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Diagnosis,treatment and complications of radial head and neck fractures in the pediatric patient

World Journal of Orthopedics 2022年第3期13卷 238-249页

作者： Arno A Macken Denise Eygendaal christiaan ja van bergen Department of Orthopedic Surgery Amphia HospitalBreda 4818 CKNoord-BrabantNetherlands Department of Orthopedic Surgery and Sports medicine Erasmus Medical CentreRotterdam 3015 GDSouth-HollandNetherlands

Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric *** up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard *** treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal *** choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical *** with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical *** proper management,good to excellent results are achieved in most cases,and long-term sequelae are ***,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive *** follow-up is therefore warranted.

关键词： Radial head Proximal radius Fracture Pediatrics Closed fracture reduction Open reduction fracture Fracture fixation Synostosis Osteonecrosis

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Developments in diagnosis and treatment of paediatric septic arthritis

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World Journal of Orthopedics 2022年第2期13卷 122-130页

作者： Cornelia M Donders Anne J Spaans Herbert van Wering christiaan ja van bergen Department of Orthopaedic Surgery Meander Medical CentreAmersfoort 3813 TZNetherlands Department of Orthopaedic Surgery Sint MaartenskliniekNijmegen 6574 NANetherlands Department of Paediatrics Amphia HospitalBreda 4818 CKNetherlands Department of Orthopedic Surgery Amphia HospitalBreda 4818 CKNetherlands

Acute septic arthritis in children is an orthopaedic emergency.A delay in diagnosis and inappropriate treatment can result in devastating damage to the joint with lifelong disability as a *** clinical presentation can be a diagnostic challenge,especially in young children.A recent systematic review showed that joint tenderness and fever are important signals of septic *** is helpful in detecting the presence of a joint *** radiographs may show bone changes but magnetic resonance imaging is the most reliable imaging study for detecting concomitant *** diagnosis of acute septic arthritis is highly suggestive when pus is aspirated from the joint,in case of a positive culture or a positive gram stain of the joint fluid,or if there is a white blood-cell count in the joint fluid of more than 50000/*** aureus is the most commonly cultured *** systematic reviews have identified the most effective drainage techniques,including needle aspiration,arthroscopy and arthrotomy,depending on the affected *** the drainage procedure it is important to monitor the clinical and laboratory *** drainage procedures may be necessary in select cases.

关键词： Septic arthritis Paediatric Children Analysis Treatment Drainage

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Fractures around the shoulder in the skeletally immature:A scoping review

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世界骨科杂志:英文版 2023年第8期14卷 604-611页

作者： Tim Kraal Peter AA Struijs Lisette C Langenberg christiaan ja van bergen Department of Orthopedic Surgery and Sports Medicine Amsterdam University Medical CentersAmsterdam 1105 AZNetherlands Department of Orthopedic Surgery NoordWest ZiekenhuisgroepAlkmaar 1815 JDNetherlands Department of Orthopedic Surgery and Sports Medicine Erasmus University Medical Center-Sophia Children’s HospitalRotterdam 3015 GDNetherlands Department of Orthopedic Surgery AmphiaBreda 4818 CKNetherlands

Fractures around the shoulder girdle in children are mainly caused by sports *** clavicle and the proximal humerus are most commonly *** the clavicle and the proximal humerus have a remarkable potential for remodeling,which is why most of these fractures in children can be treated ***,the key is to understand when a child benefits from surgical *** indications for surgery of these fractures are *** review focuses on the available evidence on the management of clavicle and proximal humerus fractures in *** only strict indications for surgery for diaphyseal clavicle fractures in children are open fractures,tenting of the skin with necrosis,associated neurovascular injury,or a floating *** is no evidence to argue for surgery of displaced clavicle fractures to prevent malunion since most malunions are *** the rare case of a symptomatic malunion of the clavicle in children,corrective osteosynthesis is a viable treatment *** proximal humerus fractures in children,treatment is dictated by the patient's age(and thus remodeling potential)and the amount of fracture *** ten years of age,even severely displaced fractures can be treated *** the age of 13 and onwards,surgery has better outcomes for severely displaced(Neer types III and IV)*** 10 and 13 years of age,the indications for surgical treatment are less clear,with varying cut-off values of angulation(30-60 degrees)or displacement(1/3–2/3 shaft width)in the current literature.

关键词： Clavicle fracture Proximal humerus fracture Pediatric Skeletally immature Children Shoulder

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Three-dimensional printing in paediatric orthopaedic surgery

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World Journal of Orthopedics 2022年第1期13卷 1-10页

作者： Sven Goetstouwers Dagmar Kempink Bertram The Denise Eygendaal Bart van Oirschot christiaan ja van bergen Department of Orthopaedic Surgery and Sports Medicine Erasmus Medical Centre/Sophia Children's HospitalRotterdam 3015GDSouth-HollandNetherlands Department of Orthopaedic Surgery Amphia HospitalBreda 4818CKNorth-BrabantNetherlands D Lab Amphia HospitalBreda 4818CKNorth-BrabantNetherlands

Three-dimensional(3D)printing is a rapidly evolving and promising field to improve outcomes of orthopaedic *** use of patient-specific 3D-printed models is specifically interesting in paediatric orthopaedic surgery,as limb deformity corrections often require an individual 3D *** this editorial,various operative applications of 3D printing in paediatric orthopaedic surgery are *** technical aspects and the imaging acquisition with computed tomography and magnetic resonance imaging are ***,there is a focus on the intraoperative applications of 3D printing during paediatric orthopaedic surgical *** overview of various upper and lower limb deformities in paediatrics is given,in which 3D printing is already implemented,including posttraumatic forearm corrections and proximal femoral *** use of patient-specific instrumentation(PSI)or guiding templates during the surgical procedure shows to be promising in reducing operation time,intraoperative haemorrhage and radiation ***,3D-printed models for the use of PSI or patient-specific navigation templates are promising in improving the accuracy of complex limb deformity surgery in ***,the future of 3D printing in paediatric orthopaedics extends beyond the intraoperative applications;various other medical applications include 3D casting and prosthetic limb *** conclusion,3D printing opportunities are numerous,and the fast developments are exciting,but more evidence is required to prove its superiority over conventional paediatric orthopaedic surgery.

关键词： Three-dimensional printing Paediatric Orthopaedic surgery Intraoperative Patient-specific instrumentation Guiding

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Kitesurf injury trauma evaluation study:A prospective cohort study evaluating kitesurf injuries

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World Journal of Orthopedics 2020年第4期11卷 243-251页

作者： christiaan ja van bergen Rik IK Weber Tim Kraal Gino MMJ Kerkhoffs Daniel Haverkamp Department of Orthopedic Surgery Amphia HospitalBreda 4818 CKthe Netherlands Academic Center for Evidence based Sports Medicine Amsterdam 1105 AZthe Netherlands Department of Sports Medicine University Medical CenterUtrecht 3584 CXthe Netherlands Department of Orthopedic Surgery Spaarne HospitalHoofddorp 2134 TMthe Netherlands Department of Orthopedic Surgery Amsterdam University Medical CenterAmsterdam 1105 AZthe Netherlands Department of Orthopedic Surgery Xpert ClinicAmsterdam 1103 TBthe Netherlands

BACKGROUND Kitesurfing is an increasingly popular and potentially dangerous extreme water *** hypothesized that kitesurfing has a higher injury rate than other(contact)sports and that the minority of injuries are *** To investigate the incidence and epidemiology of kitesurfing injuries in a Dutch cohort during a complete kitesurfing *** Injury data of 194 kitesurfers of various skill levels,riding styles and age were surveyed prospectively during a full kitesurf *** participants were recruited through the Dutch national kitesurf association,social media,local websites and kitesurf *** completed digital questionnaires *** amount of time kitesurfing was registered along with all sustained *** an injury was reported,an additional questionnaire explored the type of injury,injury location,severity and the circumstances under which the injury *** The mean age of participants was 31 years(range,13-59)and the majority of the study population was male(74.2%).A total of 177 injuries were sustained during 16816 kitesurf *** calculated injury rate was 10.5 injuries per 1000 h of *** most common injuries were cuts and abrasions(25.4%),followed by contusions(19.8%),joint sprains(17.5%)and muscle sprains(10.2%).The foot and ankle were the most common site of injury(31.8%),followed by the knee(14.1%)and hand and wrist(10.2%).Most injuries were reported to occur during a trick or *** the majority of injuries were mild,severe injuries like an anterior cruciate ligament tear,a lumbar spine fracture,a bimalleolar ankle fracture and an eardrum rupture were *** The injury rate of kitesurfing is in the range of other popular(contact)*** injuries are relatively mild,although kitesurfing has the potential to cause serious injuries.

关键词： Kite boarding Water sports Sports medicine Injuries Epidemiology Extreme sports

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Windsurfing vs kitesurfing:Injuries at the North Sea over a 2-year period

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World Journal of Orthopedics 2016年第12期7卷 814-820页

作者： christiaan ja van bergen Joris P Commandeur Rik IK Weber Daniel Haverkamp Roelf S Breederveld Department of Orthopaedic Surgery Spaarne Gasthuis Department of Surgery Luzerner Kantonsspital Department of Orthopaedic Surgery Slotervaartziekenhuis Department of Trauma Surgery Red Cross Hospital

AIM To analyze all windsurfing and kitesurfing(kiteboarding) injuries presented at our coastal hospital over a 2-year period. METHODS Twenty-five windsurfers(21 male; aged 31 ± 8 years) and 32 kitesurfers(23 male; aged 29 ± 11 years) presented at our hospital during the 2-year study period. Various injury data were recorded,including transport to hospital and treatment. After a median follow-up of 16 mo(range,7-33 mo),18 windsurfers(72%) and 26 kitesurfers(81%) completed questionnaires on the trauma mechanisms,the use of protective gear,time spent on windsurfing or kitesurfing,time to return to sports,additional injuries,and chronic disability. RESULTS Most patients sustained minor injuries but severe injuries also occurred,including vertebral and tibial plateau fractures. The lower extremities were affected the most,followed by the head and cervical spine,the upperextremities,and the trunk. The injury rates were 5.2 per 1000 h of windsurfing and 7.0 per 1000 h of kitesurfing(P = 0.005). The injury severity was the same between groups(P = 1.0). Less than 30% of the study population used protective gear. Kitesurfers had a higher number of injuries,and required transport by ambulance,inpatient hospital stay and operative treatment more often than windsurfers,but these differences were not statistically significant(P > 0.05). The median time to return to windsurfing and kitesurfing was 5 and 4 wk,respectively(P = 0.79). Approximately one-third of the patients in each group experienced chronic *** Kitesurfing results in a significantly higher injury rate than windsurfing in the same environmental conditions but the severity of the injuries does not differ.

关键词： General sports trauma Extreme sports Surfing Epidemiology Prevention

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Total elbow arthroplasty is moving forward: Review on past, present and future

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World Journal of Orthopedics 2016年第1期7卷 44-49页

作者： Ante Prki? christiaan ja van bergen Bertram The Denise Eygendaal Department of Orthopedic Surgery Amphia Hospital

The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebeen taken to optimize this treatment in order to achieve better post-operative outcomes. To understand these progresses and to discover aspects for upcoming improvements, we present a review on the past developments, the present state of affairs and future developments which may improve patient care further.

关键词： Total elbow arthroplasty History Future Improvements Review

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Osteochondritis dissecans of the capitellum in adolescents

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World Journal of Orthopedics 2016年第2期7卷 102-108页

作者： christiaan ja van bergen Kimberly IM van den Ende Bart ten Brinke Denise Eygendaal Department of Orthopedic Surgery Academic Medical Center Department of Orthopedic Surgery Amphia Hospital

Osteochondritis dissecans(OCD)is a disorder of articular cartilage and subchondral *** the elbow,an OCD is localized most commonly at the humeral *** engaged in sports that involve repetitive stress on the elbow are at risk.A high index of suspicion is warranted to prevent delay in the *** radiographs may disclose the lesion but computed tomography and magnetic resonance imaging are more accurate in the detection of *** determine the best treatment option it is important to differentiate between stable and unstable OCD *** lesions can be initially treated nonoperatively with elbow rest or activity modification and physical *** lesions and stable lesions not responding to conservative therapy require a surgical *** debridement and microfracturing has become the standard initial procedure for treatment of capitellar *** other surgical options have been reported,including internal fixation of large fragments and osteochondral autograft *** aim of this article is to provide a current concepts review of the etiology,clinical presentation,diagnosis,treatment,and outcomes of elbow OCD.

关键词： Osteochondritis dissecans Cartilage Elbow Capitellum Athletes Overhead sports Arthroscopy Bone marrow stimulation Adolescent Osteoarthritis

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Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities

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World Journal of Orthopedics 2015年第11期6卷 944-953页

作者： christiaan ja van bergen Rogier M Gerards Kim TM Opdam Maaike P Terra Gino MMJ Kerkhoffs Department of Orthopedic Surgery Academic Medical Center Department of Radiology Academic Medical Center

This current concepts review outlines the role of diffe-rent imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone(usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography(CT) and magnetic resonance imaging(MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.

关键词： Cartilage Subchondral bone Imaging Ankle Talus Radiography Computed tomography Magnetic resonance imaging Outcome assessment

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Prophylactic fixation of the unaffected contralateral side in children with slipped capital femoral epiphysis seems favorable:A systematic review

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World Journal of Orthopedics 2022年第5期13卷 515-527页

作者： Steven J C Vink Renée A van Stralen Sophie Moerman christiaan J A van bergen Department of Orthopedic Surgery Erasmus Medical CenterRotterdam 3015GDNetherlands Department of Orthopedic Surgery University Medical Center GroningenGroningen 9713GZNetherlands Department of Orthopedic Surgery Amphia HospitalBreda 4818CKNetherlands

BACKGROUND Slipped capital femoral epiphysis(SCFE)occurs in adolescents and has an incidence of around 10 per 100000 *** presenting with a unilateral SCFE are 2335 times more likely to develop a contralateral SCFE than the general *** factors that have been suggested to increase the risk of contralateral slip include a younger patient,an underlying endocrine disorder,growth hormone use and a higher radiographic posterior sloping ***,there is still much debate on the advantages and disadvantages of prophylactic fixation of the unaffected side in an otherwise healthy *** To investigate the risk rate of contralateral SCFE and assess the(dis)advantages of prophylactic fixation of the contralateral *** A systematic literature search was performed in the Embase,Medline,Web of Science Core Collection and Cochrane *** terms included‘slipped capital femoral epiphysis,’‘fixation,’‘contralateral,’and *** eligibility of the acquired articles was independently assessed by the authors and additional relevant articles were included through *** were considered eligible for inclusion if they presented data about otherwise healthy children with primarily unilateral SCFE and the outcomes of prophylactically pinning their unaffected side,or about the rates of contralateral slips and complications *** study quality of the included articles was assessed independently by the authors by means of the methodological index for non-randomized studies *** Of 293 identified unique publications,we included 26 studies with a total of 12897 patients.1762 patients(14%)developed a subsequent symptomatic contralateral *** addition,38%of patients developed a subsequent slip on the contralateral side without experiencing clinical *** most outspoken advantage of prophylactic fixation of the contralateral hip in the literature is prevention of an(asymptomatic)slip

关键词： Slipped capital femoral epiphysis Primary prevention Postoperative complications Risk factors Radiography

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