Biomedical subjects

J R Kasser

Publications and source records attributed to J R Kasser.

58 records · Page 4Linked to original sources

PubMedDate not supplied

Pediatric floating elbow.

SUMMARY: A retrospective review of 16 patients with floating elbow injuries over a 9-year period at a tertiary care children's hospital confirms that these injuries are associated with substantial swelling and the potential to develop compartment syndrome, particularly when circumferential cast immobilization is used. Among 10 patients in whom the forearm was treated with closed reduction and plaster immobilization, a compartment syndrome developed in 2, and 4 patients had incipient compartment syndrome that responded to splitting of the cast; 3 of these subsequently required remanipulation of the distal radius. One patient with compartment syndrome had Volkmann ischemic contracture. Six patients underwent stabilization of both the distal humeral and forearm fractures with percutaneously inserted Kirschner wires, thereby allowing postreduction immobilization in a split cast. None of these patients had problems with excessive swelling or compartment syndrome. Percutaneous Kirschner wire fixation of both the humeral and forearm fractures in pediatric floating elbow injuries allows noncircumferential immobilization, thereby reducing the risk of compartment syndrome.

Adolescent↗

PubMedDate not supplied

The triceps-dividing approach to open reduction of complex distal humeral fractures in adolescents: a Cybex evaluation of triceps function and motion.

Triceps function and elbow motion were evaluated in nine elbows after open reduction of complex distal humeral fractures through a triceps dividing approach. At 3-year 6-month follow-up, the patients had an average flexion/extension of 136 degrees to -6 degrees. Triceps peak torque decreased slightly, measured by Cybex testing with a 6% deficit at 60 degrees/s, 3% deficit at 120 degrees/s, and 3% deficit at 180 degrees/s. We recommend triceps division rather than olecranon osteotomy in children who require open reduction of complex distal humeral fractures.

Adolescent↗

PubMedDate not supplied

Femur fractures in children: treatment with early sitting spica casting.

The purpose of this article is to review our experience with early spica casting and determine risk factors for loss of reduction and skin complications. The radiographic and clinical charts of 114 children were retrospectively reviewed. At the time of fracture union, excessive shortening and angular malunion were not significant problems. Loss of reduction and skin complications occurred in 20 and 14% of patients, respectively. In addition to previously described risk factors, we identified spica knee flexion angle < 50 degrees as predictive of eventual loss of reduction and found that > 2 cm of initial shortening was not a contraindication to early spica casting. Factors associated with skin problems included younger age and abuse as a mechanism of injury. In our opinion, early spica casting is the treatment of choice for all isolated, closed femur fractures in otherwise healthy children aged 6 years or younger, regardless of the degree of initial deformity.

Analysis of Variance↗

PubMedDate not supplied

Radiographic appearance of the normal distal tibiofibular syndesmosis in children.

In adults, a tibiofibular clear space (i.e., distance from the incisura fibularis to the medial fibula) of > or = 6 mm or a loss of tibiofibular overlap has been reported to correlate with injury to the distal tibiofibular syndesmosis. We reviewed anteroposterior (AP), lateral, and mortise ankle radiographs from 106 children (50 boys, 56 girls) aged 1-15 years in an attempt to assess whether these criteria are applicable to children. The incisura was detectable at a mean age of 8.2 years for girls and 11.2 years for boys. The range of tibiofibular clear space among the 48 children with a detectable incisura was 2-8 mm; seven (23%) of these 48 children had a clear space of > or = 6 mm in one or more views. The mean age at which the tibiofibular overlap began to appear on the AP view was 5 years for both genders, whereas on the mortise view, it was 10 years for girls and 16 years for boys. The criteria used to evaluate the integrity of the distal tibiofibular syndesmosis in adults do not apply to children in this normal study population.

Adolescent↗