Predictors of failure of nonoperative treatment for type-2 supracondylar humerus fractures.

Background: Closed reduction and casting for type-2 supracondylar fractures is a viable treatment option, but studies have shown that some patients will fail to maintain the initial reduction in a cast. This study sought to identify predictors of failed treatment of closed reduction and casting for these fractures.

Methods: We performed a retrospective case-control study of type-2 supracondylar fractures treated by closed reduction and casting.

Posterior sternoclavicular disruption with ipsilateral clavicle fracture in a nine-year-old hockey player.

Posterior sternoclavicular joint disruptions are rare, and a concomitant fracture is even less common in the pediatric population. This case report concerns a posterior sternoclavicular joint disruption and ipsilateral medial clavicle fracture in a 9-year-old male hockey player. We describe the various imaging modalities that may be necessary for this injury, the complications to be considered in dealing with this injury as well as an internal fixation technique using FiberWire.

Social and economic benefits of flexible intramedullary nails in the treatment of pediatric femoral shaft fractures.

All patients between the ages of 5 and 15 years with isolated femoral shaft fractures treated at our institution with flexible intramedullary nails between 1996 and 1998 were examined and compared to an age-matched group of patients treated with spica casting. All fractures healed well with no significant complications. Patients treated with flexible intramedullary nails achieved earlier independent ambulation, at an average of 19 days, compared to 106 in the control group (P<.