904 results match your criteria physeal fractures

Reduction of Neglected Displaced Fractures of the Distal Femoral Physis.

JBJS Essent Surg Tech 2021 Jan-Mar;11(1). Epub 2021 Mar 2.

Université Nazi Boni, Bobo-Dioulasso, Burkina Faso.

Background: We performed open osteoclasis, soft-tissue release, and fracture fragment reduction and fixation to treat 10 cases of neglected physeal fractures of the distal aspect of the femur with severe deformity. To our knowledge, no specific surgical procedure for this problem has been reported in the literature.

Description: The procedure is typically performed through an extensile anterolateral approach. Read More

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Distal Radius Physeal Bar and Ulnar Overgrowth: Indications for Treatment.

J Pediatr Orthop 2021 Jul;41(Suppl 1):S6-S13

Department of Orthopedic Surgery, Nationwide Children's Hospital.

Background: Distal radius physeal bar with associated growth arrest can occur because of fractures, ischemia, infection, radiation, tumor, blood dyscrasias, and repetitive stress injuries. The age of the patient as well as the size, shape, and location of the bony bridge determines the deformity and associated pathology that will develop.

Methods: A search of the English literature was performed using PubMed and multiple search terms to identify manuscripts dealing with the evaluation and treatment of distal radius physeal bars and ulnar overgrowth. Read More

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Does the size of Thurston-Holland fragment have an effect on premature physeal closure occurrence in type 2 distal tibia epiphyseal fractures?

J Pediatr Orthop B 2021 May 20. Epub 2021 May 20.

Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, İzmir, Turkey.

The purpose of this study was to investigate the possible effect of Thurston-Holland fragment (THF) size on the development of premature physeal closure (PPC) in distal tibia type 2 epiphyseal injuries. Fifty-eight fractures in 57 patients with a minimum follow-up period of 12 months were included. For statistical analysis, sex and age of the patient, number of reduction attempts, percentage of THF base relative to physis length on anteroposterior or lateral radiograph, maximal initial and postreduction displacement amount, presence of accompanying fibula fracture and trauma mechanism were evaluated. Read More

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Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases.

J Hand Surg Eur Vol 2021 Jun 10;46(5):471-475. Epub 2020 Sep 10.

Olympia Hospital & Research Centre, Tamilnadu, India.

We retrospectively reviewed 20 children with Salter-Harris II fractures of the distal radius treated with intrafocal pinning according to Kapandji. Unlike conventional crossed K-wire pinning, this method avoids crossing the physis with the pins and thus minimizes the risk of physeal damage. None of the children had fracture re-displacement, angulation or growth deformities. Read More

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Patterns of Articular Cartilage Thickness in Pediatric and Adolescent Knees: A Magnetic Resonance Imaging-Based Study.

Arthrosc Sports Med Rehabil 2021 Apr 2;3(2):e381-e390. Epub 2021 Feb 2.

Divisions of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.

Purpose: To establish normative values for articular cartilage thickness in pediatric and adolescent knees using magnetic resonance imaging (MRI) and investigate for any associations with age and skeletal maturity.

Methods: MRI scans were analyzed in patients 7 to 18 years old without osteochondral lesions, chondral wear/pathology, intra-articular fractures, or history of knee surgery. Measurements of articular cartilage thickness at the patella (medial facet, lateral facet, median ridge), femur (medial condyle, lateral condyle, lateral trochlea), and tibia (medial plateau, lateral plateau) were made on axial, coronal, and sagittal MRI. Read More

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Case report-Vascular injury in association with posteriorly displaced medial clavicle fracture.

Trauma Case Rep 2021 Jun 21;33:100483. Epub 2021 Apr 21.

Starship Hospital Orthopaedic Department, 2 Park Road, Grafton, Auckland 1023, New Zealand.

The primary stabiliser of the diarthrodial sterno-clavicular (SC) joint is the costo-clavicular ligament, this holds the clavicle to the first costal cartilage and the end of the first rib. The costo-clavicular and surrounding ligaments help maintain the stability and strength of the SC joint. As a result, SC joint dislocations are far less common than fractures to the clavicle due to the relatively larger forces required to disrupt these ligaments. Read More

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A Rare Case of Isolated Type III Salter-Harris Physeal Injury of the Distal Ulna.

Cureus 2021 Apr 18;13(4):e14547. Epub 2021 Apr 18.

Department of Orthopedics, All India Institute of Medical Sciences, Nagpur, IND.

Pediatric distal forearm fractures are very commonly seen in orthopedic and trauma services. The majority of such fractures involve either distal radius alone or concomitant with distal ulna physis. Isolated injuries of the distal ulna physis are exceedingly rare. Read More

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Irreducible Distal Tibia Physeal Injury with Tibialis Posterior Tendon Interposition.

Case Rep Orthop 2021 27;2021:6646953. Epub 2021 Apr 27.

Division of Pediatric Orthopaedics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.

A 14-year-old basketball player presented with a displaced distal tibia physeal fracture which is typically treated with closed reduction with or without internal fixation. However, repeated attempts at closed reduction failed to align the fracture fragments. At open reduction, tibialis posterior tendon interposition was identified within the fracture site and bowstringing of the tendon prevented closed reduction. Read More

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Remodelling in Children's Fractures and Limits of Acceptability.

Premal Naik

Indian J Orthop 2021 Jun 10;55(3):549-559. Epub 2021 Mar 10.

Rainbow Super-Speciality Hospital and Children's Orthopaedic Centre, Next to Asia School, Behind HDFC Bank, Opposite Drive in Cinema, Bodakdev, Ahmedabad, Gujarat 380 054 India.

Remodeling follows inflammatory and reparative phases of bone healing and is very pronounced in children. Unlike adults, in growing children, remodeling can restore the alignment of initially malunited fractures to a certain extent, making anatomic reduction less essential. Remodeling is not universal and ubiquitous. Read More

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Management of Physeal Fractures: A Review Article.

Indian J Orthop 2021 Jun 13;55(3):525-538. Epub 2021 Jan 13.

Department of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229 USA.

Background: Physis is the weakest structure in the skeleton of a child and a frequent site of an injury or fracture. A physeal fracture presents a unique challenge in the management as the sequalae of such an injury could lead to growth disturbances.

Methods: In this review, mainly focussing on traumatic physeal injuries, the authors discuss the applied anatomy, different fracture patterns, clinical assessment and management of physeal fractures in children. Read More

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Associations of childhood overweight and obesity with upper-extremity fracture characteristics.

Medicine (Baltimore) 2021 May;100(18):e25302

The Johns Hopkins University, Baltimore, MD.

Abstract: Childhood obesity is a growing epidemic in the United States, and is associated with an increased risk of lower-extremity physeal fractures, and fractures requiring operative intervention. However, no study has assessed the risk upper extremity physeal fractures among overweight children. Our purpose was to compare the following upper-extremity fracture characteristics in overweight and obese children with those of normal-weight/underweight children (herein, "normal weight"): mechanism of injury, anatomical location, fracture pattern, physeal involvement, and treatment types. Read More

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Successful Nonsurgical Management of a Posteriorly Displaced Medial Clavicular Physeal Fracture in an Adolescent Athlete: A Case Report.

Clin J Sport Med 2020 Sep 22. Epub 2020 Sep 22.

Departments of *Orthopaedic Surgery; †Radiology; and ‡Community and Family Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; and §Wits Institute for Sport & Health (WISH), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Traumatic and sport-related sternoclavicular (SCJ) injuries in adolescent athletes are more commonly physeal fractures rather than true SCJ dislocations. Although rare, posterior displacement of the medial clavicular metaphysis after a physeal fracture necessitates prompt evaluation and treatment. Despite the inherent healing ability of physeal separations, delayed or failed diagnosis has the capacity to cause serious complications or fatality secondary to injury of retrosternal structures. Read More

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September 2020

Use of a circular fixator construct to facilitate closed reduction and percutaneous stabilization of a distal femoral physeal fracture in a dog.

Open Vet J 2021 Jan-Mar;11(1):89-95. Epub 2021 Feb 2.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.

Background: Fractures of the distal femoral physis are the most common physeal fracture sustained by skeletally immature dogs. Reduction and stabilization of these fractures can sometimes be achieved through closed reduction, primarily in fractures that are nominally displaced. Circular external fixator constructs have been used to assist in indirect, closed reduction of fractures at other anatomic locations in dogs and this report describes application of this method to reduce a displaced Salter-Harris type II fracture of the distal femur in a 1-year-old dog. Read More

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February 2021

Physeal-Sparing Rigid Intramedullary Nailing in Adolescent Tibial Shaft Fractures: A Pilot Study.

Cureus 2021 Mar 15;13(3):e13893. Epub 2021 Mar 15.

Orthopaedic Surgery, Prisma Health - University of South Carolina, Columbia, USA.

Purpose: Elastic stable intramedullary nailing (ESIN) and open reduction internal fixation (ORIF) are literature-supported operative treatments for displaced tibial shaft fractures in skeletally immature patients. Very little is written about rigid intramedullary nails (RIMNs) in adolescents. Our purpose is to describe a physeal-sparing, reamed, locked RIMN technique for adolescent tibial shaft fractures and report its safety. Read More

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Traumatic physeal fractures in cats: a review of 36 cases (2010-2020).

J Feline Med Surg 2021 Apr 13:1098612X211005886. Epub 2021 Apr 13.

Department of Clinical Science and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, UK.

Objectives: The aim of this study was to describe the demography, aetiology, location and classification of physeal fractures in cats, and to describe their management and outcomes.

Methods: Clinical records and radiographs of cats referred for management of physeal fractures were retrospectively reviewed. Fractures of the proximal femoral physis were excluded. Read More

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Physeal Fractures of Distal Tibia: A Systematic Review and Meta-analysis.

J Pediatr Orthop 2021 Apr 12. Epub 2021 Apr 12.

Department of Pediatric Surgery, Kuopio University Hospital, Kuopio Department of Pediatric Surgery and Orthopaedics, PEDEGO Research Unit, Oulu University Hospital, University of Oulu, Oulu Department of Orthopedics and Traumatology, HEPO Research Unit, Helsinki University Central Hospital, Helsinki, Finland.

Background: Fractures involving the distal tibia growth plate are common in children. Injury or treatment that damages the growth plate may result in progressive angular deformity or leg length discrepancy. There is no consensus on treatment and follow-up of these injuries. Read More

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Talus Fracture Dislocation Management With Crossed Kirschner Wires in Children.

Cureus 2021 Mar 10;13(3):e13801. Epub 2021 Mar 10.

Trauma and Orthopaedics, University Hospitals of Derby and Burton NHS Foundation Trust, Burton-on-Trent, GBR.

Skeletal trauma accounts for 10% to 15% of all childhood injuries, with approximately 15% to 30% of these representing physeal injuries. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. Read More

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The clinical features, management options and complications of paediatric femoral fractures.

Eur J Orthop Surg Traumatol 2021 Apr 11. Epub 2021 Apr 11.

Bristol Children's Hospital, Bristol, UK.

This article discusses the incidence, applied anatomy and classification of paediatric femoral fractures based on critical appraisal of the available evidence. The aim is to identify techniques that are relevant to contemporary practice whilst excluding the technical details of individual procedures that are beyond the scope of this review. Injuries of the proximal, diaphyseal and distal segments are considered individually as there are considerations that are specific to each anatomical site. Read More

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Distal Clavicle Physeal Separation Mimicking an Acromioclavicular Joint Separation: A Case Report.

JBJS Case Connect 2021 04 2;11(2). Epub 2021 Apr 2.

Department of Orthopaedics, Toowoomba Hospital, Queensland, Australia.

Case: A 9-year-old boy sustained a right distal clavicle physeal separation with superior and posterior displacement through the periosteum. He was treated surgically with open reduction, Kirschner wire fixation, and periosteal repair and had an excellent outcome.

Conclusion: Distal clavicle fractures are rare in children, and acromioclavicular joint (ACJ) separations are exceedingly rare. Read More

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What are the risk factors and presenting features of premature physeal arrest of the distal radius? A systematic review.

Eur J Orthop Surg Traumatol 2021 Mar 31. Epub 2021 Mar 31.

Trauma and Orthopaedic Department, St George's Hospitals NHS Foundation Trust, London, SW17 0QT, UK.

Introduction: Premature physeal arrest (PPA) of the distal radius is considered a rare complication of physeal wrist fractures. Standardised guidelines for duration of follow up do not exist. The aim of this review is to recognise the risk factors of PPA and guide follow up protocols. Read More

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Posterior Tibial Slope is Increased in Patients With Tibial Tubercle Fractures and Osgood-Schlatter Disease.

J Pediatr Orthop 2021 Jul;41(6):e411-e416

Children's National Hospital.

Background: Osgood-Schlatter disease (OSD) and tibial tubercle fractures are pathologies that affect the tibial tubercle apophysis in preadolescents and adolescents. Anatomic alignment of the proximal tibia may explain why some children develop OSD or sustain tibial tubercle fractures and some do not. Recent data has shown an association between posterior tibial slope angle (PTSA) and both OSD and proximal tibia physeal fractures. Read More

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The Medial Femoral Condyle Flap in the Pediatric Patient.

Plast Reconstr Surg 2021 Apr;147(4):613e-622e

From the Division of Plastic Surgery, Department of Surgery, Yale School of Medicine; the Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine; the Division of Plastic Surgery, Department of Surgery, and the Department of Orthopaedic Surgery, University of Pennsylvania Health System; and Plastic and Reconstructive Microsurgery, Careggi University Hospital.

Background: The use of free flaps from the medial femoral condyle has grown in popularity and is now a workhorse in the reconstruction of skeletal defects. The utility of this technique has not yet been described for the pediatric patient population. The authors present their series of pediatric patients who underwent surgery using a medial femoral condyle free flap or a variant thereof in skeletal reconstruction and demonstrate the efficacy of this technique in this population. Read More

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Open reduction and internal fixation for displaced Salter-Harris type II fractures of the distal tibia: a retrospective study of sixty-five cases in children.

J Orthop Surg Res 2021 Mar 27;16(1):224. Epub 2021 Mar 27.

Children's Hospital of Soochow University, No.92 Zhongnan Street, Suzhou Industiral Park, Suzhou, Jiangsu province, China.

Background: The treatment for displaced Salter-Harris II (S-H II) distal tibia fractures remains controversial. The purpose of this study was to review S-H II distal tibia fractures and evaluate the rate of premature physeal closure (PPC) treated by open reduction and internal fixation (ORIF).

Methods: We reviewed the charts and radiographs of S-H II fractures of the distal tibia with displacement > 3 mm between 2012 and 2019 treated by ORIF. Read More

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Medial Patellofemoral Complex Advancement for Recurrent Lateral Patellar Instability and Selective Acute Primary Patellar Dislocations.

Arthrosc Tech 2021 Mar 8;10(3):e767-e774. Epub 2021 Feb 8.

Advance Knee and Shoulder Hospital, Ahmedabad, Gujarat, India.

Medial patellofemoral complex (MPFC) is considered as the primary medial patellar restraint and has a static, as well as dynamic, component. MPFL reconstruction (MPFL-R) restores only the static component of MPFC, is associated with multiple technical concerns, and has a steep learning curve. Need for physeal sparing techniques and relatively high rates of complications including patella fracture are some other concerns with MPFL-R. Read More

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Simultaneous bilateral versus unilateral tibial tubercle fractures.

J Clin Orthop Trauma 2021 Feb 17;13:85-91. Epub 2020 Aug 17.

Department of Orthopedic Surgery, Texas Children's Hospital, Houston, 17580 Interstate 45 South, the Woodlands, Texas, 77384, USA.

Purpose: Tibial tubercle/tuberosity fractures are rare injuries in young patients accounting for less than one percent of physeal fractures. Bilateral simultaneous fractures are even rarer, with only a few case reports in literature. The purpose of our study was to describe the largest case series of bilateral simultaneous tibial tuberosity avulsion fractures and compare it with unilateral fractures. Read More

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February 2021

Zürich cementless total hip arthroplasty as a treatment option for capital physeal fractures in dogs: Outcome in 53 cases.

Vet Surg 2021 Mar 12. Epub 2021 Mar 12.

University of Minnesota, College of Veterinary Medicine, St Paul, MN, USA.

Objective: To review the outcome of dogs that underwent Zürich cementless total hip arthroplasty (Z-THA) for the repair of acute and chronic capital physeal fractures (CPF) and document the CPF-related hip remodeling.

Study Design: Retrospective study.

Sample Population: Fifty-three Z-THA in 53 dogs. Read More

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Adolescent Tillaux Fractures: A Systematic Review of the Literature.

Cureus 2021 Jan 22;13(1):e12860. Epub 2021 Jan 22.

Trauma and Orthopaedics, Hull University Teaching Hospitals NHS Trust, Hull, GBR.

The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis. It occurs during a distinct time period when adolescent patients are transitioning to skeletal maturity. Owing to its rarity, the optimal management strategy for this fracture is not well-described. Read More

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January 2021

Anterior Physeal Separation of Distal Humerus: Report of a Rare Case with Review of Literature.

Indian J Orthop 2021 Feb 23;55(1):208-212. Epub 2020 Apr 23.

Paediatric Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641043 Tamil Nadu India.

Background: Distal humeral physeal separation is a rare injury and often missed during the initial presentation. They are usually associated with birth trauma or child abuse. These fractures are often misdiagnosed as infection or dislocation. Read More

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February 2021

Paediatric Ankle Fractures: Guidelines to Management.

Indian J Orthop 2021 Feb 6;55(1):35-46. Epub 2020 Oct 6.

Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Main Road, Coimbatore, Tamilnadu India.

Introduction: Paediatric ankle fractures represents about 5% of all paediatric fractures. It is the most common physis to be injured in the lower limb accounting to approximately 15-20% of all physeal injuries. This article reviews the literature on this common injury which still has many controversial areas and gives guidelines to management based on the existing evidence along with clinical experience gained from a Level I trauma center. Read More

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February 2021

Fractures of the Proximal Femur in Childhood: A Review.

Indian J Orthop 2021 Feb 18;55(1):23-34. Epub 2020 Sep 18.

Department of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Mumbai, Maharashtra 400012 India.

Background: Femoral neck fractures in children are rare injuries, occurring due to high-energy trauma. Due to the unique anatomy and blood supply of the proximal femur in growing children, these fractures are notorious for high rates of complications despite appropriate management. Classification of these fractures is according to the Delbet system, which not only guides management but also gives prognostic clues. Read More

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February 2021