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Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

Volume 9 | Issue 2 | May-August 2023 | Page: 16-20 | Cury Sharma, Vivek Singh, Aditya Gowda, Parshwanath Bondarde, Naveen Kumar, Ch Sri Madhusudhan, Vikas Maheshwari DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.166 Submitted: 14/12/2022; Reviewed: 17/02/2023; Accepted: 20/06/2023; Published: 18/08/2023 Authors: Cury Sharma MS Ortho [1], Vivek Singh MS Ortho [1], Aditya Gowda MS Ortho [1], Parshwanath Bondarde […]

Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

Volume 9 | Issue 2 | May-August 2023 | Page: 10-15 | Raghavendra S. Kulkarni, SriRam R. Kulkani DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.165 Submitted: 14/05/2023; Reviewed: 28/05/2023; Accepted: 29/06/2023; Published: 10/08/2023 Authors: Raghavendra S. Kulkarni MS Ortho [1], SriRam R. Kulkani MS Ortho [2] [1] Department of Orthopaedics, SSPM Medical College & Lifetime Hospital, Padve, Sindhudurg, Maharashtra, India. [2] […]

Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

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Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

Volume 9 | Issue 2 | May-August 2023 | Page: 16-20 | Cury Sharma, Vivek Singh, Aditya Gowda, Parshwanath Bondarde, Naveen Kumar, Ch Sri Madhusudhan, Vikas Maheshwari

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.166

Submitted: 14/12/2022; Reviewed: 17/02/2023; Accepted: 20/06/2023; Published: 18/08/2023

Authors: Cury Sharma MS Ortho [1], Vivek Singh MS Ortho [1], Aditya Gowda MS Ortho [1], Parshwanath Bondarde MBBS [2], Naveen Kumar MS Ortho, MCH Paediatric Orthopaedics [1], Ch Sri Madhusudhan MBBS [2], Vikas Maheshwari MS Ortho [1]

[1] Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

[2] MBBS, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Address of Correspondence

Dr. Vivek Singh
Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
E-mail: singhvr27@gmail.com

Abstract

Introduction: Chronic osteomyelitis presents a significant challenge when it comes to treatment in children. Despite thorough radical debridement and extended antibiotic courses, it often proves resistant to resolution. The literature lacks definitive guidelines on the optimal management of chronic osteomyelitis, leaving several unanswered questions.
Patients and methods: The study comprised all patients who underwent surgery in the year 2022. After clinical history, examination, radiological studies, and blood investigations; single stage debridement and bone cement beads application was performed and patients were followed up for a period of 12 months.
Result: Eighteen patients (12 males and 6 females) with a mean age 6 years requiring surgical debridement were included in the study. Involved bones were tibia (12%), ulna (6%), humerus (6%), and femur (76%). Erythrocyte sedimentation rate (ESR) normalized in a mean time of 2.3 months and C-reactive protein (CRP) normalised in a mean time of 2.3 weeks. The average duration of infection prior to treatment was 5.6 months (Table 2). The most common organism isolated was Methicillin resistant Staphylococcus aureus (MRSA) (Table 4) and most common antibiotic sensitivity found was with Linezolid (58%) followed by Vancomycin (41%). Mean bone healing time radiologically was 3.3 months and mean cement absorption time was 2.6 months.
At 1 year follow up, all patients had healing both clinically and radiologically. There was reactivation of infection in 1 patient that settled with antibiotic therapy only. None of the children in the series required reoperation for infection.o signs of relapse at 1 year follow up and 0 percent – reoperation.
Conclusion: The addition of biodegradable cement increases the rate of eradication of infection during treatment of chronic osteomyelitis in children. Antibiotic course should be continued until the ESR and CRP normalise with an initial short intravenous course.
Keywords: Chronic osteomyelitis, Stimulan, Paediatric

References

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How to Cite this Article: Sharma C, Singh V, Gowda A, Bondarde P, Kumar N, Srimadhusudhan C, Maheshwari V | Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 16-20. https://doi.org/10.13107/ijpo.2023.v09.i02.166

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Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

Volume 9 | Issue 2 | May-August 2023 | Page: 10-15 | Raghavendra S. Kulkarni, SriRam R. Kulkani

DOI- https://doi.org/10.13107/ijpo.2023.v09.i02.165

Submitted: 14/05/2023; Reviewed: 28/05/2023; Accepted: 29/06/2023; Published: 10/08/2023

Authors: Raghavendra S. Kulkarni MS Ortho [1], SriRam R. Kulkani MS Ortho [2]

[1] Department of Orthopaedics, SSPM Medical College & Lifetime Hospital, Padve, Sindhudurg, Maharashtra, India.
[2] Department of Orthopaedics, ACPM Medical College & Hospital, Dhule, Maharashtra, India.

Address of Correspondence

Dr. Raghavendra S. Kulkarni,
Professor of Orthopaedics & Medical Superintendent, SSPM Medical College & Lifetime Hospital, Padve, 415634 Sindhudurg, Maharashtra, India.
E-mail: rskulkarnics53@gmail.com

Abstract

Introduction: A significant asynchrony between statural growth rate and mineral mass accrual may contribute to the increased prevalence of low-energy fractures observed during puberty. This disparity is most pronounced when the compact bone of the radius exhibits a temporary surge in porosity concurrent with the most rapid phase of linear growth.
Materials & Methods: The district hospital, Sindhadurg complete medical records are used to identify all distal radius fracture younger than 18 years, treated during 2000 to 2011. The medical record linkage system of regular and periodical school health medical examination performed by medical officers tested biannually, anthropometrically, physiologically and clinically for whole district children provides the unique data on velocity of growth. This demographic data of distal radius fracture in children and adolescents are compared with, documentation of longitudinal velocity of growth of the same children that was collected during the identical time period for children from the same student population of Sindhudurg.
Results: After adjusting for age and sex, the annual incidence rates per 100,000 population showed a statistically significant increase from 2.8 (95% CI 2.4-3.3) in 2000, to 6.3 (95% CI 5.7-6.9) in 2006, and 12.7 (95% CI 11.9-13.4) in 2011. The average age for peak growth velocity was 14.2 years in boys and 12.6 years in girls, according to the Government of Maharashtra’s school health program. Notably, the incidence of fractures peaked at ages 13.1 to 15.2 in boys and 11.4 to 13.8 in girls.
Conclusion: This long term data for the whole Sindhudurg district indicates a correlation between the peak incidence of distal radius fractures and the age of maximum growth velocity in both boys and girls, suggesting a potential vulnerability during this critical growth phase.
Keywords: Distal radius fracture in children, adolescent, puberty, growth spurt, longitudinal velocity of growth.

References

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How to Cite this Article: Kulkarni RS, Kulkani SR | Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011) | International Journal of Paediatric Orthopaedics | May-August 2023; 9(2): 10-15 | https://doi.org/10.13107/ijpo.2023.v09.i02.165

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Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

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Role of Biodegradable Cement in Musculoskeletal Infection in the Pediatric Population

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Incidence of Distal Radius Fracture in Children Peaks Around the Pubertal Growth Spurt: A Hospital-Based Study Over Twelve Years (2000 to 2011)

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