Variables affecting complication rates in type III paediatric supracondylar humerus fractures.

Purpose: Unstable supracondylar humerus (SCH) fractures may have different outcomes as a result of direction of displacement and pin configuration. This study evaluates the impact of fracture displacement, pin configuration and fellowship training on clinical and radiographic outcomes in unstable fractures.

Methods: A total of 99 patients with completely displaced type III fractures were identified at an academic centre and a local community hospital.

The prevalence of and specific risk factors for venous thromboembolic disease following elective spine surgery.

Background: Venous thromboembolic disease, including deep venous thrombosis and pulmonary embolism, is a serious and potentially life-threatening complication following orthopaedic surgical procedures. We sought to investigate the prevalence of thromboembolism as well as the efficacy and complications of various prophylactic measures in a population of patients who had undergone elective spine surgery.

Methods: A meta-analysis and univariate logistic regression were performed on selected studies to determine the prevalence of and risk factors for deep venous thrombosis and pulmonary embolism following elective spine surgery.

A rare case of posterior interosseous nerve palsy associated with radial head fracture.

Background: Radial head fractures are the most common fractures occurring about the elbow in adults, but there have been few reported cases of associated nerve injury. The little-known posterior interosseous nerve travels in close proximity to the radial head and is particularly susceptible to injury.

Objectives: The objectives of this case report include raising awareness of the possibility of posterior interosseous nerve palsy after radial head fracture and reviewing the clinical assessment of the posterior interosseous nerve to exclude occult injury.

The effect of fluoroquinolone antibiotics on growing cartilage in the lamb model.

Background: The fluoroquinolones are a relatively new class of antimicrobials with an appealing spectrum of activity. Their use in pediatric medicine is limited because of the concern over possible growth inhibition, as published reports have documented articular cartilage damage in animal models after their administration. These data, extrapolated to include the epiphyseal cartilage, suggest that these agents may reduce growth rates, but limited human data are at the least equivocal, if not strictly contradictory to such claims.

The effect of periosteal resection on tibial growth velocity measured by microtransducer technology in lambs.

Background: Disruption of the periosteum, whether traumatic or elective, has long been known to accelerate growth in the developing skeleton. However, the extent, timing, and mechanism of the resultant increase in growth velocity (if any) remain undefined. The primary research questions were: Does periosteal resection result in a change (increase) in growth velocity of a long bone at the growth plate? When does the effect start after the resection and for how long? Finally, which of several cellular mechanisms is most likely responsible for the change in growth velocity?

Methods: Five lambs underwent proximal tibial growth plate periosteal resection with subsequent measurement of growth velocity by implantable microtransducers or fluorochrome labeling.

Rapid progression of scoliosis following insertion of intrathecal baclofen pump.

Placement of an intrathecal baclofen pump is a common treatment of spasticity in cerebral palsy patients. Though effective, the hardware is prone to malfunction, and multiple revisions are often necessary. Additional complications have also been described, including infection and drug toxicity or withdrawal.

Endoscopic cerebral aqueductoplasty: a trans-fourth ventricle approach.

Object: Advances in endoscopic technology have afforded the neurosurgeon new avenues in the treatment of hydrocephalus, rendering many patients independent of shunts, thus averting shunt complications and failure. Cerebral aqueductoplasty has gained popularity as an effective treatment for membranous and short-segment stenoses of the sylvian aqueduct. Traditionally, this procedure has been performed via a coronal approach, passing through the lateral ventricle, foramen of Monro, and third ventricle into the aqueduct.

The use of quick-brain magnetic resonance imaging in the evaluation of shunt-treated hydrocephalus.

Object: Children with shunt-treated hydrocephalus are exposed to serious amounts of radiation when undergoing computerized tomography (CT) scanning. The authors report their clinical experience with single-shot fast-spin echo (SSFSE) (quick-brain) magnetic resonance (MR) imaging as the modality of choice for the workup and follow up of patients in whom a shunt has been placed to treat hydrocephalus.

Methods: A retrospective chart review was performed to obtain data on all cases in which a quick-brain MR image was acquired for either symptomatic workup or asymptomatic follow-up examination of shunt-treated hydrocephalus.