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The Bone & Joint Journal
Vol. 104-B, Issue 2 | Pages 302 - 308
1 Feb 2022
Dala-Ali B Donnan L Masterton G Briggs L Kauiers C O’Sullivan M Calder P Eastwood DM

Aims

Osteofibrous dysplasia (OFD) is a rare benign lesion predominantly affecting the tibia in children. Its potential link to adamantinoma has influenced management. This international case series reviews the presentation of OFD and management approaches to improve our understanding of OFD.

Methods

A retrospective review at three paediatric tertiary centres identified 101 cases of tibial OFD in 99 patients. The clinical records, radiological images, and histology were analyzed.


The Bone & Joint Journal
Vol. 101-B, Issue 4 | Pages 491 - 496
1 Apr 2019
Li NY Kalagara S Hersey A Eltorai AEM Daniels AH Cruz Jr AI

Aims

The aim of this study was to utilize a national paediatric inpatient database to determine whether obesity influences the operative management and inpatient outcomes of paediatric limb fractures.

Patients and Methods

The Kids’ Inpatient Database (KID) was used to evaluate children between birth and 17 years of age, from 1997 and 2012, who had undergone open and closed treatment of humeral, radial and ulna, femoral, tibial, and ankle fractures. Demographics, hospital charges, lengths of stay (LOS), and complications were analyzed.


The Bone & Joint Journal
Vol. 101-B, Issue 9 | Pages 1160 - 1167
1 Sep 2019
Wang WT Li YQ Guo YM Li M Mei HB Shao JF Xiong Z Li J Canavese F Chen SY

Aims

The aim of this study was to clarify the factors that predict the development of avascular necrosis (AVN) of the femoral head in children with a fracture of the femoral neck.

Patients and Methods

We retrospectively reviewed 239 children with a mean age of 10.0 years (sd 3.9) who underwent surgical treatment for a femoral neck fracture. Risk factors were recorded, including age, sex, laterality, mechanism of injury, initial displacement, the type of fracture, the time to reduction, and the method and quality of reduction. AVN of the femoral head was assessed on radiographs. Logistic regression analysis was used to evaluate the independent risk factors for AVN. Chi-squared tests and Student’s t-tests were used for subgroup analyses to determine the risk factors for AVN.


The Journal of Bone & Joint Surgery British Volume
Vol. 92-B, Issue 7 | Pages 1006 - 1012
1 Jul 2010
Davids JR Hydorn C Dillingham C Hardin JW Pugh LI

We have reviewed our experience of the removal of deep extremity orthopaedic implants in children to establish the nature, rate and risk of complications associated with this procedure. A retrospective review was performed of 801 children who had 1223 implants inserted and subsequently removed over a period of 17 years. Bivariate analysis of possible predictors including clinical factors, complications associated with implant insertion and indications for removal and the complications encountered at removal was performed. A logistical regression model was then constructed using those predictors which were significantly associated with surgical complications from the bivariate analyses. Odds ratios estimated in the logistical regression models were converted to risk ratios.

The overall rate of complications after removal of the implant was 12.5% (100 complications in 801 patients), with 48 (6.0%) major and 52 (6.5%) minor. Children with a complication after insertion of the initial implant or with a non-elective indication for removal, a neuromuscular disease associated with a seizure disorder or a neuromuscular disease in those unable to walk, had a significantly greater chance of having a major complication after removal of the implant. Children with all four of these predictors were 14.6 times more likely to have a major complication.