The purpose of this article is to review the literature related to extensor pollicis longus tendon rupture following nondisplaced distal radius fractures in the pediatric population. This injury is more commonly seen in adults and is relatively rare in children and adolescents. In our literature search, only one case report of pediatric extensor pollicis longus rupture after nondisplaced displaced distal radius fracture is reported. Therefore, it is possible that anatomic and physiologic differences in pediatric patients may be protective against the physical irritation and ischemia thought to cause this injury in their adult counterparts. More research, including biomechanical studies and vascular studies, ought to be done to evaluate for the physiologic differences in pediatric patients that may account for the decreased risk of extensor pollicis longus rupture after nondisplaced distal radius fractures.
While juvenile idiopathic arthritis is the most common inflammatory joint condition within the pediatric population, the burden of this pathology can be lessened by early detection and interdisciplinary management to avoid severe joint damage and skeletal deformity. The etiology of juvenile idiopathic arthritis is largely unknown; however, immunologic studies show possible involvement of CD141+, CD123+, and dendritic cells. The natural disease course consists of inflammatory soft tissue damage coupled with joint effusion that eventually progresses to bone and joint changes. In terms of diagnosis, musculoskeletal ultrasonography has been shown to be effective in the early detection of juvenile idiopathic arthritis, especially in small joints. Magnetic resonance imaging and radiography are also valid techniques for diagnosis, but they generally fail to detect preclinical juvenile idiopathic arthritis, whereas ultrasound is successful in doing so. Orthopedic treatment options include conservative measures such as non-steroidal inflammatory drugs and corticosteroid injections. Surgical intervention is often indicated to treat deformity, limb length, and severe arthritis. Total joint replacement is primarily performed for functional impairment and deformity rather than for pain. Factors that may complicate surgical intervention include small bone size, limb deformity, and soft tissue contracture.
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