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J Orthop Surg Res 2020 Jul 6;15(1):246. Epub 2020 Jul 6.

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Background: Postoperative pain in children has always been inadequately evaluated. This study aims to evaluate the postoperative pain response using an additional dose of brachial plexus block (BPB) for younger children receiving elbow surgeries under general anesthesia (GA).

Methods: This retrospective case-control study included pediatric patients (3-10 years) who underwent surgeries for elbow injuries between January 2015 and January 2019. Read More

Cureus 2020 May 15;12(5):e8139. Epub 2020 May 15.

Orthopaedic Surgery, University of Tennessee, Memphis, USA.

Introduction Walk-in and after-hours clinics are being increasingly utilized in orthopedics and are especially beneficial for patients with simple sprains, fractures, or overuse injuries that might otherwise require an emergency room visit. To meet the increased patient load, additional staffing often is required, which might include a family medicine physician, nurse practitioner, or physician assistant. Few studies have evaluated the performance of these non-surgeon providers in an orthopedic clinical setting. Read More

J Neurosurg Pediatr 2020 Jun 12:1-9. Epub 2020 Jun 12.

2Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona.

Objective: The goal of this study was to determine the functional efficacy of acellular processed nerve allograft (ALG) as compared to sural nerve autograft (AUG) harvested at time of surgery for children with obstetrical brachial plexus injury (OBPI).

Methods: A retrospective review of records was performed in patients who underwent surgical repair of OBPI between 2009 and 2015 at Phoenix Children's Hospital. Patients were grouped based on the type of nerve graft used (AUG using the patient's own sural nerve or decellularized processed cadaveric nerve ALG) and compared in terms of motor strength, British Medical Research Council score, functionality (Mallet scale score), surgical time, rate of complications, and need for further intervention. Read More

J Pediatr Orthop 2020 Jul;40(6):e424-e429

Department of Orthopaedics, University of Maryland Medical Center.

Purpose: Transphyseal humeral separations (TPHS) are rare injuries with only case reports and small series reported in the literature. This multicenter study aimed to assess the various patient characteristics, injury patterns, treatments, outcomes, and complications in a large series of these injuries.

Methods: A retrospective review was conducted at 5 pediatric institutions to identify TPHS that were treated surgically in patients 0 to 3 years of age over a 25-year period. Read More

Arthrosc Tech 2020 May 4;9(5):e639-e643. Epub 2020 May 4.

Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A.

Ulnar collateral ligament (UCL) injury is commonly seen in overhead throwing athletes resulting from the repetitive valgus stress placed on the medial elbow. UCL injuries (attenuation, insufficiency, or rupture) can result in medial elbow pain, a loss of pitch velocity and accuracy, and increased fatigue. Diagnosis can be made by performing a thorough physical examination along with imaging if indicated, such as ultrasound or magnetic resonance imaging. Read More

J Pediatr Orthop 2020 May 22. Epub 2020 May 22.

Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute.

Background: Managing the pulseless pediatric supracondylar humerus fracture (PSHF) remains a significant clinical decision-making challenge for the treating surgeon. The purpose of the study is to determine frequency of the treatments according to the American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria (AUC) for the PSHF with vascular injury and evaluate the appropriateness of these interventions.

Methods: We identified all PSHF with concern for vascular injury at one high volume, level 1 trauma center managed by 6 fellowship-trained pediatric orthopaedic surgeons over 4. Read More

Clin Sports Med 2020 Jul 16;39(3):575-588. Epub 2020 Apr 16.

University of Miami Sports Medicine Institute, 5555 Ponce De Leon Boulevard, Coral Gables, FL 33146, USA.

Olecranon stress fractures are a rare upper extremity fracture that primarily affects throwing athletes. The incidence of olecranon stress fractures are increasing owing to the number of patients playing and the volume of engagement in competitive sports, especially in the pediatric population. However, olecranon stress fractures can present a challenge from a management and a rehabilitation perspective owing to their vague presentation, thereby affecting how these patients are diagnosed and managed. Read More

Cureus 2020 Apr 19;12(4):e7734. Epub 2020 Apr 19.

Orthopaedic Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Introduction:  Supracondylar fractures are one of the most common fracture patterns sustained by children, and one of the most common injuries requiring operative fixation. Understanding the complications associated with supracondylar fractures is vital for the practicing orthopedic surgeon. This analysis of supracondylar fractures examined the clinically important aspects including vascular injury, compartment syndrome, neurological injury, brachialis entrapment, associated injuries, and etiologies of injury. Read More

Radiologe 2020 Jun;60(6):487-497

Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.

Background: Fractures in children are significantly more common than bone fractures in adults. Overall, they have a good prognosis regarding spontaneous correction and a restitutio ad integrum. The aim of this study is to provide an overview of established modern (low-dose radiation) imaging techniques in pediatric fractures. Read More

J Hand Surg Am 2020 May 15. Epub 2020 May 15.

Department of Orthopaedic Surgery, University of South Alabama College of Medicine, Mobile, AL.

Pediatric olecranon osteochondral flap fractures are shear injuries of the humeroulnar joint with elevation of an articular cartilaginous flap from the subchondral bone of the olecranon articular surface. All previously reported cases included an osteochondral flap containing the coronoid, with varying imaging and fixation methods used. We treated 2 pediatric patients with this injury. Read More

J Surg Res 2020 May 7;253:254-261. Epub 2020 May 7.

Information Systems, Children's Hospital of Orange County, Orange, California.

Background: Pediatric patients admitted for trauma may have unique risk factors of unplanned readmission and require condition-specific models to maximize accuracy of prediction. We used a multicenter data set on trauma admissions to study risk factors and predict unplanned 7-day readmissions with comparison to the 30-day metric.

Methods: Data from 28 hospitals in the United States consisting of 82,532 patients (95,158 encounters) were retrieved, and 75% of the data were used for building a random intercept, mixed-effects regression model, whereas the remaining were used for evaluating model performance. Read More

J Shoulder Elbow Surg 2020 May 4. Epub 2020 May 4.

Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA.

Background And Hypothesis: Sport specialization is increasingly common in youth sports and is a risk factor for lower-extremity overuse injuries. However, limited data exist on whether specialization is associated with upper-extremity (UE) overuse injuries, specifically in youth baseball players. We hypothesized that specialization in baseball and being a pitcher would be associated with poorer arm health and UE overuse injury history in the previous year. Read More

BMC Musculoskelet Disord 2020 May 6;21(1):282. Epub 2020 May 6.

Department of Orthopaedics, Children's Hospital, Zhejiang University School of Medicine, 14th Floor, Inpatient Building, No. 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China.

Background: Monteggia equivalent lesion represents a series of combined elbow and forearm injuries that resemble typical Monteggia fracture either in presentation or mechanism. The term has gradually evolved since its introduction, as sporadic case reports continued to complement it. The aim of this study was to present a furthermore type of that lesion which no previous study had reported and arouse pediatric orthopedists' additional awareness of it. Read More

Medicine (Baltimore) 2020 Apr;99(17):e19861

Department II of Orthopaedics; Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Children's Hospital of Chongqing Medical University, Chongqing, China.

The best treatment for medial humeral epicondyle fractures in children has been debated. In case of incarceration of the epicondylar fragment, particularly after elbow dislocation, several materials are used for fixation, including Kirschner wires (K-wires), metallic compression screws, tension band wire, and suture anchors. Herein, we introduce a new fixation material: the absorbable self-reinforced polylactide (SR-PLA) pin. Read More

J Pediatr Orthop 2020 Apr 7. Epub 2020 Apr 7.

Department of Orthopedic Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA.

Background: Prematurity is usually considered as a protective factor for brachial plexus birth injury (BPBI). However, BPBI can occur in the preterm infant, and can cause significant dysfunction and morbidity. There is scant literature regarding this subgroup of patients with BPBI. Read More

Phys Sportsmed 2020 Apr 7:1-6. Epub 2020 Apr 7.

The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.

: To describe common injuries of youth American football quarterbacks (QBs) cared for in a regional sports medicine center within the last 15 years.: A retrospective chart review of all male youth American football QB patients who sustained sports-related injuries at a regional pediatric medical center between 01/01/2003 and 10/01/2018. Patients were identified using to search the term 'quarterback. Read More

J Shoulder Elbow Surg 2020 Apr;29(4):845-852

Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Background: Cubitus varus deformity is a well-known late complication of supracondylar fractures in children. In this retrospective study, the primary objective was to compare clinical and radiologic outcomes of lateral closing-wedge osteotomy with either internal fixation or external fixation in pediatric patients with cubitus varus deformities.

Materials And Methods: From 2010 to 2017, 35 consecutive patients with cubitus varus deformities secondary to supracondylar fractures were included in this study. Read More

Microsurgery 2020 Mar 18. Epub 2020 Mar 18.

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

Lower-type brachial plexus injuries (BPI) are uncommon, and traditional reconstruction with tendon transfer procedures generally produce mediocre results. However, the advent of nerve transfers has rejuvenated the reconstructive options for peripheral nerve and spinal cord injuries. In this paper, we report the case 32 year-old patient with a C7-T1 avulsion BPI in whom multiple motor and sensory nerve transfers, combined with a free gracilis muscle flap transfer, were used to restore upper-limb functional defects. Read More

Injury 2020 Feb 28. Epub 2020 Feb 28.

Department of Traumatology, University of Szeged, Hungary.

Introduction: Positive role of ultrasound in the diagnosis of pediatric elbow injuries were confirmed by many papers but no comprehensive, standardized method has been developed for daily clinical practice. The aim of our prospective diagnostic study was to prove the efficacy of a five point sonographic point of care method for detecting different pediatric elbow fractures or dislocations.

Methods: Between 2016 January and 2017 March 365 children (age 1-14) with suspected closed elbow injury were enrolled in our study. Read More

Eur J Orthop Surg Traumatol 2020 Jul 14;30(5):931-937. Epub 2020 Mar 14.

Clinical Orthopaedics, Department of Clinical and Molecular Sciences, School of Medicine, Università Politecnica delle Marche, Via Conca, Torrette, 60100, Ancona, Italy.

Purpose: To describe clinical and radiographic outcomes after surgical management of angulated radial neck fracture in children.

Methods: Twenty children (aged 2-11 years) with angulated radial neck fracture with more than 30° angulations (Judet type III and IV fractures) were retrospectively reviewed. All the enrolled patients were surgically treated with percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation. Read More

Pediatr Emerg Care 2020 Mar 6. Epub 2020 Mar 6.

From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Loma Linda University Children's Hospital, Loma Linda, CA.

Objective: This study aims to better describe those patients who present with nonaxial traction mechanisms for nursemaid's elbow.

Methods: A retrospective review on patients with the International Statistical Classification of Diseases, Ninth/Tenth Revision, code for nursemaid's elbow was performed. Patients with the classic axial traction mechanism and unknown mechanism were excluded. Read More

Injury 2020 Feb 16. Epub 2020 Feb 16.

Department of Péterfy Hospital and Jenő Manninger National Institute for Traumatology, Fiumei út 17., Budapest 1081, Hungary. Electronic address:

Background: The literature places the occurrence of paediatric Monteggia lesions between 1.5% and 3% of all childhood elbow injuries. There are circumstances, which may make early correct diagnosis difficult. Read More

Radiol Case Rep 2020 May 25;15(5):498-501. Epub 2020 Feb 25.

St Joseph Regional Medical Center, 415 6th St, Lewiston, ID 83501, USA.

Acute tears or ruptures of the brachialis muscle are rare events, with only 10 cases reported to date and all of which have been in adults. We report a case of an acute, complete tear of brachialis in an 8-year-old female that occurred while the patient was practicing a gymnastic move. Although rare, this case underscores the need to include brachialis tears in the differential diagnosis for musculoskeletal injuries at the elbow in all age groups. Read More

J Clin Orthop Trauma 2020 Mar-Apr;11(2):286-290. Epub 2018 Aug 31.

Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH, United States.

Background: While hospitalizations attributed to opioid poisonings are increasing in the pediatric population, the patterns of prescribing behaviors of health care providers remains unclear. The aims of this study were to identify the opioid prescribing patterns of an orthopaedic team for post-surgical pediatric orthopaedic fracture patients, and to examine whether patient demographics, injury type, and type of providers were associated with the opioid prescribing patterns at discharge.

Methods: A retrospective chart review was performed among all patients aged 0-18 years undergoing surgery for elbow, forearm, wrist, femur, tibia and ankle fractures between 2014 and 2016 at a large children's hospital. Read More

Injury 2020 Feb 19. Epub 2020 Feb 19.

University of Szeged, Department of Traumatology, Hungary.

Introduction: Pulled elbow (PE) is one of the most common injury in children under the age of five years. Diagnosis of PE is usually based on the typical anamnesis and clinical symptoms. A simple reduction maneuver without the need of any imaging modality can eliminate the problem. Read More

Am J Case Rep 2020 Feb 21;21:e921293. Epub 2020 Feb 21.

Department of Orthopaedics and Traumatology Surgery, Papageorgiou General Hospital, Thessaloniki, Greece.

BACKGROUND Supracondylar humeral fracture is a common fracture in the pediatric population. Although extension-type is the most common fracture pattern (97% to 98%), flexion-type supracondylar fractures are rarely encountered (2% to 3%). The combination of a flexion-type supracondylar humeral fracture with an ulnar nerve injury represents a real challenge for an orthopaedic surgeon. Read More

J Pediatr Orthop 2020 Aug;40(7):329-333

Department of Orthopedics and Sports Medicine, Nemours Children's Hospital and Specialty Care, Orlando, FL.

Purpose: Repeat intervention for pediatric forearm fractures after closed manipulation is as high as 46% with flexed elbow (FE) long-arm casts. Casting with the elbow extended (EE) has been advocated as an alternative technique. We documented outcomes of patients treated with closed manipulation and casting with EE long-arm casts for displaced, diaphyseal both-bone forearm fractures. Read More

Instr Course Lect 2019 ;68:407-414

Since pediatric Monteggia fracture-dislocations were first described in 1814, they have been a complicated injury for orthopaedic surgeons to manage. These injuries typically consist of a fracture of the ulna with dislocation of the radial head. Unlike most pediatric injuries, Monteggia fracture-dislocations remodel very poorly, and the relationship between the radial head and the capitellum does not improve with time. Read More

Instr Course Lect 2019 ;68:367-374

Lateral condyle fractures are the second most common fracture sustained in the pediatric elbow. Several classification systems are used to describe these fractures. The more recently described classifications help guide management, which is based on the degree of displacement and stability of the fracture. Read More

Ultraschall Med 2020 Feb 5;41(1):12-28. Epub 2020 Feb 5.

Pediatric surgery, Marienhospital Gelsenkirchen, Germany.

Fracture ultrasound has increasingly come into the focus of international research. A growing number of original articles and a meta-analysis show that wrist fractures can be diagnosed without X-ray in children up to 12 years. Further original publications state that elbow fractures can be ruled out by exclusion of intraarticular effusion and in proximal humerus fractures the number of X-rays is reduced by about 50 %, while the quality of diagnosis is improved. Read More

J Pediatr Orthop 2020 Jan 31. Epub 2020 Jan 31.

Department II of Orthopaedics, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders.

Background: The standard treatment for supracondylar humeral fractures (SHFs) in children is closed reduction and percutaneous Kirschner (K)-wire fixation. In patients who present >14 days after injury and show callus formation, this procedure cannot be performed. There are 2 options in these cases: functional exercises with osteotomy performed at a later stage if cubitus varus is present, or immediate open reduction and percutaneous K-wire fixation. Read More

Pediatr Emerg Care 2020 Jan 22. Epub 2020 Jan 22.

From the Children's Emergency, KK Women's and Children's Hospital, Singapore, Singapore.

Background: The lateral humeral condyle fractures in children accounts for one fifth of all elbow fractures. These fractures have a propensity to displace because of the pull of the extensor muscles on the condyle.

Objectives: The aim of this study was to examine the epidemiology, injury patterns, complications, and predictors for conservative/surgical management in patients with lateral condyle humeral fractures between 0 and 18 years of age. Read More

Trauma Case Rep 2020 Feb 11;25:100278. Epub 2020 Jan 11.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO 80045, United States of America.

Cases: Two pediatric patients, aged 4 and 6-years-old, presented to a level one children's hospital with displaced lateral condylar mass (LCM) and ipsilateral displaced olecranon fractures after falling directly on to the affected extremity. Both patients underwent surgical fixation of the fractures, one of whom was found to have a laterally dislocated radial head intra-operatively. While one of the patients underwent open reduction internal fixation (ORIF) of both the LCM and olecranon fractures, the other patient underwent ORIF of the LCM and closed reduction percutaneous pinning (CRPP) of the olecranon fracture. Read More

J Shoulder Elbow Surg 2020 Feb;29(2):340-346

Department of Orthopedic Surgery, University of Utah Hospital, Salt Lake City, UT, USA.

Background: Post-traumatic elbow arthrofibrosis (PEA) and its associated limitations to elbow range of motion (ROM) are a recognized consequence of trauma to the pediatric elbow. Closed manipulation under anesthesia (CMUA) of the elbow can be performed in pediatric patients as a nonoperative attempt to improve dysfunctional ROM. Minimal outcome data to support CMUA exist. Read More

Curr Rev Musculoskelet Med 2020 Feb;13(1):50-57

Department of Orthopedic Surgery, Benioff Children's Hospital, University of California San Francisco, 747 52nd Street, Oakland, CA, 94609, USA.

Purpose Of Review: With an increase in single-sport specialization, elbow injuries have become increasingly common in the pediatric and adolescent population. Osteochondritis dissecans (OCD) of the capitellum frequently requires intervention yet can be difficult to treat given high patient activity demands. The purpose of this paper is to review treatment options, understand failure rates, and provide strategies for successful revision surgery. Read More

Orthop J Sports Med 2020 Jan 8;8(1):2325967119892322. Epub 2020 Jan 8.

Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.

Background: Lack of uniformity in reported outcomes makes comparisons between acromioclavicular joint (ACJ) injury studies challenging. Knowledge of common outcome measures and standardization will help orthopaedic surgeons report and compare outcomes more consistently.

Purpose: To identify the most commonly reported outcome measures for ACJ injuries. Read More

J Child Orthop 2019 Dec;13(6):560-568

Department of Pediatric and Trauma Surgery, Third Faculty of Medicine, Charles University and Thomayer Hospital, Prague.

Purpose: The aim of the study is to evaluate our group of paediatric patients with Monteggia lesion and its equivalents and to compare the characteristics of basic types of these lesions concerning therapeutic approach and results of the treatment.

Methods: Retrospective study of 111 children treated in the Department of Pediatric and Trauma Surgery of the Thomayer Hospital in Prague between 2001 and 2013 (13 years). When evaluating the outcome of the therapy, Bruce's criteria modified by Letts that assesses range of movement, pain and deformity of the elbow joint were applied. Read More

Acta Ortop Bras 2019 Sep-Oct;27(5):261-264

Hospital Dr Jesser Amarante Faria, Joinville, SC, Brazil.

Objective: To analyze the epidemiological profiles of children with orthopedic distal humerus fractures.

Methods: An analytical descriptive study was conducted with a retrospective approach using medical records of 665 orthopedic children who attended the Jesser Amarante Faria Children's Hospital, a reference hospital in the city of Joinville, Santa Catarina, between June 2012 and December 2016.

Results: The results showed a predominance of male patients (64. Read More

J Pediatr Orthop 2020 May/Jun;40(5):223-227

Department of Orthopaedic Surgery and Rehabilitation, Loyola University of Chicago, Maywood, IL.

Background: Pediatric supracondylar humerus fractures are the most common elbow injury in children, accounting for 12% to 17% of all childhood fractures. A lack of information exists regarding complication rates on the basis of fellowship status and geography.

Methods: The American Board of Orthopaedic Surgery (ABOS) Part-II database was used to identify candidates who performed either percutaneous or open treatment of humeral supracondylar or transcondylar fractures between 2002 and 2016 on patients aged 0 to 12 years. Read More

Malays Fam Physician 2019 31;14(2):44-45. Epub 2019 Aug 31.

Department of Family Medicine Universiti Sains Malaysia 16150 Kubang Kerian, Kelantan.

Elbow injuries are common in children. Supracondylar fractures occurred in 16% of all pediatric fractures. Supracondylar fractures can be classified into 4 types according to the Gartland classification, depending on the degree of the fracture present in the lateral radiograph. Read More

Cureus 2019 Oct 29;11(10):e6024. Epub 2019 Oct 29.

Orthopaedics, General Children's Hospital Panagiotis & Aglaia Kyriakou, Athens, GRC.

The posterior fat pad sign (PFPS) on the lateral elbow X-ray is useful in the diagnosis of a suspected nondisplaced fracture about the elbow after a subtle injury. However, the presence of a PFPS hallmarks a continuous posterior periosteum-posterior capsule of the distal humerus. This anatomic structure is crucial for the stable anatomic reduction of a displaced extension type supracondylar fracture. Read More

Arthroscopy 2020 05 27;36(5):1283-1290. Epub 2019 Nov 27.

Department of Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, California, U.S.A.. Electronic address:

Purpose: The purpose of this study was to report the complications of elbow arthroscopy in a large community practice with multiple surgeons and to analyze potential risk factors for these complications.

Methods: Patient demographic information, surgical variables, surgeon variables, and complications were retrospectively reviewed for all elbow arthroscopies performed within the health network from 2006 to 2014. Inclusion criteria included patients of any age undergoing a primary and revision elbow arthroscopy, which may have been performed in conjunction with other procedures. Read More

Bull Hosp Jt Dis (2013) 2019 12;77(4):250-255

Background: Supracondylar humerus fractures account for two thirds of all hospitalizations for elbow injuries in children. A prevailing assumption exists regarding whether treatment quality varies by surgeon training background. This study compares radiographic outcomes of pediatric supracondylar humerus fractures treated by fellowship trained pediatric orthopedists (PO) and non-pediatric orthopedists (adult traumatologists, AT) with regard specifically to ability to obtain and maintain an operative closed reduction. Read More

BMC Musculoskelet Disord 2019 Nov 27;20(1):567. Epub 2019 Nov 27.

Department of Pediatric Orthopaedic, Dalian Children's Hospital, 154 Zhongshan Road, Dalian, 116012, China.

Background: Severely displaced radial neck fractures in skeletally immature children are rare and can be difficult to reduce. The purpose of this study is to evaluate the results using our reduction maneuver.

Methods: From October 2011 to December 2015, 26 children with radial neck fractures(O'Brien type II, III and Judet type III, IV) were treated at our institute. Read More

Pediatr Radiol 2020 03 19;50(3):363-370. Epub 2019 Nov 19.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, Benioff Children's Hospital, 1975 Fourth St., San Francisco, CA, 94158, USA.

Background: Pediatric elbow fractures are common but remain challenging to accurately diagnose. Digital tomosynthesis is a technique that has shown promise in difficult adult fracture patterns but has not been formally studied in the pediatric population.

Objective: To assess the added value of digital tomosynthesis on the detection and diagnostic confidence of pediatric elbow fractures. Read More

J Orthop Surg Res 2019 Nov 15;14(1):370. Epub 2019 Nov 15.

Department of Arthroscopy and Sports Medicine, The Second Hospital of Inner Mongolia Medical University, No. 1 Yingfang Street, Huimin District, Hohhot, 010000, Inner Mongolia Autonomous Region, China.

Background: The best treatment for lesions of the long head of the biceps tendon (LHBT) with concomitant reparable rotator cuff tears is still controversial. The purpose of the meta-analysis was to compare clinical outcomes of biceps tenotomy and tenodesis for LHBT lesions.

Methods: A literature retrieval was conducted in MEDLINE, Embase, and Cochrane Library from 1979 to March 2018. Read More

J Emerg Med 2019 Nov 5;57(5):653-661. Epub 2019 Nov 5.

Department of Orthopedics, Children's Hospital Orange County, Adult and Pediatric Orthopedic Specialists, Orange, California; Department of Orthopedics, Riverside University Health Systems, Moreno Valley, California.

Background: Radiographic imaging is essential in assessing the severity and treatment of injuries. However, when a radiographic series is of poor quality, its diagnostic utility is limited, especially in cases involving pediatric elbow injuries.

Objectives: This study aims to investigate the variability of elbow radiographs in the injured child, review parameters used to assess diagnostic quality, and introduce the lateral distal humeral metaphyseal-diaphyseal (LDHMD) ratio as a potential measurement of the quality of a lateral elbow radiograph. Read More

Cureus 2019 Sep 5;11(9):e5570. Epub 2019 Sep 5.

Emergency Medicine, Envision Physician Services, Orlando, USA.

Isolated radial head subluxation without fracture, commonly referred to as "nursemaid's elbow," is one of the most common pediatric upper extremity injuries. Radial head dislocation without an associated fracture is rarely seen in adults. They are usually associated with ulnar fractures or an elbow dislocation. Read More

Medicine (Baltimore) 2019 Nov;98(44):e17850

Department II of Orthopaedics, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, the Children's Hospital of Chongqing Medical University, Chongqing, China.

Background: Lateral humeral condyle fractures are the second most common elbow fracture in children. Displaced and rotated fractures require stabilization and reduction. Kirschner wires (K-wires) are most commonly used in the fixation of these fractures. Read More