Long bone fractures in children and adolescents treated surgically in West Pomeranian Voivodeship in 2005-2014

bone fractures in children is a problem that has been recently addressed with growing attention. The unique specifics of fractures in the developmental age compared with fractures in adult patients requires an appropriate approach. Disregarding the issue may lead to long-lasting complications, including severe skeletal deformities. Methods: The analysis included 821 children (575 boys, 246 girls) admitted to the hospital with long bone fractures. Data were obtained from medical records from between 2005 and 2014. Results: Long bone fractures were the cause of hospitalizations in 64.9% of cases during the spring-summer period. The average age was 12 years old. Fractures occurred more often in boys. The main cause of fractures in the test group was indirect trauma during sports activities (32%). Fractures of the distal meta and epiphysis of the radius bone were the most common result of trauma in children and adolescents (12.4 % of all fractures). A total of 32.1% of fractures of the upper limbs concerned the radius bone and 12% concerned the supracondylar humeral bone fractures. In lower limb fractures, the most common site was the distal part of the tibia bone (8.9% of all fractures). In surgical treatment, 399 (43.3%) K-wires were used. Plate stabilization was performed 225 times (24.5%), screw fixations 119 times (12.9%), FIN/ESIN fixations 141 times (15.3%), tension bands 11 times (1.2%), intramedullary nailing 19 times (2.1%), and external stabilizations 4 times (0.5%). Fracture healing complications were observed in 3 cases in patients with polytrauma. Conclusions: Risk of a long bone fracture grows with a child’s age. Fractures are more frequent in boys. We observed triple the number of fractures that needed surgery yearly from 2005 to 2014. The increase was linear. The choice of surgical treatment method depends on the fracture type, dislocation size, and the patient’s age.

Major complications and risk factors associated with surgical correction of congenital medial patellar luxation in 124 dogs

SummaryDogs treated for congenital medial patellar luxation were reviewed for the purpose of determining the incidence of postoperative major complications requiring surgical revision and the risk factors for their occurrence. Major complications occurred in 18.5% of the patellar luxation stabilization procedures with implant associated complications being the most frequent, patellar reluxation the second, and tibial tuberosity avulsion the third most common major complication. Other complications included patellar ligament rupture and trochlear wedge displacement. When recession trochleoplasty was performed in addition to tibial tuberosity transposition, a 5.1-fold reduction in the rate of patellar reluxation was observed. Release of the cranial belly of the sartorius muscle further reduced the incidence of patellar reluxation, while patella alta (pre- or postoperative) and patellar luxation grade were not found to influence the rate of reluxation. Tibial tuberosity avulsion was 11.1-times more likely when using a single Kirschner wire to stabilize a transposition, compared with two Kirschner wires. Independent to the number of Kirschner wires used, the more caudodistally the Kirschner wires were directed, the higher the risk for tibial tuberosity avulsion. Tension bands were used in 24.4% of the transpositions with no tuberosity avulsion occurring in stifles stabilized with a tension band. Overall, grade 1 luxations had a significantly lower incidence of major complications than other grades, while body weight, age, sex, and bilateral patellar stabilization were not associated with risk of major complication development.

Tension Bands Placed on the Thigh and Shank Produce Changes in the Knee Flexion Moment and Gait Asymmetry

Decreased symmetry in walking mechanics is common to many conditions associated with falling, such as muscle weakness, poor balance or flexibility, dizziness or vertigo, confusion, and vision problems [1]. Falls and the risk of falls have a substantial impact on the quality of life with aging. More than one in three adults over 65 years experience falls each year, and in half of these cases the falls are recurrent [2,3]. As patients with asymmetric gait are at a greater risk of falling during activities of daily living such as walking [1], conducting experiments on methods to correct gait asymmetries on this cohort can be potentially dangerous. However, experiments conducted with healthy patients that have an induced gait asymmetry during walking would minimize the risk to the unhealthy population while still allowing the researcher to test a subject with a gait asymmetry.