Nonossifying Fibromas: A Computed Tomography-based Criteria to Predict Fracture Risk.

Background: Nonossifying fibroma (NOF) is the most common benign osseous lesion in children; however, our understanding of which lesions progress to a fracture remains unclear. In this study, we seek to formulate a classification system for NOFs to assess for fracture risk and determine what this classification system tells us regarding fracture risk of the distal tibia and distal femur NOFs.

Methods: Charts were retrospectively reviewed for patients with NOFs.

Transhumeral Anterior Radial Nerve Transposition to Simplify Anticipated Future Humeral Reconstruction.

Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated.

Nonossifying fibromas of the distal tibia: possible etiologic relationship to the interosseous membrane.

Purpose: Nonossifying fibromas (NOFs) present in a characteristic pattern in the distal tibia. Their predilection to this region and etiology remain imprecisely defined.

Methods: We performed a retrospective chart review of patients between January 2003 and March 2014 for distal tibial NOFs.

Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications.

Mobile devices are increasingly becoming integral communication and clinical tools. Monitoring the prevalence and utilization characteristics of surgeons and trainees is critical to understanding how these new technologies can be best used in practice. The authors conducted a prospective Internet-based survey over 7 time points from August 2010 to August 2014 at all nationwide American Council for Graduate Medical Education-accredited orthopedic programs.

The effect of intrinsic loading and reconstruction upon grip capacity and finger extension kinematics.

Purpose: To compare active and passive reconstructive procedures for tetraplegia and their ability to produce a powerful grip and allow appropriate finger extension in a cadaveric model.

Methods: Seventeen fresh-frozen hands were used, which included 5 in intrinsic minus and intrinsic activation conditions, 6 with Zancolli-lasso tenodeses, and 6 with modified House tenodeses to simulate intrinsic function. To test grip, flexor digitorum profundus tendons were powered with a motor.

Intrinsic hand muscle function, part 2: kinematic comparison of 2 reconstructive procedures.

Purpose: Reconstruction of grasp is a high priority for tetraplegic patients. Restoration of finger flexion by surgical activation of flexor digitorum profundus can result in roll-up finger flexion, interphalangeal (IP) joint before metacarpophalangeal (MCP) joint flexion, which can be improved by restoring intrinsic function. This study compares grasp kinematics between 2 intrinsic balancing procedures-Zancolli-lasso and House.

Intrinsic hand muscle function, part 1: creating a functional grasp.

Purpose: Regaining hand function has been identified as the highest priority for persons with tetraplegia. In many patients, finger flexion can be restored with a tendon transfer of extensor carpi radialis longus to flexor digitorum profundus (FDP). In the absence of intrinsic function, this results in a roll-up finger movement, which tends to push large objects out of grasp.

Multifocal micronodular pneumocyte hyperplasia: computed tomographic appearance and follow-up in tuberous sclerosis complex.

Objective: To characterize pulmonary nodules in patients with tuberous sclerosis complex (TSC) using computed tomography.

Methods: We retrospectively reviewed chest computed tomographic images of 73 patients with TSC (22 males and 51 females; mean ± SD age, 31.5 ± 13.

Efficacy, safety, and tolerability of the low glycemic index treatment in pediatric epilepsy.

Purpose: To report the efficacy, safety, and tolerability of the low glycemic index treatment (LGIT) in pediatric epilepsy.

Methods: A retrospective chart review was performed on patients initiating the LGIT at the Massachusetts General Hospital between January 2002 and June 2008. Demographic and clinical information including seizure type, baseline seizure frequency, medications, blood chemistries, side effects, and anthropometrics were collected.

Infantile spasms in tuberous sclerosis complex: prognostic utility of EEG.

Purpose: To assess cognitive and epilepsy outcomes in tuberous sclerosis complex (TSC) patients with a history of infantile spasms (IS), in relation to spasm history, electroencephalography (EEG) characteristics, genetic mutation, and treatment history.

Methods: The authors conducted a retrospective review of 45 children and adults with TSC and a history of IS. EEG reports from the time of spasms were evaluated for all patients, and EEG tracings were accessible and evaluated for 20 patients.

Self-injurious behavior and tuberous sclerosis complex: frequency and possible associations in a population of 257 patients.

Self-injurious behavior (SIB) has been observed in people with tuberous sclerosis complex (TSC), although the frequency of SIB in TSC is largely unknown. SIB is associated with intellectual and developmental disabilities, but there is no single cause of SIB. We retrospectively examined the frequency of SIB in a population of 257 patients with TSC and determined possible associations with SIB.

Behavior problems in children with tuberous sclerosis complex and parental stress.

Behavioral problems are common in children with tuberous sclerosis complex (TSC) and can be challenging to manage at home. Standardized measures were used to assess behavior in 99 pediatric patients with TSC and to evaluate parenting stress in their parents. About 40% of the pediatric patients presented clinically significant behavioral problems, most frequently involving symptoms of autism spectrum disorder, inattention, and hyperactivity.

Psychiatric comorbid conditions in a clinic population of 241 patients with tuberous sclerosis complex.

Psychiatric symptoms were retrospectively assessed in a clinic population of 241 children and adults with tuberous sclerosis complex (TSC). Sixty-six (27%) patients had a history of mood disorder symptoms, 66 (27%) had a history of anxiety disorder symptoms, 73 (30%) had a history of attention-deficit hyperactivity disorder (ADHD) symptoms, and 68 (28%) had a history of aggressive/disruptive behavior disorder symptoms. Significant relationships were found between these symptoms and patient age, gender, genetic mutation, seizure history, surgical history, cognitive impairment, features of autism or pervasive developmental disorder, and neurological manifestations of TSC.