1. Interventions for treating wrist fractures in children
Helen Hg Handoll, Joanne Elliott, Zipporah Iheozor-Ejiofor, James Hunter, Alexia Karantana Cochrane Database Syst Rev. 2018 Dec 19;12(12):CD012470. doi: 10.1002/14651858.CD012470.pub2.
Background: Wrist fractures, involving the distal radius, are the most common fractures in children. Most are buckle fractures, which are stable fractures, unlike greenstick and other usually displaced fractures. There is considerable variation in practice, such as the extent of immobilisation for buckle fractures and use of surgery for seriously displaced fractures. Objectives: To assess the effects (benefits and harms) of interventions for common distal radius fractures in children, including skeletally immature adolescents.
2. Conservative management following closed reduction of traumatic anterior dislocation of the shoulder
Cordula Braun, Cliona J McRobert Cochrane Database Syst Rev. 2019 May 10;5(5):CD004962. doi: 10.1002/14651858.CD004962.pub4.
Background: Acute anterior shoulder dislocation, which is the most common type of dislocation, usually results from an injury. Subsequently, the shoulder is less stable and is more susceptible to re-dislocation or recurrent instability (e.g. subluxation), especially in active young adults. After closed reduction, most of these injuries are treated with immobilisation of the injured arm in a sling or brace for a few weeks, followed by exercises. This is an update of a Cochrane Review first published in 2006 and last updated in 2014. Objectives: To assess the effects (benefits and harms) of conservative interventions after closed reduction of traumatic anterior dislocation of the shoulder. These might include immobilisation, rehabilitative interventions or both.
3. Alternatives to Sedation and General Anesthesia in Pediatric Magnetic Resonance Imaging: A Literature Review
Delaney McGuirt Radiol Technol. 2016 Sep;88(1):18-26.
Purpose: To assess alternatives to sedation and general anesthesia to prepare children for magnetic resonance (MR) imaging examinations. Methods: Online databases were searched for articles discussing methods of preparing children for MR imaging procedures. Because of the large number of articles returned, criteria were limited to only studies that prepared patients without the use of sedation or general anesthesia. Results: Twenty-four studies were deemed appropriate for inclusion in the review. The following methods emerged as alternatives to pediatric sedation: mock scanners, MR-compatible audiovisual systems, feed-sleep manipulation, play therapy, infant incubators/immobilizers, photo diaries, sucrose solutions, and guided imagery. The approaches with the most extensive research were mock MR scanners and feed-sleep manipulation. Discussion: Evidence supports the use of these alternative techniques as valid substitutes for pediatric sedation and general anesthesia. Conclusion: To reduce the risks associated with sedation of pediatric patients, institutions could implement the alternatives discussed in this review. Cost analyses should be conducted first because some methods are more expensive than others. Finally, further research is needed to better assess the effectiveness of lesser-practiced methods, including photo diaries, sucrose solutions, and guided imagery.
