Abstract：
BACKGROUND:Child abuse and neglect (CAN) is a serious problem that has major implications for the welfare of the child involved. Unexplained fractures are of particular concern to the orthopaedic surgeon, who must often consider alternative diagnoses to CAN. QUESTIONS/PURPOSES:We therefore (1) determined which bone diseases most commonly mimic CAN; (2) what types of osteogenesis imperfecta (OI) are most commonly confused with CAN and why; and (3) what specific findings in OI and bone disease render a mistaken diagnosis of CAN more likely. METHODS:A systematic review of the literature was performed. We identified studies that compared cases of CAN with cases in which patients had bone disease that resulted in an unexplained fracture. We also included studies in which patients with fractures resulting from underlying bony pathology were misclassified as CAN and were subsequently reclassified as bone disease as a result of further investigation. Our search netted only five studies that directly compared and contrasted CAN with metabolic or genetic bone disease in the same study. RESULTS:The published literature suggests OI is most frequently confused with CAN, although metaphyseal dysplasia, disorders of phosphate metabolism, and temporary brittle bone disease are also documented in the literature identified by our search. Difficulty in differentiating these bony diseases from CAN stems from ambiguity in the history and physical examination at the time of presentation. CONCLUSIONS:Bone disease is a diagnosis of exclusion in the differential diagnosis of CAN.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Pandya NK,Baldwin K,Kamath AF,Wenger DR,Hosalkar HSdoi
10.1007/s11999-010-1578-zsubject
Has Abstractpub_date
2011-03-01 00:00:00pages
805-12issue
3eissn
0009-921Xissn
1528-1132journal_volume
469pub_type
杂志文章,评审abstract：:A method of surface replacement of the knee joint using an uncemented titanium-on-high-density-polyethylene prosthesis has been investigated in 61 patients. The results show that pain is relieved in the vast majority of cases. Overall, the joint range is marginally improved. Preoperative deformities can be considerabl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-05-01 00:00:00
abstract：:Total knee arthroplasty can be performed with acceptably low risk in the elderly patient. The risk for postoperative complications is significantly higher than in younger patients, however. Pain relief is the principle indication for this procedure in elderly patients. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-02-01 00:00:00
abstract：:Although celecoxib may provide perioperative pain relief, the effect of the short-term use of celecoxib on bone ingrowth into porous-coated devices has not been previously studied in humans. Bone ingrowth into titanium and tantalum plugs was measured in nine patients who underwent staged bilateral total knee arthropla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000238838.18799.61
更新日期：2006-11-01 00:00:00
abstract：:The dislocation rate of 3197 Charnley prostheses with 22 mm head in which the surgery was done between 1979 and 1991 in 2 orthopaedic centers was compared with that of 2875 Lubinus prostheses with 32 mm head in which the surgery was done between 1980 to 1991 in 3 other centers. A 1-year followup showed an equal rate o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：
更新日期：1996-12-01 00:00:00
abstract：:Of 1100 femoral neck fractures observed through an eight-year period, 27 occurred in rheumatoid conditions. The complications and functional results were compared with unselected femoral neck fracture data of nonrheumatoid patients. At two-year follow-up examinations, five of 27 surviving rheumatoid patients had had u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:A cement-free bioceramic aluminum oxide double cup endoprosthesis is under investigation as an alternative to the cemented stem endoprosthesis. Nine patients with 11 operated hips are without complaints after an average of 20.8 months (range 8--28 months). Early loosening of 2 femoral components occurred because of te...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:In view of the increasing incidence of stem-type femoral component loosening, a detailed retrospective radiographic zonal analysis of 389 total hip replacements indicated a 19.5% incidence (76 hips) of radiological evidences of mechanical looseness, i.e., fractured acrylic cement and/or a radiolucent gap at the stem-c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-06-01 00:00:00
abstract：:Forty-nine children with diaphyseal both-bone forearm fractures were treated with either both-bone intramedullary wire fixation (24), single ulnar intramedullary wire fixation (22), or single radial intramedullary wire fixation (3). Six fractures were open and 43 were closed. A limited open approach to one or both bon...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200209000-00024
更新日期：2002-09-01 00:00:00
abstract：:The treatment of 19 congenitally dislocated knees in 11 patients is reviewed. The knees were subdivided into genu recurvatum, subluxation and dislocation. Nine knees were treated conservatively and ten surgically. A good result was obtained with conservative treatment if started before the age of three months; after t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:The cases of 16 patients with Ewing's sarcoma of the proximal femur treated in the era of multiagent chemotherapy were reviewed, with emphasis on the mechanical problem of tumor involvement in this structurally demanding site. Fourteen patients received chemotherapy and local radiotherapy as the initial primary treatm...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：:A prospective comparative study was conducted involving 62 patients to determine the effects and limits of accelerated rehabilitation on clinical outcome. The study focused on whether aggressive rehabilitation after anterior cruciate ligament reconstruction with the doubled semitendinosus and gracilis tendon autograft...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200204000-00043
更新日期：2002-04-01 00:00:00
abstract：PURPOSE:A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist afte...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4975-0
更新日期：2016-12-01 00:00:00
abstract：:Two hundred thirty-four consecutive alumina-on-alumina hip replacements using a press-fit metal-backed socket, performed on 214 patients (98 women, 116 men) have been reviewed. These included 201 primary procedures and 33 revision procedures. The median age of the patients at the time of surgery was 62 years (range, 2...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200010000-00016
更新日期：2000-10-01 00:00:00
abstract：BACKGROUND:Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-4946-5
更新日期：2016-10-01 00:00:00
abstract：:This is a report of experience with 48 carpal disruptions including anterior dislocations of the lunate, transnavicular perilunate and perilunate dislocations and subluxation of the navicular. The correct radiographic diagnosis is absolutely essential for effective treatment. Many of these injuries may be treated by c...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-07-01 00:00:00
abstract：:A simple but efficient way to secure the biceps tendon after it has been detached at its upper end by either trauma, attrition or surgical interference is the use of the keyhole in the upper humerus. A tied or rolled knot of tendon inserted into a keyhole shaped opening in the bicipital groove permits firm attachment ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：:A way to prevent polyethylene wear in total hip replacements is to use metal-on-metal bearings. The cup design of these bearings may be a metal inlay in a polyethylene cup. However, these metal inlays are relatively thin and may deform on loading. The purpose of the current study was to determine whether these potenti...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200211000-00052
更新日期：2002-11-01 00:00:00
abstract：:Osteosarcoma is the most common primary bone malignancy. Despite improvements in therapy, approximately 30% of patients experience pulmonary metastasis. Expression of several growth factors, including VEGF and BMPs, has been implicated in tumor progression and metastatic potential. We hypothesized increased metastatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000229333.98781.56
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:Polyetheretherketone (PEEK) and its composites are polymers resistant to fatigue strain, radiologically transparent, and have mechanical properties suitable for a range of orthopaedic applications. In bulk form, PEEK composites are generally accepted as biocompatible. In particulate form, however, the biolog...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-016-4976-z
更新日期：2016-11-01 00:00:00
abstract：:Forty patients were studied retrospectively to evaluate the effect of epidural steroid injections on low back pain and sciatica characteristic of spinal stenosis or a herniated lumbar disc. All but one of these patients had radicular symptoms. The average age was 55 years, and the average follow-up time was eight mont...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:The fracture rate of third-generation ceramic liners is greatly reduced compared with first- and second-generation liners because of improvement in the design and manufacturing process. The ABC (alumina-bearing couple) ceramic liner is one such design, and fracture of this type of liner has not been reported. We repor...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e3180dc8c35
更新日期：2007-11-01 00:00:00
abstract：:Ulnar coronoid process fractures are relatively uncommon injuries usually occurring with elbow dislocations and contributing to elbow instability. Recent evidence suggests coronoid tip fractures have a role in the instability. We sought to quantify the capsular and brachialis attachments of the ulnar coronoid process ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000218729.59838.bc
更新日期：2006-08-01 00:00:00
abstract：:From 1977 to 1982, 13 patients were diagnosed with avascular necrosis of the femoral head. The diagnoses were made with a combination of clinical exams, radiographs, tomograms, and Tc99 bone scans. One hip was classified as Ficat Stage I, 9 as Stage II, and 5 as Stage III. There were 11 male and 2 female patients with...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：:The natural history of degenerative lumbar spinal stenosis is documented poorly. Little is known about the efficacy of nonoperative treatments. An aggressive nonoperative treatment consisting of therapeutic exercise, analgesics, and epidural steroid injections is proposed. The clinical evaluation of the patients is re...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200103000-00018
更新日期：2001-03-01 00:00:00
abstract：:The painful arc syndrome of the shoulder is a manifestation of rotator cuff tendinitis associated with tenosynovitis of the long head of the biceps under and just distal to the transverse humeral ligament. Eighty-nine patients with clinical signs of the painful arc syndrome were proven to have an associated biceps ten...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-03-01 00:00:00
abstract：:Titanium implants are an alternative to stainless steel implants for internal fixation after fracture. The advantages of titanium include decreased implant stiffness, increased bio-compatibility, and diminished stress shielding. However, titanium has been implicated in tendon irritation and adhesions when used in the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000205894.98361.29
更新日期：2006-04-01 00:00:00
abstract：:The combined Coventry-Maquet procedure has been proposed as a means of treating dual-compartment degenerative arthritis of the knee. The procedure was investigated in a prospective study of 14 patients treated by combined high tibial osteotomy and tibial tubercle elevation. Preoperative scores averaged 50 points and s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:This study examines effects of acute stretch on electrophysiologic properties of rabbit tibial nerve. Compound motor action potentials (CMAP) were measured in 30 rabbits, during and after two hours of acute, graded strain. The rabbits were assigned to one of three groups defined by the degree of stretch (0%, 8%, or 15...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：:The Knee Society Total Knee Arthroplasty Radiographic Evaluation and Scoring System was introduced to encourage uniform reporting of radiographic outcome. However, the method for evaluation of radiolucent lines has been shown to be unreliable. Because it has been shown that reducing the complexity of classification sy...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000153077.79573.a4
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:Synovial fluid biomarkers have demonstrated diagnostic accuracy surpassing the currently used diagnostic tests for periprosthetic joint infection (PJI). QUESTIONS/PURPOSES:The purpose of this study is to directly compare the sensitivity and specificity of the synovial fluid α-defensin immunoassay to the leu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3722-7
更新日期：2015-01-01 00:00:00
