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1.
Orthop Traumatol Surg Res ; : 103808, 2023 Dec 29.
Article in English | MEDLINE | ID: mdl-38159639

ABSTRACT

Cubitus varus deformity is a common complication of supracondylar fractures in children. Anatomic correction is the key to obtaining good functional results and avoiding later symptomatic degradation. Different techniques have been described, mainly lateral closing wedge osteotomy. A medial opening wedge osteotomy seems more intuitive, allowing an anatomic reduction, but it is technically challenging. Two-plane radiographs are too simplistic to appreciate the 3D deformity. With medical imaging and image processing advances, three-dimensional (3D) virtual models of a patient's anatomy can be generated. Rapid 3D printing has allowed virtual simulations of surgical corrections to be transferred to real-world applications in the operating room, allowing more precise and accurate surgery with better 3D corrections. 3D computer modeling with the development of customized drilling and cutting guides allows complex medial opening wedge osteotomy for correction of cubitus varus deformity in immature children with best-fit plate synthesis. LEVEL OF EVIDENCE: IV.

2.
J Pediatr Gastroenterol Nutr ; 74(3): e45-e56, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35226643

ABSTRACT

OBJECTIVES: The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) aims to educate pediatric gastroenterologists, members of ESPGHAN and professionals from other specialties promoting an exchange of clinical expertise in the field of pediatric hepatology. Herewith we have concentrated on detailing the recent advances in acute liver failure in infants and children. METHODS: The 2020 ESPGHAN monothematic three-day conference on pediatric hepatology disease, entitled "acute liver failure" (ALF), was organized in Athens, Greece. ALF is a devastating disease with high mortality and most cases remain undiagnosed. As knowledge in diagnosis and treatment of ALF in infants and children has increased in the past decades, the objective was to update physicians in the field with the latest research and developments in early recognition, curative therapies and intensive care management, imaging techniques and treatment paradigms in these age groups. RESULTS: In the first session, the definition, epidemiology, various causes of ALF, in neonates and older children and recurrent ALF (RALF) were discussed. The second session was dedicated to new aspects of ALF management including hepatic encephalopathy (HE), coagulopathy, intensive care interventions, acute on chronic liver failure, and the role of imaging in treatment and prognosis. Oral presentations by experts in various fields are summarized highlighting key learning points. CONCLUSIONS: The current report summarizes the major learning points from this meeting. It also identifies areas where there is gap of knowledge, thereby identifying the research agenda for the near future.


Subject(s)
Gastroenterology , Liver Failure, Acute , Adolescent , Child , Child Nutritional Physiological Phenomena , Humans , Infant , Infant, Newborn , Liver Failure, Acute/diagnosis , Liver Failure, Acute/etiology , Liver Failure, Acute/therapy , Nutritional Status , Societies, Medical
3.
J Pediatr Gastroenterol Nutr ; 74(3): 338-347, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35226644

ABSTRACT

OBJECTIVES: The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) aims to educate pediatric gastroenterologists, members of ESPGHAN and professionals from other specialties promoting an exchange of clinical expertise in the field of pediatric hepatology. METHODS: The 2020 single topic ESPGHAN monothematic 3-day conference on pediatric liver disease, was organized in Athens, Greece and was entitled " Acute Liver Failure" (ALF). ALF is a devastating disease with high mortality and in a considerable fraction of patients, the cause remains unresolved. As knowledge in diagnosis and treatment of ALF in infants and children has increased in the past decades, the objective was to update physicians in the field with developments in medical therapy and indications for liver transplantation (LT) and to identify areas for future research in clinical and neurocognitive outcomes in ALF. RESULTS: We recently reported the epidemiology, diagnosis, and initial intensive care management issues in separate manuscript. Herewith we report on the medical treatment, clinical lessons arising from pediatric studies, nutritional and renal replacement therapy (RRT), indications and contraindications for LT, neurocognitive outcomes, new techniques used as bridging to LT, and areas for future research. Oral presentations by experts in various fields are summarized highlighting key learning points. CONCLUSIONS: The current report summarizes the current insights in medical treatment of pediatric ALF and the directions for future research.


Subject(s)
Gastroenterology , Liver Failure, Acute , Child , Child Nutritional Physiological Phenomena , Humans , Infant , Liver Failure, Acute/diagnosis , Liver Failure, Acute/etiology , Liver Failure, Acute/therapy , Nutritional Status , Societies, Medical
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