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Lewis E Zionts

Publications and source records attributed to Lewis E Zionts.

6 recordsLinked to original sources
PubMed2005

Pediatric fractures during skateboarding, roller skating, and scooter riding.

BACKGROUND: Skateboarding, roller skating, and scooter riding are popular recreational and sporting activities for children and adolescents but can be associated with skeletal injury. The purpose of this study is to describe the frequency and characteristics of fractures resulting from these activities. PURPOSE: Fractures from skateboarding, roller skating, and scooter riding compose a considerable proportion of pediatric musculoskeletal injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Demographic data and injury characteristics were analyzed for all patients who presented to the pediatric fracture clinic of the level I trauma center from January 2001 to May 2002 after sustaining fractures due to skateboarding, roller skating, and scooter riding. RESULTS: Among a total of 2371 fractures, the authors identified 325 fractures (13.7%) that occurred during one of these activities. There were 187 patients (mean age, 13 years; 95% male) who sustained 191 skateboard-related fractures, 64 patients (mean age, 10.8 years; 54% male) who sustained 65 fractures while roller skating, and 66 patients (mean age, 9.7 years; 64% male) who sustained 69 fractures while riding a scooter. The forearm was fractured most often, composing 48.2% of skate-boarding fractures, 63.1% of roller-skating fractures, and 50.7% of fractures due to scooter riding. Of the forearm fractures, 94% were located in the distal third. In the skateboarding group, 10 of 191 (5.2%) fractures were open injuries of the forearm, compared to 6 of 2046 (0.3%) fractures caused by other mechanisms of injury (significant odds ratio, 18.8). CONCLUSIONS: Skateboarding, roller-skating, and scooter-riding accidents result in a large proportion of pediatric fractures. An open fracture, especially of the forearm, was more likely to be caused by skateboarding than by other mechanisms of injury. Use of wrist and forearm protective equipment should be considered in all children who ride a skateboard.

Adolescent↗
PubMedDate not supplied

Closed treatment of displaced diaphyseal both-bone forearm fractures in older children and adolescents.

The management of adolescent radius and ulna diaphyseal fractures is controversial. The purpose of this study was to address the residual deformity and functional outcome following closed treatment of these fractures. Twenty-five older children and adolescents (mean age 13.3 years, range 8.8-15.5) with displaced diaphyseal both-bone forearm fractures underwent closed treatment and were followed for a mean of 49.6 weeks. All fractures united. On the final AP radiograph, the mean angulation was 9 degrees (range 0-18 degrees) for the radius and 8 degrees (0-20 degrees) for the ulna. All patients achieved full elbow and wrist range of motion. Loss of forearm supination and pronation averaged 4 degrees (range 0 to 20 degrees) and 6.8 degrees (0 to 40 degrees), respectively. Closed reduction and casting of displaced both-bone diaphyseal forearm fractures, despite the residual angulation, results in satisfactory functional outcome and should remain a viable treatment option in the management of this injury.

Adolescent↗
PubMedDate not supplied

The early diagnosis of sacroiliac joint infections in children.

UNLABELLED: We retrospectively reviewed the medical records and imaging studies of 15 children with infections of the sacroiliac joint to determine the usefulness of specific examinations and studies to aid in the early diagnosis of this condition. The clinical presentation, physical examination findings, pertinent laboratory data, and imaging studies were reviewed. Thirteen patients (87%) were febrile at the time of presentation. One patient presented in septic shock requiring intubation and critical care management. Tenderness to palpation over the sacroiliac joint was present in all 9 patients who had this examination performed, and the flexion abduction external rotation test was positive in 10 of 12 patients (83%) who had this test done. Laboratory indicators of infection were elevated in most patients, and 6 patients (46%) had positive blood cultures, most commonly growing Staphylococcus aureus. Initial conventional radiographs were negative in all but 1 patient. Radionuclide 99-m-technetium bone scans were positive in 7 of 10 patients (70%), and magnetic resonance imaging studies were ultimately positive in 13 of 14 patients (93%). However, within the first 6 days after the onset of symptoms, only 5 of 8 bone scans (63%) and 5 of 9 magnetic resonance imaging studies (57%) were consistent with infection. We conclude that while diagnostic imaging studies are ultimately helpful in confirming the diagnosis of sacroiliac joint infections in children, studies made within 6 days of the onset of symptoms may not always confirm the diagnosis. The early diagnosis of this condition is best made on the basis of clinical and laboratory findings. LEVEL OF EVIDENCE: Therapeutic Study, level IV (Case series [no, or historical control group]).

Adolescent↗
PubMedDate not supplied

Fractures around the knee in children.

Traumatic forces applied to the immature knee result in fracture patterns different from those in adults. The relative abundance of cartilage in the knee of the growing child may make the diagnosis of certain injuries more challenging. If plain radiographs fail to reveal a fracture, a stress radiograph, computed tomography scan, or magnetic resonance imaging study may help to establish the diagnosis. Certain fractures, such as hyperextension injuries to the distal femoral or proximal tibial epiphysis, or displaced tibial tuberosity fractures, may be especially susceptible to neurovascular problems. Although the use of appropriate treatment techniques may minimize the occurrence of late complications such as malunion and physeal bridging, not all problems are preventable. A careful discussion of the injury with both patient and parents should stress the importance of follow-up so that any problems that do occur can be promptly addressed.

Child↗
PubMedDate not supplied

Olecranon apophysis fractures in children with osteogenesis imperfecta revisited.

The authors reviewed 17 fractures of the olecranon apophysis in 10 children with mild osteogenesis imperfecta (OI). Seven of the 10 patients sustained the same injury to the opposite extremity 1 to 70 months (mean 15.1) after their initial fracture. Four fractures were initially treated by cast immobilization alone. Two of these eventually required operative treatment because of refracture or late displacement. In all, 15 fractures were treated operatively. All had healed at the time the cast was removed; however, two refractured. At latest follow-up (mean 53 months), no patient reported pain or limited function. Children with OI may be prone to this injury. Cast immobilization with careful follow-up may be used for minimally displaced fractures, but operative treatment is recommended for displaced fractures. The high rate of bilateral injury (70%) suggests that children with OI who sustain this fracture should be counseled regarding the risk of injury to the opposite extremity.

Adolescent↗