Pediatric Septic Arthritis.

Acute septic arthritis is a condition with the potential for joint destruction, physeal damage, and osteonecrosis, which warrants urgent identification and treatment. The organism most frequently responsible is Staphylococcus aureus; however, our understanding of pathogens continues to evolve as detection methods continue to improve. MRI has improved our ability to detect concurrent infections and is a useful clinical tool where available.

The TeamSTEPPS Approach to Safety and Quality.

Despite advances in patient safety since the landmark Institute of Medicine Report To Err is Human was published, adverse events and medical errors remain a persistent problem throughout health care. Safety experts have examined the practices in high-risk industries that maintain outstanding safety records for strategies to address the problem. Those efforts led to the development of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), a patient safety program that incorporates the principles of crew resource management and teamwork successfully used by industry into the health care setting.

Emergency department on-call status for pediatric orthopaedics: a survey of the POSNA membership.

Background: The emergency room on-call status of pediatric orthopaedic surgeons is an important factor affecting their practices and lifestyles and was last evaluated in 2006.

Methods: The entire membership of the Pediatric Orthopaedic Society of North America (POSNA) was surveyed in 2010 for information regarding their emergency room on-call status with 382 surveys returned of over 1000 e-mailed to members of POSNA. Detailed information about on-call coverage, support, and frequency was obtained in answers to 14 different questions.

Preventable childhood injuries.

Background: This is a literature review generated from The Committee on Trauma and Prevention of Pediatric Orthopaedic Society of North America to bring to the forefront 4 main areas of preventable injuries in children.

Methods: Literature review of pertinent published studies or available information of 4 areas of childhood injury: trampoline and moonbouncers, skateboards, all-terrain vehicles, and lawn mowers.

Results: Much literature exists on these injuries.

The current medical practice of the pediatric orthopaedic surgeon in North America.

Musculoskeletal disorders in children are common and comprise 20% to 30% of the complaints observed by primary care physicians. Most primary care physicians prefer to refer patients with pediatric musculoskeletal conditions to the pediatric orthopaedic surgeon; most of whom are treated nonoperatively. Pediatric orthopaedic surgeons are well trained to provide efficient, cost-effective, and definitive quality care.

Impact of fractures on school attendance.

Background: The purpose of this study was to determine the average prevalence of children across the nation who experience difficulty in attending school after an acute orthopaedic injury.

Methods: A survey was created to obtain information on school absence for children with acute orthopaedic injuries. All members of the Pediatric Orthopaedic Society of North America were invited to complete the survey.

Medical errors in orthopaedics. Results of an AAOS member survey.

Background: There has been widespread interest in medical errors since the publication of To Err Is Human: Building a Safer Health System by the Institute of Medicine in 2000. The Patient Safety Committee of the American Academy of Orthopaedic Surgeons has compiled the results of a member survey to identify trends in orthopaedic errors that would help to direct quality assurance efforts.

Methods: Surveys were sent to 5540 Academy fellows, and 917 were returned (a response rate of 16.

Immediate single-leg spica cast for pediatric femoral diaphysis fractures.

Purpose: Immediate spica cast application is the standard of care for young children with isolated femur fractures. We evaluated the outcomes and function of children treated with single-leg spica casts.

Methods: We performed a retrospective review of 45 children treated with single-leg spica casts.

Communication skills.

Surveys of American Academy of Orthopaedic Surgeons members and patients indicate that orthopaedic surgeons are "high tech, low touch." According to patients and colleagues surveyed, orthopaedic surgeons are given high ratings by patients and colleagues for their skills in the operating room, but their listening and communication skills can be improved upon; they could listen better and show more empathy for their patients. Communication affects patient satisfaction, adherence to treatment, and physician satisfaction.

Compartment syndrome in children and adolescents.

Background: The authors performed a computerized search of the National Pediatric Trauma Registry for all patients who had compartment syndrome during a 51-month period.

Methods: One hundred thirty-three cases were identified. Boys outnumbered girls 4 to 1.

Bilateral femoral neck fractures after pelvic irradiation.

Our patient, who had no history of trauma, developed bilateral femoral neck fractures several years after pelvic irradiation. The well-documented sequelae of femoral neck fractures include avascular necrosis, nonunion, and malunion. Postirradiation pelvic pain, particularly in the absence of trauma, should be aggressively evaluated.

Mangled extremity severity score in children.

Treatment of the severely traumatized or mangled lower extremity poses significant challenges. The Mangled Extremity Severity Score (MESS) is a scale that uses objective criteria to assist with acute management decisions. Most research on the MESS has been in adults or combined series with few children.