Patient positioning on the operative table for more accurate reduction during elastic stable intramedullary nailing of the femur: a technical note

Elastic stable intramedullary nailing is currently considered a clinical practice standard for the treatment of femoral fractures in children in the age-appropriate group. Malreduction, particularly in rotation, due to the closed reduction technique has been reported. We describe a new technique of positioning on a standard operating table that permits better control of rotational alignment during femoral elastic stable intramedullary nailing

An Interdisciplinary Study of Orthodontic, Orthopedic, and Otorhinolaryngological Findings in 12–14-Year-Old Preorthodontic Children

Background and Objective. Malocclusion, the body posture, and the breathing pat- tern may correlate, but this issue is still controversial. The aim of the study was to examine the relationship between the type of malocclusion, the body posture, and the nasopharyngeal obstruction in 12-14-year-old children. Material and Methods. The study group consisted of 76 orthodontic patients (35 boys, 41 girls) aged 12-14 years (mean age, 12.79 years {SD, 0.98J). All the patients were examined by the same orthodontist (study model and cephalometric radiograph analysis), the same orthopedic surgeon (body posture examined from the front, the side, and the back), and the same otorhinolaryngologist (anterior and posterior rhinoscopy and pharyngoscopy) in a blind manner. Results. The prevalence of a poor body posture and a nasopharyngeal pathology was high in the present study. In total, 48.7% of the orthodontic patients had a kyphotic posture and 55.3% a rib hump in the thoracic region. The nasopharyngeal pathology was diagnosed in 78.9% of the patients. The patients with the kyphotic posture had a higher mandibular plane angle (MP-SN) and a lower sagittal position of the mandible SNB angle. A deeper overbite correlated with shoulder and scapular asymmetry. The kyphotic posture was diagnosed in 55.0% of the patients with the naso- pharyngeal pathology. Conclusions. The sagittal body posture was related to the vertical craniofacial parameters and hypertrophy of the tonsils and/or the adenoids. The study showed no relationship between the degree of crowding, the presence of a posterior cross bite, orthopedic parameters, and a breathing pattern

Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess

Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body

A retrospective epidemiological study of paediatric femoral fractures

Background: Femoral fracture is a significant major trauma in children and adolescents, sometimes resulting in serious complications. This study aimed to determine the epidemiology of femoral fractures and to define associated injuries and mortality incidence in a pediatric population below 16 years old.Methods: The medical records of all patients with a femoral fracture treated in our hospital from 1997&ndash;2016 were reviewed retrospectively. Age, gender, mechanism of the trauma, month and season of fracture occurrence, fracture type, associated injuries, and mortality data were collected. Patients were divided into four age groups and compared.Results: The study included 348 children with 353 femoral fractures. The mean annual prevalence of femoral fracture during the study period was 22.7 per 100,000 children. Except for children less than 1 year old, most fractures occurred in male patients (69%), with a male-to-female ratio of 2.2:1. Road accidents were the most common mechanism at all ages. Femoral fractures were mainly due to low-energy trauma in neonates and infants, to road accidents and low-energy trauma in preschool children, to sports accidents in school-age children, and to road traffic accidents in teenagers. February was the month with the most occurrences of femoral fractures. Winter was the peak season for femoral fractures in children aged &lt;1 year and 6&ndash;11 years (37.8% and 46.4% of fractures respectively), whereas autumn was the most common season (29.5%) for preschool children and spring (31.1%) the most common in the teenagers group. Diaphyseal fractures were the most commonly reported lesions in all four age groups, representing 72.3% of all fractures. Only 18 fractures were open (5.1%). Eighty-eight patients (25.3%) presented with associated injuries at admission, 12 presented with Waddell&rsquo;s triad of injuries, and the mortality rate was calculated to be 1.1% (four cases).Conclusion: The circumstances of injury and the seasonality of femoral fractures differed significantly depending on the children&rsquo;s ages. Moreover, the morbidity of femoral fractures in children was closely correlated with associated injuries. (Level of evidence: Level III).</p

Primary subacute hematogenous osteomyelitis in children: a clearer bacteriological etiology

This study aimed to describe the spectrum of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to investigate its bacterial etiology

Radiation-free measurement tools to evaluate sagittal parameters in AIS patients: a reliability and validity study

This study aimed to evaluate the intra-rater reliability and validity in comparison with the two-dimensional radiography (XR) of inclinometer (INCL) and rasterstereography (RAST) for assessing spinal sagittal angles of AIS patients