Polylactide bioabsorbable struts for chest wall reconstruction in a pediatric patient.

Chest wall reconstruction after pediatric tumor resection is challenging. Children have unique characteristics related to growth and prosthetic material for reconstruction must be chosen carefully. Poly-L-Lactide (PLA), a bioabsorbable prosthetic material, has been used in the plate form for reconstruction after tumor resection in children.

Postoperative pain management after spinal fusion surgery: an analysis of the efficacy of continuous infusion of local anesthetics.

Spinal fusion surgery is a major surgery that results in severe postoperative pain, therefore pain reduction is a primary concern. New strategies for pain management are currently under investigation and include multimodal treatment. A 3-year retrospective analysis of patients with idiopathic scoliosis undergoing spinal fusion surgery was performed at our hospital, assessing patient pain scores, opioid use, and recovery.

An evaluation of supracondylar humerus fractures: is there a correlation between postponing treatment and the need for open surgical intervention?

Purpose: The goal of this study was to evaluate the treatment and recovery of patients treated for Gartland type III supracondylar humerus fractures in order to determine if postponing treatment leads to a higher rate of open surgical treatment or complications.

Methods: A retrospective study was conducted examining the medical records of children with Gartland type III supracondylar humerus fractures at our institution for a two-year period. The patients included in the study were treated with closed reduction and percutaneous pinning (CRPP) or open reduction and internal fixation (ORIF).

Early Hippocampal Synaptic Loss Precedes Neuronal Loss and Associates with Early Behavioural Deficits in Three Distinct Strains of Prion Disease.

Prion diseases are fatal neurodegenerative diseases of the CNS that are associated with the accumulation of misfolded cellular prion protein. There are several different strains of prion disease defined by different patterns of tissue vacuolation in the brain and disease time course, but features of neurodegeneration in these strains have not been extensively studied. Our previous studies using the prion strains ME7, 79A and 22L showed that infected mice developed behavioural deficits in the same sequence and temporal pattern despite divergent end-stage neuropathology.

Intramedullary nails for pediatric diaphyseal femur fractures in older, heavier children: early results.

Purpose: A common treatment for pediatric femur fractures is intramedullary nail (IMN) insertion. Elastic stable intramedullary nails (ESINs) are often used for these procedures in heavier patients, but the potential for complications and malunion is greater. We describe here a rigid IMN specifically designed for adolescents, the adolescent lateral entry femoral nail (ALFN).

Brain region specific pre-synaptic and post-synaptic degeneration are early components of neuropathology in prion disease.

Synaptic abnormalities, one of the key features of prion disease pathogenesis, gives rise to functional deficits and contributes to the devastating clinical outcome. The synaptic compartment is the first to succumb in several neurodegenerative diseases linked with protein misfolding but the mechanisms underpinning this are poorly defined. In our current study we document that a focal intrahippocampal injection of the mouse-adapted 22L scrapie strain produces a complex, region-specific pathology in the brain.

Ultrasound evaluation of ulnar nerve anatomy in the pediatric population.

Background: Ulnar nerve instability has been reported in up to 17% of children. Accurate assessment is important to achieve because of potential nerve complications that can arise from treatment of common pediatric fractures, including supracondylar humerus fractures. The objective of our study was to evaluate our ability to use ultrasonography to determine the extent of ulnar nerve dislocation in the normal pediatric population and to determine if there is a relationship between ulnar nerve instability and ligamentous laxity.

Management of pelvic heterotopic ossification post-myocutaneous flap reconstruction of a sacral pressure ulcer.

Heterotopic ossification (HO) is a process whereby lamellar bone forms in the soft tissues surrounding a joint. The most common type of HO is traumatic myositis ossificans, which develops following traumatic injuries, burns or arthroplasty. A variety of other forms of HO also exist, such as those associated with central nervous system injury and systemic forms that can manifest at other joints simultaneously.

The delay in diagnosis of slipped capital femoral epiphysis: a review of 102 patients.

Objectives: The aim of this study were (1) to evaluate the incidence of apparent missed diagnosis of slipped capital femoral epiphysis (SCFE) by the primary care system and (2) to identify possible factors leading to a delay in diagnosis of this disorder.

Setting And Design: A retrospective review of emergency department records, outside medical charts, and preoperative and postoperative radiographs of children treated surgically for SCFE at the Children's Hospital of Los Angeles (CHLA) from 1989 to 1997 was done to assess the delay in diagnosis for SCFE. The primary care system included outside emergency department visits, urgent care clinic visits, and private office visits.

Concept of treatment in supracondylar humeral fractures.

This opinion of treatment for children's supracondylar humeral fractures discusses techniques of fracture reduction and stabilization. A useful method of external visualization of the fracture is reviewed. The article discusses the treatment of 95 fractures in children using crossed and two lateral pin techniques.

Lymphangiomatosis of the spine: two cases requiring surgical intervention.

Study Design: Two cases of lymphangiomatosis of the spine are presented.

Objectives: To report two cases of lymphangiomatosis of the spine requiring surgical intervention and to review the literature.

Summary Of Background Information: Lymphangiomatosis is a rare childhood disease characterized by abnormal lymph tissue at multiple sites.

Thoracoscopic anterior spinal release and fusion: evolution of a faster, improved approach.

Purpose: The aim of this study was to compare the perioperative parameters and outcomes of video-assisted thoracoscopic surgery (VATS) with open thoracotomy for anterior release and fusion in the treatment of pediatric spinal deformities.

Methods: Twenty-six patients treated with VATS anterior spinal release and posterior spinal fusion by the authors were reviewed retrospectively. Fourteen age- and disease-matched patients who underwent open thoracotomy for anterior spinal release and posterior spinal fusion by the same group of surgeons during the same time period were evaluated for comparison.

Rib fixation for humeral lengthening following interscapulothoracic resection for malignant tumor.

We report a case of humeral lengthening in an adolescent, 6.5 years after interscapulothoracic resection for an osteosarcoma of the scapula. The lengthening external fixator was augmented by ipsilateral rib fixation in order to prevent cephalad migration of the proximal fragment.