1
|
Wang G, Huo L, Xu Y, Dai G, Yang Z, Hu J, Liu W. Clinical observation on the treatment of displaced distal radial and ulnar fractures in children by closed manipulation combined with splinting. Front Surg 2023; 10:1199437. [PMID: 37795148 PMCID: PMC10546061 DOI: 10.3389/fsurg.2023.1199437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Objective The aim of this study was to investigate the clinical efficacy of closed manipulation combined with splinting in the treatment of displaced distal radial and ulnar fractures in children. Methods A total of 82 children with displaced fractures of the distal radial and ulnar segment who met the inclusion criteria and were treated as outpatients or inpatients in the orthopedic department of Guangzhou Orthopedic Hospital, from January 2016 to June 2022 were randomly divided into an observation group and a control group: 41 children in the observation group were treated with closed manipulation combined with splint fixation; 41 children in the control group were fixed with incisional repositioning elastic nails combined with internal plates. The Anderson efficacy grading, visual analog scale (VAS) score, fracture healing time, treatment cost, hospital days, and complications were observed and compared between the two groups. Result The efficacy was evaluated according to the Anderson forearm fracture efficacy evaluation criteria, and the results of statistical analysis showed no statistically significant differences between the two groups (P > 0.05). At 3 and 7 weeks after treatment, the VAS scores of children in both groups decreased (P < 0.05), and the VAS scores in the observation group were significantly lower than those in the control group (P < 0.05), indicating that the observation group had a significant advantage in the relief of pain after treatment. The fractures healed in both groups after treatment with the two different methods, and the difference in healing time between the two groups was not statistically significant (P > 0.05). The length of hospital stay, treatment cost, and complication ratio were significantly lower in the observation group than in the control group (P < 0.05). Conclusion In children with displaced fractures of the distal radial and ulnar segments, treatment by manual repositioning with external splinting can achieve satisfactory results with simple operation, low cost, short hospital stay, and few complications, which is especially suitable to be promoted in primary hospitals and has good social benefits.
Collapse
Affiliation(s)
- Guangwei Wang
- Department of Orthopaedics, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Liwei Huo
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Yidong Xu
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Gerong Dai
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Zhong Yang
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Jianwei Hu
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| | - Weinian Liu
- Department of Orthopaedics, Guangzhou Orthopedic Hospital, Guangzhou, China
| |
Collapse
|
2
|
Abstract
Childhood osteoporosis leads to increased propensity to fracture, and thus is an important cause of morbidity, pain and healthcare utilisation. Osteoporosis in children may be caused by a primary bone defect or secondary to an underlying medical condition and/or its treatment. Primary osteoporosis is rare, but there is an increasing number of children with risk factors for secondary osteoporosis. Therefore it is imperative that all paediatricians are aware of the diagnostic criteria and baseline investigations for childhood osteoporosis to enable timely referral to a specialist in paediatric bone health. This review will discuss the approach to diagnosis, investigation and management of childhood osteoporosis, with particular consideration to advances in molecular diagnosis of primary bone disorders, and current and emerging therapies for fracture reduction.
Collapse
Affiliation(s)
- David B. N. Lim
- University Hospital Southampton NHS Foundation Trust, Southampton Children’s Hospital, Paediatric Endocrinology, Hampshire, England
| | - Rebecca J. Moon
- University Hospital Southampton NHS Foundation Trust, Southampton Children’s Hospital, Paediatric Endocrinology, Hampshire, England,MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, England
| | - Justin H. Davies
- University Hospital Southampton NHS Foundation Trust, Southampton Children’s Hospital, Paediatric Endocrinology, Hampshire, England,University of Southampton, Faculty of Medicine, Southampton, England
| |
Collapse
|
3
|
Moon RJ, D'Angelo S, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Is the skull responsive to bone mineralisation stimuli in children? Bone 2022; 160:116415. [PMID: 35398588 DOI: 10.1016/j.bone.2022.116415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI. METHODS Children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6-7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS. RESULTS 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was β (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH. CONCLUSION Associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.
Collapse
Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton SO16 7NP, UK.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| |
Collapse
|
4
|
Abstract
The purpose of the study was to estimate the burden to families of raising a child with attention-deficit/hyperactivity disorder (ADHD). Data were drawn from a longitudinal sample recruited in western Pennsylvania. When participants were between 14 and 17 years old, parents completed a questionnaire assessing economic burden over the course of raising their children. Domains of economic burden to families included direct costs related to child's behaviors (excluding treatment expenses) and indirect costs related to caregiver strain. On average, participants with ADHD incurred a total economic burden over the course of child development that was more than five times greater compared to youths without ADHD (ADHD = $15,036 per child, Control = $2,848 per child), and this difference remained significant after controlling for intellectual functioning, oppositional defiant symptoms, or conduct problems. Parents of participants with ADHD were more likely to have changed their job responsibilities or been fired and reported lower work efficiency. The current evaluation of economic burden to individual families extends previous estimates of annual societal cost of illness (COI) of ADHD. Our rough annual estimate of COI for ADHD in children and adolescents is $124.5 billion (2017 US Dollars). Findings underscore the need for interventions to reduce the costly dysfunctional outcomes in families of children with ADHD.
Collapse
|
5
|
Bornstein MH, Putnick DL, Costlow KM, Suwalsky JTD. Retrospective Report Revisited: Long-Term Recall in European American Mothers Moderated by Developmental Domain, Child Age, Person, and Metric of Agreement. APPLIED DEVELOPMENTAL SCIENCE 2018; 24:242-262. [PMID: 32601518 PMCID: PMC7323926 DOI: 10.1080/10888691.2018.1462090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Retrospective parental reports are common in the developmental science literature, but their validity has been questioned. We investigated the consistency of retrospective maternal recall by comparing original with retrospective maternal reports in three domains (maternal cognitions, mother-reported child and mother behaviors, and observed child and mother behaviors) at three retention intervals (12, 14, and 15 years) in two metrics (individual standing and group level). In a longitudinal study, European American mothers (N=46) provided data when their children were 5, 20, and 48 months of age and retrospective recall data for each age when their children were 16 years. Overall, mothers recalled similar average mean levels (49% of variables explored) or better mean levels (41% of variables) retrospectively; better levels indicating a positive recollection bias. At least moderate consistency in relative standing was evident for 52% of variables. Still, the findings varied somewhat by domain, child age, and person. Retrospective parental reports can provide accurate accounts of the past, but should be used with caution, as their consistency varies and is specific to moderating factors.
Collapse
Affiliation(s)
- Marc H Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
| | - Diane L Putnick
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
| | - Kyrsten M Costlow
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
| | - Joan T D Suwalsky
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
| |
Collapse
|
6
|
|
7
|
Martins A, Monjardino T, Nogueira L, Canhão H, Lucas R. Do bone mineral content and density determine fracture in children? A possible threshold for physical activity. Pediatr Res 2017; 82:396-404. [PMID: 28467405 DOI: 10.1038/pr.2017.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/15/2017] [Indexed: 11/09/2022]
Abstract
BackgroundRelations between bone parameters, physical exertion, and childhood fractures are complex. We aimed to estimate the associations between fracture history and bone mineral content (BMC) and areal bone mineral density (aBMD) at 7 years of age, by levels of physical activity, as a proxy for trauma frequency.MethodsWe used data collected from 2,261 children of the Generation XXI birth cohort, assembled in 2005/6 in Porto, Portugal. At the age of 7 years (2012/4), fracture history, time spent per week in active play, and sports practice were reported by parents. Subtotal and lumbar spine (LS) BMC and aBMD were measured using whole-body dual-energy X-ray absorptiometry.ResultsBoys and girls in the highest categories of time spent in sports practice or active play generally had higher BMC and aBMD. Among girls, BMC and aBMD were protective of fracture only in the highest quarter of active play (>660 min/week)-odds ratios (OR; 95% confidence interval (95% CI)) for subtotal BMC=0.27 (0.11-0.67), subtotal aBMD=0.18 (0.06-0.49), and LS aBMD=0.41 (0.22-0.75). For boys in the highest quarter of sports practice (>240 min/week), subtotal and LS BMC were protective of fracture-OR=0.39 (0.16-0.98) and 0.51 (0.27-0.96), respectively.ConclusionIn prepubertal children, BMC and aBMD predicted fracture history only in the highest levels of physical activity.
Collapse
Affiliation(s)
- Ana Martins
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa Monjardino
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Luísa Nogueira
- Department of Radiology, School of Health Technology of Porto/Polytechnic Institute of Porto (ESTSP/IPP), Porto, Portugal
| | - Helena Canhão
- EpiDoC, CEDOC, Nova Medical School, NOVA University, Lisbon, Portugal
| | - Raquel Lucas
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| |
Collapse
|
8
|
Jeddi M, Dabbaghmanesh MH, Kharmandar A, Ranjbar Omrani G, Bakhshayeshkaram M. Prevalence of Fracture in Healthy Iranian Children Aged 9-18 Years and Associated Risk Factors; A Population Based Study. Bull Emerg Trauma 2017; 5:29-35. [PMID: 28246621 PMCID: PMC5316134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/05/2016] [Accepted: 12/16/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents. METHODS In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9-18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured. RESULTS We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03, p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4, p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188, p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003, p=0.039). CONCLUSION Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures.
Collapse
Affiliation(s)
- Marjan Jeddi
- Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alireza Kharmandar
- Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | |
Collapse
|