Instructional Video did not reduce anxiety during pediatric cast removal: a prospective cohort study.

The aim of the study was to determine if the use of an Instructional Video will decrease anxiety during cast removal. We enrolled 60 healthy children undergoing their first cast removal following conservative fracture treatment. Patients were divided into one of three groups (1) No Video (control group), (2) watching a video of a well-tolerated pediatric cast removal (Instructional Video), or (3) watching a nonmedical Children's Video during cast removal. We assessed anxiety to the cast saw by recording heart rate in the waiting room, during the procedure, and 1-2 min after the procedure. There were no significant differences in waiting room, procedure, and post-procedure heart rates between the two interventions and the control group. The mean change in heart rate from baseline to the procedure room for the Instructional Video cohort exhibited a similar increase (25.8 beats/min) in heart rate during cast removal as the No Video group (26.3 beats/min), while the Children's Video had the smallest change in heart rate (17.7 beats/min) with a trend towards significance (P = 0.12). The results were not statistically significant for the full linear mixed-effect model on the three measurements. When we use age to control for variability in the data, we have a moderate effect size between Children's Video and control (η2P = 0.0592), revealing that certain ages likely benefited from the Children's Video intervention. Distraction using a Children's Video may help reduce anxiety during cast removal whereas the Instructional Video did not reduce anxiety as hypothesized.

Reconstruction of Chronic Patellar Tendon Injury with Achilles Tendon Allograft: A Case Report.

CASE: There have been several methods described for the reconstruction of chronic patellar tendon injuries in the native knee. Here, we report a former athlete who sustained a tibial tubercle fracture as an adolescent and presented with functional deficits from a patellar tendon that healed in elongation after the removal of hardware and debridement of ossifications within the tendon. He underwent reconstruction with Achilles allograft. CONCLUSIONS: Achilles tendon allograft is a good option for reconstructing chronic patellar tendon injuries. Our patient had an excellent outcome at 1 year.

Conversion of Glenohumeral Fusion to Reverse Total Shoulder Arthroplasty: A Case Report.

CASE: A 41-year-old woman presented 5 years after glenohumeral arthrodesis. She experienced symptomatic relief following conversion to reverse total shoulder arthroplasty, regaining nearly full passive range of motion and >50% of normal active forward flexion, abduction, internal rotation, and external rotation. CONCLUSION: Conversion from glenohumeral arthrodesis to reverse total shoulder arthroplasty in a patient with a functioning deltoid and adequate bone stock may provide symptomatic relief and improved function in the setting of symptomatic glenohumeral arthrodesis refractory to conservative measures.