Spiral tibial fractures revisited.
Explore the source record for details and available documents.
Child↗
Biomedical subjects
L B Mellick
Publications and source records attributed to L B Mellick.
Spiral tibial fractures of children: a commonly accidental spiral long bone fracture.
Pediatric training in child abuse has consistently emphasized a strong association between nonaccidental injuries and spiral fractures of long bones. Isolated spiral tibial fractures of childhood have previously been recognized by the orthopedic specialty to most frequently be accidental in etiology. The authors present evidence that supports a predominantly accidental etiology for isolated spiral tibial fractures of young children. This article presents a series in which 9 of 10 such spiral fractures were most likely the result of an accident and not child abuse or gross neglect. Additionally, almost all of these fractures presented as a gait disturbance and should be included in the differential of this complaint.
Accidents, Home↗
Presentations of acute phenytoin overdose.
A 15-year-old boy ingested 19.6 g (15 g verifiable) phenytoin sodium approximately four hours before emergency department presentation. The patient survived the suicide attempt with only supportive care, despite the ingestion of 392 mg/kg and a peak serum level of 100.8 micrograms/mL. A wide spectrum of physical findings consistent with acute massive ingestion of phenytoin was noted. This case report and a review of cases reported in the English literature of acute single anticonvulsant ingestion further delineate the clinical presentation of acute phenytoin overdose.
Adolescent↗
Tibial fractures of young children.
Tibial fractures are relatively frequent injuries of young children. These fractures are occasionally the cause of a childhood gait disturbance. Additionally, tibial fractures may be the result of child abuse. Consequently, the pediatrician should have knowledge concerning these injuries. In this paper, we present a review of tibial fractures in hospitalized children and describe their associations with nonaccidental trauma (NAT). Finally, we provide suggestions for improving nonmenclature clarity for isolated spiral fractures of the tibia.
Accidental Falls↗
Testicular torsion following orchiopexy.
A case of testicular torsion one year after orchiopexy is presented. The occurrence of testicular torsion following surgery is a rare event which has the potential for diagnostic misadventures. To better delineate this condition, we performed a literature review of all reported cases of recurrent testicular torsion. Thirteen reported patients with testicular torsion following orchiopexy are presented and discussed.
Adult↗