Description: The following case study presents the results of the use of static progressive and serial static orthoses with a young patient who presented with both elbow extension and flexion contractures after a complex fracture dislocation injury. Read More

J Orthop 2019 Jan-Feb;16(1):31-35. Epub 2018 Dec 18.

Department of Orthopaedics and Traumatology, Sant'Andrea Hospital, University of Rome "La Sapienza", Rome, Italy.

Background: Pediatric supracondylar humeral fractures (PSHF) are most common elbow fractures among children and adolescents. While there is substantial agreement on treating type 1 and type 3 fractures (conservatively and surgically, respectively), the debate on optimal treatment of Gartland type 2 fractures is still open.We wanted to review our cases, analyzing outcomes and seeking for parameters that could help surgeons treating these injuries. Read More

Medicine (Baltimore) 2019 Jan;98(2):e13942

Department of Pediatric Surgery.

Various methods are applied in the treatment of fresh and neglected Monteggia fractures. The purpose of this retrospective study was to evaluate the efficacy of various treatment methods, and assess the complexity associated with missed radial head dislocation.All fracture patients were reviewed between Jan 2012 and Dec 2016. Read More

J Pediatr Orthop B 2019 Jan 4. Epub 2019 Jan 4.

Department of Pediatric Orthopedic, Wuhan Puai Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan, China.

The aim of this study was to analyse the management of Gartland type III supracondylar humerus fractures in children older than 10 years at our paediatric orthopaedics and to determine the clinical and radiographic long-term effects following open reduction by the small medial approach and cross-fixation with three kirschner wires. Eighty-three cases of Gartland type III supracondylar humerus fractures in children older than 10 years were treated by open reduction by the small medial approach and cross-fixation with three kirschner wires from January 2010 to December 2015. All patients were followed up from 12 to 15 months (mean: 13 months). Read More

Medicine (Baltimore) 2019 Jan;98(1):e13978

Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan.

Treatment of chronic Monteggia fracture-dislocations remains controversial in skeletally immature patients. The present study aimed to review the clinical outcomes of surgical treatment with an Ilizarov mini-fixator for chronic Monteggia fracture-dislocations in children. From April 2003 to March 2014, 5 pediatric patients (4 males, 1 female) with chronic Monteggia fracture-dislocation were treated with an Ilizarov mini-fixator at our institution. Read More

Medicine (Baltimore) 2019 Jan;98(1):e13882

Department of Pediatric Orthopedics, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi, Xi'an, China.

Cubitus varus deformity is common in children. The purpose of this study was to assess the usefulness of computer simulation based on three-dimensional computed tomography (3D-CT) reconstruction with regard to preoperative planning and surgical treatment in children with traumatic cubitus varus deformity.The study included 13 patients with traumatic cubitus varus deformity between January 2012 and January 2015. Read More

Arch Pediatr 2019 Jan 13;26(1):38-43. Epub 2018 Dec 13.

Orthopedics department, Sahloul University, Hospital Sousse Tunisia, 4045 Sousse, Tunisia.

Introduction: Septic elbow arthritis is a rare disease, especially in children. The aim of this study was to report the functional outcome of our pediatric population with both demographic and microbiological features.

Methods: We retrospectively reviewed all our cases of pediatric septic elbow arthritis between 2007 and 2017. Read More

Indian J Orthop 2018 Nov-Dec;52(6):678-681

Department of Radiology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

Pediatric elbow dislocations are rare injuries and are often accompanied by concomitant fractures. We report a rare case of medial dislocation of the right elbow without accompanying fracture in a 10.5-year-old boy after fall from a bicycle. Read More

Curr Sports Med Rep 2018 Dec;17(12):407-409

Georgetown University School of Medicine, MedStar National Rehabilitation Network, Washington, DC.

Platelet-rich plasma (PRP), as a regenerative treatment for partial ulnar collateral ligament (UCL) tears, is validated to lead to faster clinical recovery and return to play in adult athletes. However, studies examining such a role of PRP in younger pediatric and adolescent athletes are scarce. A 14-year-old adolescent throwing athlete, a right-handed pitcher, presented with chronic right medial elbow pain discovered to be secondary to a partial UCL tear, as identified on both ultrasound and magnetic resonance imaging. Read More

J Pediatr Orthop 2018 Nov 13. Epub 2018 Nov 13.

Department of Orthopedic Surgery, Washington University School of Medicine, Saint Louis Children's Hospital, St. Louis, MO.

Background: Opioids are a commonly utilized component of pain management following pediatric extremity fractures, yet an increasing number of adolescents and children are falling victim to their negative effects. The purpose of this study was to examine opioid use in the pediatric fracture population by determining and comparing the average hospital opioid dosage utilized in the operative pediatric elbow and femur fractures and determining and comparing the average dose prescribed following operative treatment of elbow and femur fractures.

Methods: All elbow and femur fractures treated operatively between January and December 2016 were identified. Read More

Ulus Travma Acil Cerrahi Derg 2018 Sep;24(5):474-480

Department of Orthopedics and Traumatology, Health Sciences University Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul.

Background: Forearm fractures constitute approximately 40% of all pediatric fractures. Generally, in conservative treatment,a plaster cast is applied with the elbow in 90° flexion. Success of the treatment depends on theprevention of the reduction in the correct position and suitable duration of the plaster cast. Read More

J Burn Care Res 2019 Jan;40(1):107-111

Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children-Galveston® Galveston, Texas.

Electrical injuries induce substantial morbidity and mortality. Amputations are often necessary to enable survival and based on tissue nonviability, development of life-threatening infection, or expected nonfunctional outcome. They analyzed occurrence and type of amputations in their institution for electrical and nonelectrical pediatric burns and the number of reconstructive operations. Read More

J Hand Surg Am 2019 Jan 23;44(1):9-17. Epub 2018 Oct 23.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, SC, Brazil.

Purpose: With ulnar nerve injuries, paralysis of the first dorsal interosseous (FDI) and the adductor pollicis (ADP) muscles weakens pinch. The likelihood that these muscles will be reinnervated following ulnar nerve repair around the elbow is very low. To overcome this obstacle, we propose a more distal repair: transferring the opponens pollicis motor branch (OPB) to the terminal division of the deep branch of the ulnar nerve (TDDBUN). Read More

Trauma Case Rep 2018 Oct 29;17:14-17. Epub 2018 Sep 29.

Department of Orthopaedics, Penn State College of Medicine, Hershey, PA, USA.

A long arm cast with the elbow extended is a useful but often forgotten technique to manage some pediatric fractures. Specifically, proximal forearm fractures of both the radius and ulna, olecranon fractures, flexion-type supracondylar fractures and type II Monteggia fractures are well managed in this manner. Although some of these fractures are seen infrequently, timely diagnosis and treatment are essential to prevent complications. Read More

AJR Am J Roentgenol 2018 Dec 9;211(6):1361-1368. Epub 2018 Oct 9.

1 Department of Radiology, Keck School of Medicine of USC, 1441 Eastlake Ave, Ste 2315B, Los Angeles, CA 90033.

Objective: The purpose of this study is to determine whether a deep convolutional neural network (DCNN) trained on a dataset of limited size can accurately diagnose traumatic pediatric elbow effusion on lateral radiographs.

Materials And Methods: A total of 901 lateral elbow radiographs from 882 pediatric patients who presented to the emergency department with upper extremity trauma were divided into a training set (657 images), a validation set (115 images), and an independent test set (129 images). The training set was used to train DCNNs of varying depth, architecture, and parameter initialization, some trained from randomly initialized parameter weights and others trained using parameter weights derived from pretraining on an ImageNet dataset. Read More

Injury 2018 Nov 27;49 Suppl 3:S37-S42. Epub 2018 Sep 27.

Orthopedic and Traumatology Unit, Cesare Arrigo Children's Hospital, Spalto Marengo 46, Alessandria, Italy.

Introduction: Supracondylar humerus fractures are the most common elbow injuries in children. The widely adopted approach for Gartland III extension type consists of closed reduction and percutaneous pinning; the pin configuration can be lateral or crossed in relationship with the habit of the surgeons. Iatrogenic injury of the ulnar nerve is the most common risk during the insertion of the medial pin. Read More

Curr Rev Musculoskelet Med 2018 Dec;11(4):598-606

Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, UniversitàdegliStudi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.

Purpose Of Review: Platelet-rich plasma is used in many orthopedic pathologies such as tendinopathies and ligament injuries. The clinical results reported in the scientific literature are, however, confusing. The aim of this manuscript is to provide a narrative literature review regarding the role of PRP in the most common elbow soft tissue pathologies. Read More

J Exp Orthop 2018 Sep 18;5(1):36. Epub 2018 Sep 18.

Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, 1215 21st Ave. South, Suite 4200 MCE, South Tower, Nashville, TN, 37232, USA.

Background: Peri-articular injury may result in functional deficits and pain. In particular, post-traumatic elbow stiffness is a debilitating condition, precluding patients from performing activities of daily living. As such, clinicians and basic scientists alike, aim to develop novel therapeutic interventions to prevent and treat elbow stiffness; thereby reducing patient morbidity. Read More

J Shoulder Elbow Surg 2018 Nov 14;27(11):e337-e343. Epub 2018 Sep 14.

Department of Orthopedic Surgery, University Hospitals Leuven, Pellenberg, Belgium.

Background: Pediatric Monteggia fractures are relatively rare and are commonly missed. Radial head subluxation can persist with long-term consequences if these fractures are left untreated. We evaluated the long-term treatment outcomes after open reduction with ulnar osteotomy for missed Monteggia fractures during childhood. Read More

Orthop Clin North Am 2018 Oct 16;49(4):477-490. Epub 2018 Aug 16.

Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2017, Cincinnati, OH 45229, USA.

Distal radius fractures are the most common site of fracture in the pediatric population. Supracondylar humerus fractures are the most common pediatric elbow fracture. Although there is abundant literature discussing treatment and outcomes of these fractures, there is only emerging literature specifically discussing the variation in care among surgeons. Read More

J Am Acad Orthop Surg Glob Res Rev 2017 Nov 1;1(8):e040. Epub 2017 Nov 1.

Department of Orthopedic Surgery, New York Presbyterian, Columbia University Medical Center, New York, NY (Dr. Popkin, Dr. Rosenwasser), and the Department of Orthopaedic Surgery, University of Texas Southwestern, Children's Medical Center, Texas Scottish Rite Hospital for Children, Dallas, TX (Dr. Ellis).

Although fractures of the elbow are extremely common in pediatric patients, the T-type distal humerus fracture is rare and offers unique challenges. The mechanism of injury may be similar to the adult counterpart and is usually caused by a fall onto a flexed elbow or from a direct blow. Diagnosing these injuries may be difficult. Read More

Childs Nerv Syst 2019 Jan 12;35(1):37-45. Epub 2018 Sep 12.

Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.

Introduction: Entrapment neuropathies are infrequent in children, and therefore remain unrecognized. The incidence of radial, median, and cubital mononeuropathies are all similar. Despite the rarity of such cases, extensive, albeit scattered, literature has accumulated concerning entrapment neuropathies in children. Read More

Medicine (Baltimore) 2018 Sep;97(36):e12161

Pediatric Orthopaedic Surgery, Lenval University Children's Hospital.

Rationale: Tumors of the scaphoid are rare, and some can cause pathological fractures. No cases of pathological fractures of the scaphoid have been reported in children. The most common treatment for pathologic fractures of the scaphoid bone associated with a benign lesion in adults is surgical, with intralesional curettage associated with autologous bone grafting and internal fixation. Read More

JBJS Rev 2018 Sep;6(9):e2

Department of Orthopedics, Mayo Clinic-Arizona, Phoenix, Arizona.

Background: The minimum clinically important difference (MCID) attempts to define the patient's experience of treatment outcomes. Efforts at calculating the MCID have yielded multiple and inconsistent MCID values. The purposes of this review were to describe the usage of the MCID in the most recent orthopaedic literature, to explain the limitations of its current uses, and to clarify the underpinnings of the MCID calculation, so as to help practitioners to understand and utilize the MCID and to guide future efforts to calculate the MCID. Read More

JBJS Rev 2018 Sep;6(9):e1

Department of Orthopaedics, Mayo Clinic-Arizona, Phoenix, Arizona.

Background: The minimum clinically important difference (MCID) attempts to define the patient's experience of treatment outcomes. Efforts at calculating the MCID have yielded multiple and inconsistent MCID values. The purposes of this review were to describe the usage of the MCID in the most recent orthopaedic literature, to explain the limitations of its current uses, and to clarify the underpinnings of MCID calculation. Read More

Semin Ultrasound CT MR 2018 Aug 23;39(4):384-396. Epub 2018 Mar 23.

Department of Radiology, UMass Memorial Medical Center, Worcester, MA.

Elbow trauma in children is one of the most commonly encountered musculoskeletal injuries in pediatric radiology. However, elbow injuries in children can be misdiagnosed due to secondary ossification centers unique to pediatric patients. Familiarity of the normal elbow anatomy in children is crucial for an accurate diagnosis. Read More

Arch Argent Pediatr 2018 Aug;116(4):e630-e634

Instituto de Ortopedia y Traumatología "Carlos Ottolenghi", Hospital Italiano de Buenos Aires.

Anterior radial head dislocation in pediatric population is related to Monteggia fracture-dislocations. Isolated radial head dislocation is uncommon. Sometimes, radial head dislocation becomes irreducible. Read More

Cureus 2018 May 10;10(5):e2609. Epub 2018 May 10.

Emergency Department, IWK Health Centre.

Introduction: In 2007, the Canadian Pediatric Society (CPS) advised against the recreational use of trampolines at home and reaffirmed that statement in 2013. We evaluated the impact of this position statement on trampoline-related injuries at the IWK Health Centre in Halifax, Nova Scotia.

Methods: We completed a retrospective analysis (2001-2015) using the IWK Health Centre's Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. Read More

J Pediatr Orthop 2018 Oct;38(9):e507-e513

Department of Orthopaedic Surgery, The Mount Sinai Icahn School of Medicine, New York, NY.

Background: Elbow contracture is a sequelae of elbow trauma in pediatric patients. Arthroscopic contracture release has been shown to provide equivalent results to open contracture release with less associated morbidity and complications in the adult population. However, open contracture release is still commonly utilized in pediatric patients. Read More

BMJ Case Rep 2018 Jun 29;2018. Epub 2018 Jun 29.

Sports Medicine, Mayo Clinic, Jacksonville, FL, USA.

An adolescent, right hand-dominant, baseball pitcher presented to sports medicine clinic with posterolateral right elbow pain over 4 months. He rated his pain as 8/10 with pitching, especially at the late cocking phase of throwing. Prior to consult, he had rested 3 months from pitching, progressing to strengthening exercises, with no pain relief. Read More

Injury 2018 Aug 19;49(8):1381-1391. Epub 2018 Jun 19.

Department of Biostatistics, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

Background: A number of surgical approaches have been described for open reduction and internal fixation (ORIF) of intra-articular distal humerus (IDH) fractures in adults. However, there is no consensus as to which approach is better in terms of functional outcomes and complications. The purpose of this study was to determine whether the functional outcomes and types and rates of complications are influenced by the choice of surgical approach for ORIF of IDH fractures (AO/OTA types 13 B & C). Read More

Cureus 2018 Apr 16;10(4):e2484. Epub 2018 Apr 16.

Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch.

In this article, we report a case series on spanning external fixation for the treatment of open joint burn injuries in a pediatric population. We reviewed the case logs of all orthopedic surgeons from 2000 to 2010 at a burn hospital to identify pediatric patients with open joints secondary to burn injuries. Nine patients who sustained open joint injuries after a burn and treated with a spanning external fixator (SEF) were identified. Read More

J Pediatr Orthop 2018 Sep;38(8):e429-e433

Pediatric Orthopedics and Scoliosis Center, Rady Children's Hospital.

Background: Lateral condyle fractures of the distal humerus are the second most common pediatric elbow fracture. A difference of 1 or 2 mm in fracture displacement measurement may change the operative or nonoperative management of a minimally displaced fracture. The goal of this study was to determine the interobserver and intraobserver agreement in the measurements of displacement of lateral condyle fractures of the humerus. Read More

J Hand Surg Am 2018 Dec 11;43(12):1140.e1-1140.e6. Epub 2018 Jun 11.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, Brazil.

Purpose: To report the results of radial nerve grafting in 7 children who sustained a radial nerve injury following a distal humeral fracture.

Methods: Seven children, mean age 6 years (range, 4-11 years), underwent nerve grafting for radial nerve injuries following distal humeral fractures. The mean interval between injury and surgery was 6. Read More

J Shoulder Elbow Surg 2018 Oct 30;27(10):1779-1784. Epub 2018 May 30.

Pediatric Hand Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain.

Background: Glenohumeral (GH) contractures appear in most patients with incomplete motor recovery as a result of progressive development of periarticular muscle contractures. The objectives of this study were to describe a method to measure the passive range of motion of the glenohumeral joint (GHJ) in patients with brachial plexus birth palsy (BPBP) and to evaluate its intraobserver and interobserver reproducibility.

Methods: Three orthopedic surgeons measured the passive GHJ mobility of 25 patients older than 4 years with unilateral BPBP. Read More

J Orthop Case Rep 2018 Jan-Feb;8(1):8-10

Department of Orthopaedics and Traumatology, Emsey Hospital, Istanbul, Turkey.

Introduction: Elbow dislocation accounts 3-6% of all pediatric elbow injuries. Medial epicondyle is the most common fracture related to the elbow dislocation in pediatric population. About 15-18% of medial epicondyle fractures related to dislocation present with the incarceration of medial epicondyle in the elbow joint after reduction. Read More

Case Rep Orthop 2018 9;2018:8986230. Epub 2018 May 9.

Department of Orthopaedic Surgery, Emory University School of Medicine, 59 Executive Park S, Atlanta, GA 30329, USA.

Anterior elbow dislocations in the pediatric population represent rare and sometimes difficult injuries to manage. Associated olecranon fractures are even more uncommon with limited literature existing on the topic. We present the case of a six-year-old male with a traumatic transolecranon anterior elbow fracture dislocation in whom closed reduction was prevented by buttonholing of the proximal ulna through the anterior joint capsule. Read More

Case Rep Orthop 2018 19;2018:5131639. Epub 2018 Feb 19.

Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, 4202 Doctors' Office Tower, 2200 Children's Way, Nashville, TN 37232-9565, USA.

Posttraumatic proximal radioulnar synostosis (PPRUS) is a severe complication of radial head and neck fractures known to occur after severe injury or operative fixation. Cases of PPRUS occurring after minimally displaced, nonoperatively treated radial neck injuries are, by contrast, extremely rare. Here, we present a pediatric case of PPRUS that developed after a nonoperatively treated minimally displaced radial neck fracture with concomitant olecranon fracture. Read More

Eur J Orthop Surg Traumatol 2018 Oct 2;28(7):1441-1445. Epub 2018 May 2.

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.

Fracture of lateral condyle with dislocation of the elbow joint is rare in pediatric age. Diagnosis and management of these injuries could be a challenge. Delayed presentation of such injuries could be mistaken for a malunited supracondylar fracture of the humerus and treatment of these injuries remains controversial. Read More

Orthopedics 2018 Jul 30;41(4):e502-e505. Epub 2018 Apr 30.

The Gartland classification of pediatric supracondylar humerus (SCH) fractures is commonly used but inconsistently defined regarding type 1 and type 2 (posteriorly hinged) SCH fractures. This study examined the reliability of the anterior humeral line (AHL) index compared with the Gartland classification. Fifty consecutive SCH fractures on anteroposterior and lateral elbow radiographs in pediatric patients (age range, 18 months to 15 years) were classified by 11 observers (9 attendings and 2 residents) according to the Gartland classification (types 1, 2, and 3) and the AHL index (AHL0, AHL passes anterior to the capitellum; AHL1, anterior one-third capitellum; and AHL2, middle one-third capitellum), with recommendations for treatment (cast immobilization vs surgery). Read More

J Pediatr 2018 07 19;198:214-219.e2. Epub 2018 Apr 19.

Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital at Montefiore / Albert Einstein College of Medicine, Bronx, NY.

Objectives: To determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics.

Study Design: This was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. Read More

J Pediatr Orthop 2018 May/Jun;38(5):e257-e261

Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA.

Introduction: Lateral condyle fractures are a common pediatric elbow injury. Nonunion is a known complication of this injury but its incidence and causative risk factors are unknown. Further, a clear and consistent definition of nonunion for pediatric lateral condyle fractures does not exist. Read More

J Clin Orthop Trauma 2018 Mar 24;9(Suppl 1):S40-S43. Epub 2017 Jul 24.

Department of Orthopedics, SAMC & PGI, Indore, India.

Objectives: This study aims to determine the various epidemiological factors responsible for orthopedic trauma cases: how do weather patterns, month, season and public working schedule influence the daily frequency of orthopedic trauma.

Material And Methods: This was a descriptive study performed in the Department of Orthopedics at a tertiary care centre in central India Participants: 7980 trauma cases reported in our study period. Study variables: Demographic characteristics of the cases, time, day, the month of injury and type of trauma and cause of trauma. Read More

J Orthop Surg Res 2018 Apr 3;13(1):68. Epub 2018 Apr 3.

Department of Pediatric Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010030, Inner Mongolia Autonomous Region, China.

Background: The standard treatment for severe displaced pediatric supracondylar humeral fracture (SCHF) is closed reduction and percutaneous pin fixation. However, controversy persists concerning the optimal pin fixation technique. The purpose of this study was to compare the safety and efficacy on the configuration of lateral entry only with crossed entry pin fixation for SCHF, including Gartland type II and type III fractures in children. Read More

J Pediatr Orthop 2018 May/Jun;38(5):e252-e256

Department of Orthopaedic Surgery, Baylor College of Medicine.

Purpose: Although acute compartment syndrome (ACS) is associated with pediatric supracondylar humerus (SCH) fractures, there are limited data describing its incidence and risk factors. The purpose of our study was to report the local and national incidence of ACS with SCH and floating elbow (concomitant SCH and forearm) fracture patterns and the associated risk factors.

Methods: We retrospectively queried data for SCH fracture patients over a 4-year period from our institution (a level I pediatric trauma center) and the National Trauma Data Bank (NTDB). Read More