Fractures

Wrist buckle fractures are among the most common injuries in children. Until recently, the North American practice preference was to immobilize these injuries with casts. CHEO researchers have found, however, that children treated with a removable splint had better physical functioning, had fewer difficulties with activities, returned to sports sooner, and suffered no greater pain than those treated with casts.

Research Projects

The Toddler’s Fracture
01/01/2022

Although a stable fracture with an excellent prognosis, opportunities exist to improve toddler's fractures diagnosis and treatment protocols, to optimize clinical management.
Bone mineral Density Surveillance for Childhood, Adolescent, and Young Adult Cancer Survivors: Recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group.
09/09/2021

These recommendations facilitate evidence-based care for childhood, adolescent, and young adult cancer survivors internationally.
Intravenous zoledronic acid versus placebo in children with glucocorticoid-induced osteoporosis: A randomized, double-blind, multi-national phase 3 trial
06/07/2021

LSBMDZ increased significantly on ZA compared with placebo over 1 year in children with GIO. Most AEs occurred after the first infusion.
When Should Bisphosphonates Be Used in Children with Chronic Illness Osteoporosis?
19/06/2021

The decision to treat a child with a bisphosphonate hinges on distinguishing bone fragility from typical childhood fractures, and determining the potential for medication-unassisted recovery following an osteoporotic fragility fracture. While improvements in BMD are a well-known sign of recovery, restitution of bone structure is also a key indicator of recuperation, one that is unique to childhood, and that plays a pivotal role in the decision to intervene or not.
Vitamin D supplementation for children with cancer: a systematic review and consensus recommendations
08/06/2021

Further research is needed; until then, we recommend dietary vitamin D/calcium intake in keeping with standard national guidelines, and periodic 25OHD monitoring to detect levels <20 ng/ml. Vitamin D/calcium supplementation is recommended in children with low levels, to maintain levels ≥20 ng/ml year-long.
The Accuracy of Incident Vertebral Fracture Detection in Children Using Targeted Case-Finding Approaches
30/03/2021

These results provide guidance for targeting spine radiography in children at risk for IVF.
Advances in Bone Assessment Methods in Children
02/11/2020

INTRODUCTION Pediatric bone diseases present with a variety of signs and symptoms. Although some diagnoses may be straightforward based on history and physical examination, other presentations require more extensive bone assessments. In addition, clinical followup, research studies, and drug trials are predicated on strong bone health assessment.
Assessment of longitudinal bone growth in osteogenesis imperfecta using metacarpophalangeal pattern profiles
27/07/2020

COL1A1 and COL1A2 mutations affect bone growth not only by inducing fractures and bone deformities, but also through longitudinal growth deficits in bones that do not fracture or deform.
Hands-On Workshops Improve Emergency Department Physicians’ Self-Reported Understanding of Pediatric Hand Injuries
18/05/2020

Knowledge sharing between specialists and generalists through combined didactic and hands-on workshops is an effective and well-received method of refining physician knowledge and increasing confidence in treating subspecialty-specific clinical presentations.
The Accuracy of Prevalent Vertebral Fracture Detection in Children Using Targeted Case‐Finding Approaches
01/11/2019

Back pain was assessed by patient report, LS BMD was measured by dual‐energy X‐ray absorptiometry, and PVF were quantified on spine radiographs using the modified Genant semiquantitative method. Forty‐four patients (11.0%) had PVF.
Osteogenesis Imperfecta: Skeletal Outcomes After Bisphosphonate Discontinuation at Final Height
04/07/2019

None of the patients sustained a new vertebral compression fracture during follow‐up.
Bone Morbidity and Recovery in Children With Acute Lymphoblastic Leukemia: Results of a Six‐Year Prospective Cohort Study
01/05/2018

These results suggest the need for trials addressing interventions in the first 2 years of chemotherapy, targeting older children and children with more severe vertebral collapse, because these children are at greatest risk for incident VF and subsequent residual vertebral deformity.