المؤلفون: Soriano, Kylen KJ, Sabatini, Coleen S, Brar, Ravinder K, Jagodzinski, Jason E, Livingston, Kristin S

المصدر: Journal of Pediatric Orthopaedics. 43(4)

مصطلحات موضوعية: Physical Injury - Accidents and Adverse Effects, Pediatric, Injuries and accidents, Good Health and Well Being, Humans, Retrospective Studies, COVID-19 Testing, COVID-19, Communicable Disease Control, Humeral Fractures, supracondylar humerus fracture, trauma, injury patterns, monkey bars, pediatric, Paediatrics and Reproductive Medicine, Orthopedics

الوصف: BackgroundThe coronavirus disease 2019 (COVID-19) pandemic drastically altered children's activity patterns. Our goal was to investigate how COVID-19 affected demographics, injury characteristics, treatment patterns, follow-up, and outcomes in pediatric supracondylar humerus (SCH) fractures.MethodsThis was an Institutional Review Board-approved retrospective analysis of patients undergoing surgery for a SCH fracture from May to November 2019 (pre-COVID-19) and from May to November 2020 (during COVID-19) at 2 tertiary children's hospitals. Demographic information, injury characteristics, hospital course, and follow-up data were collected and compared.ResultsSCH fractures decreased by >50% from 2019 (149) to 2020 (72). Children in the 2020 cohort were younger (mean 5.2 y old) compared with 2019 (6.0 y old) ( P =0.019). Mechanism of injury was significantly different in 2020 ( P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2m7349b4Test

المؤلفون: Song, Siyou, Muhumuza, Moses Fisha, Penny, Norgrove, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 23(1)

مصطلحات موضوعية: Allied Health and Rehabilitation Science, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Pediatric, Patient Safety, Clinical Research, Musculoskeletal, Good Health and Well Being, Child, Foot Deformities, Humans, Iatrogenic Disease, Injections, Intramuscular, Paralysis, Retrospective Studies, Treatment Outcome, Post-injection paralysis, Intramuscular injection, Pediatrics, Iatrogenic disability, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundPost-injection paralysis (PIP) of the sciatic nerve is an iatrogenic paralysis that occurs after an intramuscular injection, with resultant foot deformity and disability. This study investigates the epidemiology and treatment of PIP in Uganda.MethodsHealth records of pediatric patients surgically treated for PIP at the CoRSU Rehabilitation Hospital from 2013 to 2018 were retrospectively reviewed. Pre-operative demographics, perioperative management, and outcomes were coded and analyzed with descriptive statistics, chi-square for categorical variables, and linear models for continuous variables.ResultsFour-hundred and two pediatric patients underwent 491 total procedures. Eighty-three percent of reported injection indications were for febrile illness. Twenty-five percent of reported injections explicitly identified quinine as the agent. Although ten different procedures were performed, achilles tendon lengthening, triple arthrodesis, tibialis posterior and anterior tendon transfers composed 83% of all conducted surgeries. Amongst five different foot deformities, equinus and varus were most likely to undergo soft tissue and bony procedures, respectively (p=0.0223). Ninteen percent of patients received two or more surgeries. Sixty-seven percent of patients achieved a plantigrade outcome; 13.61% had not by the end of the study period; 19.3% had unreported outcomes. Those who lived further from the facility had longer times between the inciting injection and initial hospital presentation (p=0.0216) and were more likely to be lost to follow-up (p=0.0042).ConclusionPIP is a serious iatrogenic disability. Prevention strategies are imperative, as over 400 children required 491 total surgical procedures within just six years at one hospital in Uganda.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2tp661c8Test

المؤلفون: Challa, Sravya, Agarwal-Harding, Kiran J., Levy, Paul, Barr-Walker, Jill, Sabatini, Coleen S.

مصطلحات موضوعية: orthopedic, low-income countries, supracondylar humerus fracture, LICs, systematic review, scoping review

الوصف: Background: The purpose of this scoping review was to examine the nature and quality of research regarding pediatric supracondylar humerus (SCH) fractures in low and lower-middle income countries (LICs).  Methods: We searched PubMed, Embase, Web of Science, and African Journals Online on January 9, 2018 for studies of SCH fractures in LICs. Studies were categorized by geographic region, Gartland classification of included patients, and study design. We evaluated each study’s methodology and conclusions.Results: Out of 1805 results, we analyzed 105 studies, most of which included Type 3 fractures only (66%). Many were conducted in South Asia (58%) and assessed treatment outcomes (78%). Most of the studies had level IV evidence (67%). Common limitations of research were small sample size (12%) and inadequate follow-up (6%). Epidemiological studies concluded that SCH fractures are more common among male children, are usually secondary to falls, and rarely present with nerve injuries. Most therapeutic studies reported outcomes of surgery (91%). Thirteen studies concluded that all-lateral versus cross-pinning techniques have similar outcomes. Seven studies reported preference for closed reduction over open reduction, when intraoperative fluoroscopy was available. Most common outcome measures were Flynn criteria (77%) and range of motion (53%). None of the papers looked at treatment costs.Conclusions: Our data show a predominance of small level IV studies from LICs, with few studies of higher level of evidence. Many studies examined controversies with surgical technique, similar to studies performed in HICs. Few studies examined non-operative treatment, which is commonly the predominant treatment available for patients in LICs. Further investigation of common treatment modalities and outcomes for SCH fractures in LICs is needed.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/18f88145Test

المؤلفون: Alves, Kristin, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: Journal of Bone and Joint Surgery. 101(4)

مصطلحات موضوعية: Bioengineering, Adolescent, Buttocks, Child, Child, Preschool, Female, Fibrosis, Hip Contracture, Humans, Male, Muscle, Skeletal, Postoperative Complications, Treatment Outcome, Biomedical Engineering, Clinical Sciences, Orthopedics

الوصف: BackgroundThe objective of this study was to analyze the literature regarding the diagnosis, pathogenesis, and prevalence of gluteal fibrosis (GF) and the outcomes of treatment.MethodsWe searched PubMed, Embase, and Cochrane literature databases, from database inception to December 15, 2016. We used the following search terms including variants: "contracture," "fibrosis," "injections," "injections, adverse reactions,' "gluteal," and "hip." All titles and abstracts of potentially relevant studies were scanned to determine whether the subject matter was potentially related to GF, using predefined inclusion and exclusion criteria. If the abstract had subject matter involving GF, the paper was selected for review if full text was available. Only papers including ≥10 subjects who underwent surgical treatment were included in the systematic analysis. Data abstracted included the number of patients, patient age and sex, the type of surgical treatment, the method of outcome measurement, and outcomes and complications.ResultsThe literature search yielded 2,512 titles. Of these, 82 had a focus on GF, with 50 papers meeting the inclusion criteria. Of the 50 papers reviewed, 18 addressed surgical outcomes. The surgical techniques in these papers included open, minimally invasive, and arthroscopic release and radiofrequency ablation. Of 3,733 operatively treated patients in 6 reports who were evaluated on the basis of the criteria of Liu et al., 83% were found to have excellent results. Few papers focused on the incidence, prevalence, and natural history of GF, precluding quantitative synthesis of the evidence in these domains.ConclusionsThis study provided a systematic review of surgical outcomes and a summary of what has been reported on the prevalence, diagnosis, prognosis, and pathogenesis of GF. Although GF has been reported throughout the world, it requires further study to determine the exact etiology, pathogenesis, and appropriate treatment. Surgical outcomes appear satisfactory.Level of evidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/08d0d736Test

المؤلفون: Alves, Kristin, Penny, Norgrove, Ekure, John, Olupot, Robert, Kobusingye, Olive, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Musculoskeletal Disorders. 19(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Pediatric, Prevention, Buttocks, Child, Child, Preschool, Female, Fibrosis, Humans, Injections, Intramuscular, Male, Paralysis, Prevalence, Retrospective Studies, Rural Health, Uganda, Gluteal fibrosis, Post-injection paralysis, Orthopedics, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise

الوصف: BackgroundThe purpose of this study was to estimate the prevalence of postinjection paralysis (PIP) and gluteal fibrosis (GF) among children treated in a rural Ugandan Hospital.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/82b3m32wTest

المؤلفون: Alves, Kristin, Godwin, Christine L, Chen, Angela, Akellot, Daniella, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: BMC Health Services Research. 18(1)

مصطلحات موضوعية: Health Services and Systems, Health Sciences, Clinical Research, Prevention, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Good Health and Well Being, Adult, Attitude of Health Personnel, Buttocks, Child, Delivery of Health Care, Female, Fibrosis, Health Personnel, Humans, Iatrogenic Disease, Injections, Intramuscular, Interviews as Topic, Male, Middle Aged, Motivation, Paralysis, Qualitative Research, Uganda, Gluteal fibrosis, Post-injection paralysis, Injection practices, Safe injection, Pediatric musculoskeletal health, Pediatric orthopaedics, Intramuscular injection, Library and Information Studies, Nursing, Public Health and Health Services, Health Policy & Services, Health services and systems, Public health

الوصف: BackgroundIatrogenic injection injury is a major cause of disability in Ugandan children. Two injuries thought to result from injection of medications into the gluteal region include post-injection paralysis (PIP) and gluteal fibrosis (GF). This study aimed to describe perceptions of local health care workers regarding risk factors, particularly injections, for development of GF and PIP. Specifically, we examine the role of injection practices in the development of these injuries by interviewing a diverse cohort of individuals working in the health sector.MethodsWe conducted a qualitative study in the Kumi and Wakiso Districts of Uganda in November 2017, utilizing 68 key informant interviews with individuals working in healthcare related fields. Interviews were structured utilizing a moderator guide focusing on injection practices, gluteal fibrosis and post-injection paralysis.ResultsWe identified six themes regarding perceptions of the cause of GF and PIP and organized these themes into a theoretical framework. There was a consensus among the individuals working in healthcare that inadequacies of the health care delivery system may lead to inappropriate intramuscular injection practices, which are presumed to contribute to the development of GF and PIP. Poor access to medications and qualified personnel has led to the proliferation of private clinics, which are often staffed by under-trained practitioners. Misaligned economic incentives and a lack of training may also motivate practitioners to administer frequent intramuscular injections, which cost more than oral medications. A lack of regulatory enforcement enables these practices to persist. However, due to limited community awareness, patients often perceive these practitioners as appropriately trained, and the patients frequently prefer injections over alternative treatment modalities.ConclusionThis qualitative study suggests that inappropriate intramuscular injections, may arise from problems in the health care delivery system. To prevent the disability of GF and PIP, it is important to not only address the intramuscular injections practices in Uganda, but also to examine upstream deficits in access, education, and policy enforcement.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/3nq1t9sfTest

المؤلفون: Udogwu, Ugochukwu N, Sabatini, Coleen S

المصدر: Orthopedic reviews. 10(3)

مصطلحات موضوعية: Vertical patellar dislocation, lateral patella dislocation, patella dislocation

الوصف: Vertical patellar dislocations (VPDs) are a rare event, and even more so among pediatric female patients. There have been less than 30 vertical patellar dislocations reported in the literature since the first in 1844. In this type of dislocation, the patella rotates about its vertical axis with the articular surface facing either medially or laterally. The mechanism of injury for a VPD can be broadly divided into two themes: a twisting injury or direct impact to the medial or lateral edge of the patella. We present a 10-year-old girl with a VPD after experiencing a twisting injury when descending a playground slide. The purpose of this study is to present a case report and review of the literature on vertical patella dislocations, including mechanisms of injury and suggested methods of treatment. We aim to provide a comprehensive understanding of the various categories of patella dislocations to alleviate confusion when classifying patellar dislocations. Furthermore, we provide clear suggestions for reduction methods and techniques with regards to vertical patellar dislocations, including a suggested protocol for an irreducible patella.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0jm90615Test

المؤلفون: Alves, Kristin, Penny, Norgrove, Kobusingye, Olive, Olupot, Robert, Katz, Jeffrey N, Sabatini, Coleen S

المصدر: International Orthopaedics. 42(8)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Brain Disorders, Neurosciences, Rehabilitation, Infection, Musculoskeletal, Adolescent, Child, Child, Preschool, Cohort Studies, Cost of Illness, Cross-Sectional Studies, Female, Humans, Infant, Male, Musculoskeletal Diseases, Prevalence, Retrospective Studies, Surveys and Questionnaires, Uganda, Pediatric musculoskeletal health, Pediatric orthopaedics, Gluteal fibrosis, Post-injection paralysis, MSK burden, Orthopedics, Clinical sciences

الوصف: PurposeThe purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.MethodsWe conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2253879tTest

المؤلفون: Sabatini, Coleen S., Edmonds, Eric W., Nepple, Jeffrey J., Liotta, Elizabeth S., Hergott, Katelyn, Quinn, Michael, Perkins, Crystal A., Wilson, Philip L., Ying Li, Ellis, Henry B., Pandya, Nirav K., Pennock, Andrew T., Spence, David D., Willimon, Samuel C., Bae, Donald S., Kocher, Mininder S., Busch, Michael T., Williams, David N., Heyworth, Benton E.

المصدر: Journal of Orthopaedic Trauma; Jul2024, Vol. 38 Issue 7, p351-357, 7p

المؤلفون: Thomas, Hannah S, Emmanuel, Adupa, Kayima, Peter, Ajiko, Mary Margaret, Grabski, David F, Situma, Martin, Kakembo, Nasser, Ozgediz, Doruk E, Sabatini, Coleen S

المصدر: J Surg Res ; ISSN:1095-8673 ; Volume:300

مصطلحات موضوعية: Orthopedics, Pediatric, Road traffic crash, Surgery, Trauma, Uganda

الوصف: Traumatic injury is responsible for eight million childhood deaths annually. In Uganda, there is a paucity of comprehensive data describing the burden of pediatric trauma, which is essential for resource allocation and surgical workforce planning. This study aimed to ascertain the burden of non-adolescent pediatric trauma across four Ugandan hospitals.

العلاقة: https://doi.org/10.1016/j.jss.2024.04.043Test; https://pubmed.ncbi.nlm.nih.gov/38870654Test

الإتاحة: https://doi.org/10.1016/j.jss.2024.04.043Test
https://pubmed.ncbi.nlm.nih.gov/38870654Test