Evaluating Young Children With Fractures for Child Abuse: Clinical Report.

Fractures are common injuries in childhood and can be caused by unintentional injury, medical conditions, and child abuse. Although the consequences of failing to diagnose an abusive injury in a child can be grave, the consequences of incorrectly diagnosing child abuse in a child whose fractures have another etiology are also significant. This report aims to review recent advances in the understanding of fracture specificity, fracture mechanisms, and other medical conditions that predispose infants and children to fracture.

Novel Cast-saw Alarm System Reduces Blade-to-Skin Contact in a Pediatric Upper Extremity Model.

Purpose: To determine the effectiveness of a novel cast-saw alarm system in minimizing the number and duration of cast-saw blade-to-skin contacts.

Methods: Twenty orthopaedic residents removed a pair of long-arm casts applied to instrumented pediatric upper extremity models. The model and cast-saw were instrumented to detect blade to "skin" contact at a rate of 600 Hz.

Hoverboard injuries in children and adolescents: results of a multicenter study.

With the increasing popularity of hoverboards in recent years, multiple centers have noted associated orthopaedic injuries of riders. We report the results of a multi-center study regarding hoverboard injuries in children and adolescents. who presented with extremity fractures while riding hoverboards to 12 paediatric orthopaedic centers during a 2-month period were included in the study.

Orthopaedic aspects of child abuse.

Child abuse is one of the most serious problems encountered by on-call orthopaedic surgeons. There are adverse sequelae to both overdiagnosing and underdiagnosing this condition. Orthopaedic surgeons generally manage orthopaedic aspects of child abuse but should be aware of the associated injuries, diagnoses, prognoses, and natural history of abuse.

CORR insights: Orthopaedic residency applications increase after implementation of 80-hour workweek.

This CORR Insights™ is a commentary on the article "Orthopaedic Residency Applications Increase After Implementation of 80-hour Workweek" by Anakwenze et al. available at DOI 10.1007/s11999-013-2785-1.

The treatment of pediatric supracondylar humerus fractures.

Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice and management of supracondylar fractures of the humerus in children. Two each of these recommendations are graded Weak and Consensus; eight are graded Inconclusive. The two Moderate recommendations include nonsurgical immobilization for acute or nondisplaced fractures of the humerus or posterior fat pad sign, and closed reduction with pin fixation for displaced type II and III and displaced flexion fractures.

Management of fractures in adolescents.

There are well-established treatment standards for adults who sustain fractures; however, these treatment standards are not always applicable when treating adolescents with similar fractures because of the presence of physes. Fractures in adolescents are treated by pediatric orthopaedic surgeons, adult orthopaedic traumatologists, or general orthopaedic surgeons. It is imperative that the principles of fracture management are well defined and discussed in both the pediatric and adult orthopaedic community.

Pediatric trauma: getting through the night.

As is the case in adults, the timing and type of emergent treatment of fractures in children can be controversial. Some emergent conditions, such as compartment syndrome, pelvic fractures with hemodynamic instability, and open fractures, are managed similarly in adults and children. However, other types of fractures are unique to children or are managed differently in children and adults.

Complications of high tibial osteotomy with external fixation in adolescent Blount's disease.

Reported complication rates for tibial osteotomies have been widely variable and no study has focused on a single deformity etiology, surgical technique, or stabilization method. A review of 38 high tibial osteotomies with external fixation in adolescent Blount's disease patients was performed at two institutions. Results showed an overall complication rate of 153% and an elevated (97%) prevalence of morbid obesity in the patients in this series.

Newborn with an open posterior hip dislocation and sciatic nerve injury after intrauterine radiofrequency ablation of a sacrococcygeal teratoma.

Advanced prenatal ultrasonography techniques have allowed for better understanding of the natural history, treatment, and prognosis of sacrococcygeal teratomas. Several intrauterine surgical techniques to debulk the tumor when fetal and maternal life are in jeopardy have been described. Orthopaedic impairment, such as lower extremity weakness and swelling, also has been described in association with sacrococcygeal teratomas.