Compressive orthotic bracing is a safe and effective alternative to both invasive surgical correction and no treatment for pectus carinatum in children. Compliance is critical to the success of this management strategy.
The great popularity of physical fitness in modern society has brought many pieces of exercise equipment into our homes for convenience and privacy. This trend has come with an increasing rate of injuries to children who curiously touch moving parts, including treadmill belts. Experience with a recent series of treadmill contact burns to children's hands is described in this article. A retrospective chart review at a tertiary referral center from June 1998 until June 2001 found six children sustaining hand burns from treadmills. The patients' ages at presentation ranged from 15 to 45 months (average of 31 months, three boys and three girls). All injuries occurred in the home while a parent was using the treadmill. Burns involved the palmar aspect of the hand, mostly confined to the fingers, and the severity ranged from partialto full-thickness burns. All patients were initially managed with collagenase and bacitracin zinc/polymyxin B powder dressings to second- and third-degree burns, along with splinting and range-of-motion exercises. Two patients required skin grafting at 2 weeks and 2 months for full-thickness tissue loss and tight joint contracture, respectively. At an average follow-up of 12 months, all patients had full range of motion and no physical limitation. The rate of children injured by exercise equipment is expected to increase. Friction burns to the hands remain a concern, although early recognition and appropriate management are associated with excellent functional outcomes. Protective modification of exercise machines seems to be the best approach to eliminating these injuries.
Hypertrophic pyloric stenosis (HPS) is the most common surgical condition producing vomiting in infants. It has been reported as early as the 1st week of life. We report an infant with HPS seen on prenatal ultrasound. Although infants with HPS usually present between 3 and 5 weeks of life, HPS must be considered as part of the differential diagnosis of newborns with non-bilious vomiting.
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