Prospective Evaluation of a Treatment Protocol Based on Fracture Displacement for Pediatric Lateral Condyle Humerus Fractures

Summary Objective: Severe thrombocytopenia is a common sequelae to heat stroke in dogs. So far it has been hypothezised that it is due to disseminated intravascular coagulation. We hypothezised that it is due to immune mediated destruction via antiplatelet antibodies. Material and methods: Prospective evaluation of dogs with heat stroke from May 2005 to August 2008. Dogs that developed severe thrombocytopenia within 5 days of admission were included in the study. All dogs were treated with a standardized treatment protocol. In addition, they received either immunoglobulins or prednisolone. Results: Six dogs were presented with heat stroke during that time period. Four developed a severe thrombocytopenia. All four dogs tested positive for antiplatelet antibodies and did not have elevated D-Dimers at that time. Platelet count in three dogs recovered fully, one dog was euthanized due to liver and renal failure. Conclusion: In those cases thrombocytopenia was due to immune mediated destruction not due to DIC. Clinical rele-vance: Due to the severity of the thrombocytopenia and the high risk for bleeding in those patients, immunosuppressive therapy in addition to DIC prophylaxis should be discussed.

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PROSPECTIVE EVALUATION OF A DIAGNOSTIC AND TREATMENT PROTOCOL FOR VENTILATOR-ASSOCIATED PNEUMONIA (VAP) IN SICU PATIENTS

Critical Care Medicine ◽

10.1097/00003246-200212001-00397 ◽

2002 ◽

Vol 30 (Supplement) ◽

pp. A116 ◽

Cited By ~ 1

Author(s):

Shilpa K Parbhoo ◽

Michelle M Gearhart ◽

Michelle L Dusing ◽

Steven E Pass

Keyword(s):

Treatment Protocol ◽

Ventilator Associated Pneumonia ◽

Prospective Evaluation

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Graves' disease in pregnancy: Prospective evaluation of a selective invasive treatment protocol

American Journal of Obstetrics and Gynecology ◽

10.1067/mob.2003.321 ◽

2003 ◽

Vol 189 (1) ◽

pp. 159-165 ◽

Cited By ~ 78

Author(s):

Zohar Nachum ◽

Yardena Rakover ◽

Ehud Weiner ◽

Eliezer Shalev

Keyword(s):

Treatment Protocol ◽

Graves Disease ◽

Prospective Evaluation ◽

Invasive Treatment ◽

In Pregnancy

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Image Fusion of X-ray and Magnetic Resonance Imaging-Based Evaluation of the Stability of Pediatric Lateral Humeral Condyle Fracture

10.32592/ircmj.2021.23.8.1234 ◽

2021 ◽

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Lateral Condyle ◽

Resonance Imaging ◽

Condylar Fracture ◽

X Ray ◽

Fracture Displacement ◽

The Stability ◽

Condyle Fracture ◽

Humeral Condyle

Background: Lateral humeral condyle fracture is the second most common intra-articular fracture in pediatric elbow. Objectives: The present study aimed to analyze the differences between X-ray and magnetic resonance imaging (MRI) in the evaluation of the stability of pediatric lateral humeral condyle fracture and the degree of fracture displacement. Methods: A total of 78 patients with acute elbow trauma were selected and hospitalized in our orthopedic department from July 2018-July 2019. All patients were examined with X-ray and MRI. The sensitivity and specificity of X-ray and MRI in the diagnosis of lateral humeral condyle fracture and the integrity of the trochlear cartilage chain fracture were calculated. The X-ray and MRI were examined respectively to check the value of lateral and posterior fracture space of lateral humeral condyle fracture. Results: Callus repair was observed according to the observation of fracture line during operation or the follow-up imaging examination of conservative treatment. It was confirmed that out of 78 patients with elbow joint trauma, 72 cases were diagnosed with the fracture of lateral condyle of humerus, and the other 6 patients were cured without fracture signs. The sensitivity of MRI in the diagnosis of pediatric lateral condylar fracture was 100%, which was significantly higher than that of X-ray (88.89%) (P<0.05). The results of X-ray and MRI in the diagnosis of pediatric lateral condylar fracture were generally consistent (kappa value = 0.465;< 0.01). Among the 72 confirmed cases, 35 subjects had a fracture of trochlear cartilage chain. The sensitivity of MRI in the diagnosis of pediatric fracture of lateral condyle of humerus was 97.14%, which was significantly higher than that of X-ray (62.86%) (P<0.05). The difference was statistically significant (P<0.05). The sensitivity of 3d-fs-fspgr or 3d-fspgr was significantly higher than that of fs-t2wi and fs-pdwi (P< 0.05). Conclusion: As evidenced by the obtained results, MRI was superior to X-ray in the diagnosis of pediatric humeral epicondylar fracture stability and evaluation of fracture displacement. Furthermore, 3d-fs-fspgr or 3d-fspgr was the best MR sequence to show the pediatric humeral epicondylar fracture. These findings can provide theoretical basis for the establishment of clinical treatment plan.

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Exposed versus buried K-wire fixation in paediatric lateral condyle humerus fractures

Journal of Pediatric Orthopaedics B ◽

10.1097/bpb.0000000000000880 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Madan Mohan Sahoo ◽

Udit Sourav Sahoo ◽

Manoranjan Jena

Keyword(s):

Lateral Condyle ◽

Wire Fixation ◽

Humerus Fractures

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Non operative management of blunt splenic trauma: a prospective evaluation of a standardized treatment protocol

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-015-0575-z ◽

2015 ◽

Vol 42 (5) ◽

pp. 593-598 ◽

Cited By ~ 16

Author(s):

A. Brillantino ◽

F. Iacobellis ◽

U. Robustelli ◽

E. Villamaina ◽

F. Maglione ◽

...

Keyword(s):

Treatment Protocol ◽

Operative Management ◽

Splenic Trauma ◽

Prospective Evaluation ◽

Standardized Treatment ◽

Blunt Splenic Trauma ◽

Non Operative Management

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Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02726-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yang Qi ◽

Lin Guo ◽

Man Sun ◽

Zhi Wang

Keyword(s):

Sensitivity And Specificity ◽

Unstable Fracture ◽

Lateral Condyle ◽

Clinical Value ◽

Secondary Fracture ◽

Fracture Group ◽

Fracture Displacement ◽

Lateral Condyle Fracture ◽

Condyle Fracture ◽

Osteochondral Fractures

Abstract Background Humeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs. Methods 60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients. Results Sensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01). Conclusions MRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.

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