Purpose: Medial epicondyle fractures are a common elbow injury in pediatric and adolescent patients. The management of these fractures continues to be debated. This study aims to review the long-term clinical and radiological outcomes of operative treatment of medial epicondyle fractures in pediatric and adolescent patients. Methods: In this study, 24 consecutive patients were categorized into two groups as follows: group 1, 10 patients undergoing internal fixation with Kirschner wires (K-wires) and group 2, 14 patients undergoing internal fixation with cannulated screws. To assess clinical outcomes, Mayo Elbow Performance Score were used in addition visual analogue scale for pain, subjective range of motion, ulnar nerve irritation symptoms, residual instabilities and requirement for secondary surgery were checked. To access the radiological outcomes, check the bone union and possible deformities secondary to the medial epicondyle fractures were examined. Results: There were no cases of immediate or residual ulnar nerve irritation symptoms and no cases of residual deformity or valgus instability. There was no radiological evidence of loss of reduction and all patients had achieved bone union at last follow-up. And all patients had performed secondary surgery for hardware removal regardless of symptomatic hardware irritation. Conclusion Both K-wires fixation for younger children and screw fixation for near skeletal maturity children may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity. In the K-wire fixation group, it is thought that preoperative explanation is needed because the K-wires tends to be removed earlier than screw fixation group due to hardware irritation.

Accounting ; Adenolymphoma ; Anesthesia, General ; Biopsy, Fine-Needle ; Lymphocytes ; Parotid Gland ; Parotid Neoplasms ; Physical Examination ; Salivary Glands

Purpose: Triage tools play a vital role in classifying the severity of children in emergency departments (EDs). We investigated the association between the Korean Triage and Acuity Scale (KTAS) and severity of dyspnea in the ED. Methods: We conducted a retrospective study of children aged 3-14 years with dyspnea who visited the ED from January 2015 through December 2021. They were divided into severe (KTAS level 1-3) and non-severe (KTAS level 4-5) groups. Between the groups, we compared the clinical characteristics, including age, sex, associated symptoms, vital signs, route of visit, treatment at ED, and outcomes. Results: Among a total of 468 children with dyspnea, 267 and 201 were assigned to the severe and non-severe groups, respectively. The severe group had higher frequencies of fever (21.7% vs. 13.9%; P = 0.031), cough (53.2% vs. 43.3%; P = 0.034), systemic steroids (42.3% vs. 25.9%; P < 0.001), intravenous fluids (47.6% vs. 25.4%; P < 0.001), oxygen therapy (16.5% vs. 6.5%; P = 0.001), inotropics (4.1% vs. 1.0%; P = 0.042), and hospitalization (24.7% vs. 11.9%; P = 0.002). The severe group also showed a higher mean heart rate, respiratory rate, and temperature, and lower mean oxygen saturation (all Ps < 0.001). Among these findings, fever, heart rate, respiratory rate, temperature, intravenous fluids, oxygen therapy, inotropics, and hospitalization remained significantly different between the groups after defining the severe group as a KTAS level 1-2. Conclusion This study shows the association between KTAS and severity of dyspnea in the ED. Therefore, KTAS may reflect not only the initial clinical conditions but also emergency measures and outcomes in children with dyspnea who visit EDs.