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  1. Article ; Online: Intra- and inter-fraction uncertainties during IGRT for Wilms' tumor.

    Guerreiro, Filipa / Seravalli, Enrica / Janssens, Geert O / van de Ven, Cees P / van den Heuvel-Eibrink, Marry M / Raaymakers, Bas W

    Acta oncologica (Stockholm, Sweden)

    2018  Volume 57, Issue 7, Page(s) 941–949

    Abstract: Background and purpose: To assess intra- and inter-fraction motion uncertainties, due to displacements of the tumor bed (TB) and organs at risk (OAR), as well as intra- and inter-fraction patient set-up uncertainties, due to positioning variations, ... ...

    Abstract Background and purpose: To assess intra- and inter-fraction motion uncertainties, due to displacements of the tumor bed (TB) and organs at risk (OAR), as well as intra- and inter-fraction patient set-up uncertainties, due to positioning variations, during image-guided radiation therapy (IGRT) in children with Wilms' tumor.
    Material and methods: Four-dimensional computed tomography (4D-CT) and daily pre- and post-treatment cone-beam CT (CBCT)-scans of 15 patients (average 4, range 1-8 years) undergoing flank irradiation after nephrectomy were analyzed. TB (marked by four surgical clips) and OAR motion uncertainties were quantified by displacements of the center of mass in all orthogonal directions. Translational and rotational bone off-sets were recorded for patient set-up uncertainties assessment in all orthogonal directions. The average results, systematic and random errors were computed.
    Results: Average intra- and inter-fraction motion uncertainties were ≤1.1 mm (range: [-6.9;7.9] mm) for the TB and ≤3.2 mm (range: [-9.1;9.6] mm) for the OAR. Average intra- and inter-fraction patient set-up uncertainties were ≤0.1 mm (range: [-3.3;4.8] mm) and ≤0.9° (range: [0.0;2.8°]). Both motion and patient set-up uncertainties were larger for the cranio-caudal direction. Calculated systematic and random errors were ≤2.4 mm for the motion uncertainties and ≤0.8 mm/0.7
    Conclusions: Average motion and patient set-up uncertainties during radiotherapy treatment were found to be limited. However, uncertainties were larger for the cranio-caudal direction and outliers were found in all orthogonal directions. When having available 4D-CT and CBCT information, the use of patient-specific and anisotropic safety margin expansions is advised for both target volume and OAR.
    MeSH term(s) Child ; Child, Preschool ; Combined Modality Therapy ; Cone-Beam Computed Tomography/adverse effects ; Dose Fractionation ; Female ; Four-Dimensional Computed Tomography ; Humans ; Infant ; Male ; Motion ; Nephrectomy ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy Planning, Computer-Assisted/standards ; Radiotherapy, Image-Guided/adverse effects ; Radiotherapy, Image-Guided/standards ; Radiotherapy, Intensity-Modulated/adverse effects ; Respiratory Mechanics/physiology ; Retrospective Studies ; Uncertainty ; Wilms Tumor/radiotherapy ; Wilms Tumor/surgery
    Language English
    Publishing date 2018-02-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 896449-x
    ISSN 1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
    ISSN (online) 1651-226X
    ISSN 0349-652X ; 0284-186X ; 1100-1704
    DOI 10.1080/0284186X.2018.1438655
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  2. Article ; Online: Rectal Omeprazole in Infants With Gastroesophageal Reflux Disease: A Randomized Pilot Trial.

    Bestebreurtje, Petra / de Koning, Barbara A E / Roeleveld, Nel / Knibbe, Catherijne A J / Tibboel, Dick / van Groen, Bianca / van de Ven, Cees P / Plötz, Frans B / de Wildt, Saskia N

    European journal of drug metabolism and pharmacokinetics

    2020  Volume 45, Issue 5, Page(s) 635–643

    Abstract: Background and objective: Omeprazole is a proton pump inhibitor that is used in acid suppression therapy in infants. Infants cannot swallow the oral tablets or capsules. Since, infants require a non-standard dose of omeprazole, the granules or tablets ... ...

    Abstract Background and objective: Omeprazole is a proton pump inhibitor that is used in acid suppression therapy in infants. Infants cannot swallow the oral tablets or capsules. Since, infants require a non-standard dose of omeprazole, the granules or tablets are often crushed or suspended in water or sodium bicarbonate, which may destroy the enteric coating. In this study we explore the efficacy and pharmacokinetics of rectally administered omeprazole in infants with gastroesophageal reflux disease (GERD) due to esophageal atresia (EA) or congenital diaphragmatic hernia (CDH) and compare these with orally administered omeprazole.
    Methods: Infants (6-12 weeks postnatal and bodyweight > 3 kg) with EA or CDH and GERD were randomized to receive a single dose of 1 mg/kg omeprazole rectally or orally. The primary outcome was the percentage of infants for whom omeprazole was effective according to predefined criteria for 24-h intraesophageal pH. Secondary outcomes were the percentages of time that gastric pH was < 3 or < 4, as well as the pharmacokinetic parameters.
    Results: Seventeen infants, 4 with EA and 13 with CDH, were included. The proportion of infants for whom omeprazole was effective was 56% (5 of 9 infants) after rectal administration and 50% (4 of 8 infants) after oral administration. The total reflux time in minutes and percentages and the number of reflux episodes of pH < 4 decreased statistically significantly after both rectal and oral omeprazole administration. Rectal and oral administration of omeprazole resulted in similar serum exposure.
    Conclusions: A single rectal omeprazole dose (1 mg/kg) results in consistent increases in intraesophageal and gastric pH in infants with EA- or CDH-related GERD, similar to an oral dose. Considering the challenges with existing oral formulations, rectal omeprazole presents as an innovative, promising alternative for infants with pathological GERD.
    Clinical trial register: ClinicalTrials.gov Identifier: NCT00226044.
    MeSH term(s) Administration, Oral ; Administration, Rectal ; Esophageal Atresia/complications ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/etiology ; Hernias, Diaphragmatic, Congenital/complications ; Humans ; Infant ; Male ; Omeprazole/administration & dosage ; Omeprazole/pharmacokinetics ; Pilot Projects ; Proton Pump Inhibitors/administration & dosage ; Proton Pump Inhibitors/pharmacokinetics ; Treatment Outcome
    Chemical Substances Proton Pump Inhibitors ; Omeprazole (KG60484QX9)
    Language English
    Publishing date 2020-06-24
    Publishing country France
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 196729-0
    ISSN 2107-0180 ; 0398-7639 ; 0378-7966
    ISSN (online) 2107-0180
    ISSN 0398-7639 ; 0378-7966
    DOI 10.1007/s13318-020-00630-8
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  3. Article ; Online: Characteristics and outcome of children with renal tumors in the Netherlands: The first five-year's experience of national centralization.

    Roy, Prakriti / van Peer, Sophie E / de Witte, Martin M / Tytgat, Godelieve A M / Karim-Kos, Henrike E / van Grotel, Martine / van de Ven, Cees P / Mavinkurve-Groothuis, Annelies M C / Merks, Johannes H M / Kuiper, Roland P / Hol, Janna A / Janssens, Geert O R / de Krijger, Ronald R / Jongmans, Marjolijn C J / Drost, Jarno / van der Steeg, Alida F W / Littooij, Annemieke S / Wijnen, Marc H W A / van Tinteren, Harm /
    van den Heuvel-Eibrink, Marry M

    PloS one

    2022  Volume 17, Issue 1, Page(s) e0261729

    Abstract: Around 6% of all childhood malignancies represent renal tumors, of which a majority includes Wilms tumor (WT). Although survival rates have improved over the last decades, specific patients are still at risk for adverse outcome. In the Netherlands, since ...

    Abstract Around 6% of all childhood malignancies represent renal tumors, of which a majority includes Wilms tumor (WT). Although survival rates have improved over the last decades, specific patients are still at risk for adverse outcome. In the Netherlands, since 2015, pediatric oncology care for renal tumors has been centralized in the Princess Máxima Center for Pediatric Oncology. Here, we describe experiences of the first 5 years of centralized care and explore whether this influences the epidemiological landscape by comparing data with the Netherlands Cancer Registry (NCR). We identified all patients <19 years with a renal mass diagnosed between 01-01-2015 and 31-12-2019 in the Princess Máxima Center. Epidemiology, characteristics and management were analyzed. We identified 164 patients (including 1 patient who refused consent for registration), in our center with a suspicion of a renal tumor. The remaining 163 cases included WT (n = 118)/cystic partially differentiated nephroblastoma (n = 2)/nephrogenic rests only (n = 6) and non-WT (n = 37). In this period, the NCR included 138 children, 1 17-year-old patient was not referred to the Princess Máxima Center. Central radiology review (before starting treatment) was performed in 121/163 patients, and central pathology review in 148/152 patients that underwent surgery. Treatment stratification, according to SIOP/EpSSG protocols was pursued based on multidisciplinary consensus. Preoperative chemotherapy was administered in 133 patients, whereas 19 patients underwent upfront surgery. Surgery was performed in 152 patients, and from 133 biomaterial was stored. Centralization of care for children with renal tumors led to referral of all but 1 new renal tumor cases in the Netherlands, and leads to referral of very rare subtypes not registered in the NCR, that benefit from high quality diagnostics and multidisciplinary decision making. National centralization of care led to enhanced development of molecular diagnostics and other innovation-based treatments for the future.
    MeSH term(s) Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; Child ; Child, Preschool ; Dactinomycin ; Disease-Free Survival ; Humans ; Infant ; Kidney Neoplasms/diagnostic imaging ; Kidney Neoplasms/drug therapy ; Neoplasm Staging ; Netherlands ; Prognosis ; Treatment Outcome ; Vincristine
    Chemical Substances Dactinomycin (1CC1JFE158) ; Vincristine (5J49Q6B70F)
    Language English
    Publishing date 2022-01-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0261729
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  4. Article ; Online: Intraoperative transesophageal echocardiography for mediastinal mass surgery improves anesthetic management in pediatric patients.

    Geniets, Benedicte / van de Ven, Cees P / Maat, Alexander P W M / Scohy, Thierry V

    Paediatric anaesthesia

    2011  Volume 21, Issue 12, Page(s) 1276–1278

    MeSH term(s) Anesthesia, General ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Child, Preschool ; Echocardiography, Transesophageal/methods ; Female ; Fibroma/surgery ; Humans ; Mediastinal Neoplasms/surgery ; Methyl Ethers ; Midazolam ; Monitoring, Intraoperative/methods ; Neuromuscular Nondepolarizing Agents ; Pancuronium ; Sufentanil
    Chemical Substances Anesthetics, Inhalation ; Anesthetics, Intravenous ; Methyl Ethers ; Neuromuscular Nondepolarizing Agents ; sevoflurane (38LVP0K73A) ; Sufentanil (AFE2YW0IIZ) ; Pancuronium (J76UF062FS) ; Midazolam (R60L0SM5BC)
    Language English
    Publishing date 2011-12
    Publishing country France
    Document type Case Reports ; Letter
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/j.1460-9592.2011.03681.x
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  5. Article ; Online: Apparent diffusion coefficient as it relates to histopathology findings in post-chemotherapy nephroblastoma: a feasibility study.

    Littooij, Annemieke S / Nikkels, Peter G / Hulsbergen-van de Kaa, Christina A / van de Ven, Cees P / van den Heuvel-Eibrink, Marry M / Olsen, Øystein E

    Pediatric radiology

    2017  Volume 47, Issue 12, Page(s) 1608–1614

    Abstract: Background: Nephroblastomas represent a group of heterogeneous tumours with variable proportions of distinct histopathological components.: Objective: The purpose of this study was to investigate whether direct comparison of apparent diffusion ... ...

    Abstract Background: Nephroblastomas represent a group of heterogeneous tumours with variable proportions of distinct histopathological components.
    Objective: The purpose of this study was to investigate whether direct comparison of apparent diffusion coefficient (ADC) measurements with post-resection histopathology subtypes is feasible and whether ADC metrics are related to histopathological components.
    Materials and methods: Twenty-three children were eligible for inclusion in this retrospective study. All children had MRI including diffusion-weighted imaging (DWI) after preoperative chemotherapy, just before tumour resection. A pathologist and radiologist identified corresponding slices at MRI and postoperative specimens using tumour morphology, the upper/lower calyx and hilar vessels as reference points. An experienced reader performed ADC measurements, excluding non-enhancing areas. A pathologist reviewed the corresponding postoperative slides according to the international standard guidelines. We tested potential associations with the Spearman rank test.
    Results: Side-by-side comparison of MRI-DWI with corresponding histopathology slides was feasible in 15 transverse slices in 9 lesions in 8 patients. Most exclusions were related to extensive areas of necrosis/haemorrhage. In one lesion correlation was not possible because of the different orientation of sectioning of the specimen and MRI slices. The 25% ADC showed a strong relationship with percentage of blastema (Spearman rho=-0.71, P=0.003), whereas median ADC was strongly related to the percentage stroma (Spearman rho=0.74, P=0.002) at histopathology.
    Conclusion: Side-by-side comparison of MRI-DWI and histopathology is feasible in the majority of patients who do not have massive necrosis and hemorrhage. Blastemal and stromal components have a strong linear relationship with ADC markers.
    Language English
    Publishing date 2017-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 124459-0
    ISSN 1432-1998 ; 0301-0449
    ISSN (online) 1432-1998
    ISSN 0301-0449
    DOI 10.1007/s00247-017-3931-9
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  6. Article ; Online: A Novel Standard for Systematic Reporting of Neuroblastoma Surgery: The International Neuroblastoma Surgical Report Form (INSRF): A Joint Initiative by the Pediatric Oncological Cooperative Groups SIOPEN∗, COG∗∗, and GPOH∗∗∗.

    Matthyssens, Lucas E / Nuchtern, Jed G / Van De Ven, Cees P / Gabra, Hany O S / Bjornland, Kristin / Irtan, Sabine / Stenman, Jakob / Pio, Luca / Cross, Kate M / Avanzini, Stefano / Inserra, Alessandro / Chacon, Javier Gomez / Dall'igna, Patrizia / Von Schweinitz, Dietrich / Holmes, Keith / Fuchs, Jorg / Squire, Roly / Valteau-Couanet, Dominique / Park, Julie R /
    Eggert, Angelika / Losty, Paul D / La Quaglia, Michael P / Sarnacki, Sabine

    Annals of surgery

    2020  Volume 275, Issue 3, Page(s) e575–e585

    Abstract: Objective: To create the first structured surgical report form for NBL with international consensus, to permit standardized documentation of all NBL-related surgical procedures and their outcomes.: Summary of background data: NBL, the most common ... ...

    Abstract Objective: To create the first structured surgical report form for NBL with international consensus, to permit standardized documentation of all NBL-related surgical procedures and their outcomes.
    Summary of background data: NBL, the most common extracranial solid malignant tumor in children, covers a wide spectrum of tumors with significant differences in anatomical localization, organ or vessel involvement, and tumor biology. Complete surgical resection of the primary tumor is an important part of NBL treatment, but maybe hazardous, prone to complications and its role in high-risk disease remains debated. Various surgical guidelines exist within the protocols of the different cooperative groups, although there is no standardized operative report form to document the surgical treatment of NBL.
    Methods: After analyzing the treatment protocols of the SIOP Europe International Neuroblastoma Study Group, Children's Oncology Group, and Gesellschaft fuer Paediatrische Onkologie und Haematologie - German Association of Pediatric Oncology and Haematology pediatric cooperative groups, important variables were defined to completely describe surgical biopsy and resection of NBL and their outcomes. All variables were discussed within the Surgical Committees of SIOP Europe International Neuroblastoma Study Group, Children's Oncology Group, and Gesellschaft fuer Paediatrische Onkologie und Haematologie - German Association of Pediatric Oncology and Haematology. Thereafter, joint meetings were organized to obtain intercontinental consensus.
    Results: The "International Neuroblastoma Surgical Report Form" provides a structured reporting tool for all NBL surgery, in every anatomical region, documenting all Image Defined Risk Factors and structures involved, with obligatory reporting of intraoperative and 30 day-postoperative complications.
    Conclusion: The International Neuroblastoma Surgical Report Form is the first universal form for the structured and uniform reporting of NBL-related surgical procedures and their outcomes, aiming to facilitate the postoperative communication, treatment planning and analysis of surgical treatment of NBL.
    MeSH term(s) Child ; Forms as Topic ; Humans ; International Cooperation ; Neuroblastoma/surgery ; Research Design/standards ; Surgical Oncology/standards
    Language English
    Publishing date 2020-06-03
    Publishing country United States
    Document type Consensus Development Conference ; Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000003947
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  7. Article ; Online: Which factors affect limitation of pronation/supination after forearm fractures in children? A prospective multicentre study.

    Colaris, Joost W / Allema, Jan Hein / Reijman, Max / de Vries, Mark R / Ulas Biter, L / Bloem, Rolf M / van de Ven, Cees P / Verhaar, Jan A N

    Injury

    2014  Volume 45, Issue 4, Page(s) 696–700

    Abstract: Introduction: Both-bone forearm fractures in children frequently result in a limitation of pronation/supination, which hinders daily activities. The purpose of this prospective multicentre study was to investigate which clinical factors are related to ... ...

    Abstract Introduction: Both-bone forearm fractures in children frequently result in a limitation of pronation/supination, which hinders daily activities. The purpose of this prospective multicentre study was to investigate which clinical factors are related to the limitation of pronation/supination in children with a both-bone forearm fracture.
    Methods: In four Dutch hospitals, consecutive children (<16 years) who sustained a both-bone forearm fracture were included. Children were followed up for 6-9 months and data from questionnaires, physical examination and X-rays were collected. Univariate and multivariate logistic regression analyses were used to assess the relationship between limitation of pronation/supination (≥20°) and several clinical factors.
    Results: A group of 410 children with both-bone forearm fractures were included, of which 10 children missed the final examination (follow-up rate of 97.6%). We found that a re-fracture (odds ratio (OR) 11.7, 95% confidence interval (CI) 1.2; 118.5), a fracture in the diaphysis (OR 3.3, 95% CI 1.4; 7.9) and less physiotherapy during follow-up (OR 0.90, 95% CI 0.82; 0.98) were independently associated with a limitation of pronation/supination of 20° or more.
    Conclusions: These findings imply that a re-fracture and a diaphyseal located fracture were associated independently of each other with a limitation of pronation/supination in children with a both-bone forearm fracture. Furthermore, in children with severe limitation extensive physiotherapy is associated with better functional outcome.
    MeSH term(s) Activities of Daily Living ; Adolescent ; Biomechanical Phenomena ; Casts, Surgical ; Child ; Child, Preschool ; Female ; Forearm Injuries/diagnostic imaging ; Forearm Injuries/physiopathology ; Forearm Injuries/therapy ; Fractures, Bone/diagnostic imaging ; Fractures, Bone/physiopathology ; Fractures, Bone/therapy ; Humans ; Male ; Netherlands/epidemiology ; Pronation ; Prospective Studies ; Radius Fractures/diagnostic imaging ; Radius Fractures/physiopathology ; Radius Fractures/therapy ; Range of Motion, Articular ; Supination ; Tomography, X-Ray Computed ; Ulna Fractures/diagnostic imaging ; Ulna Fractures/pathology ; Ulna Fractures/physiopathology
    Language English
    Publishing date 2014-04
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2013.09.041
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  8. Article ; Online: Re-displacement of stable distal both-bone forearm fractures in children: a randomised controlled multicentre trial.

    Colaris, Joost W / Allema, Jan Hein / Biter, L Ulas / de Vries, Mark R / van de Ven, Cees P / Bloem, Rolf M / Kerver, Albert J H / Reijman, Max / Verhaar, Jan A N

    Injury

    2013  Volume 44, Issue 4, Page(s) 498–503

    Abstract: Introduction: Displaced metaphyseal both-bone fractures of the distal forearm are generally reduced and stabilised by an above-elbow cast (AEC) with or without additional pinning. The purpose of this study was to find out if re-displacement of a reduced ...

    Abstract Introduction: Displaced metaphyseal both-bone fractures of the distal forearm are generally reduced and stabilised by an above-elbow cast (AEC) with or without additional pinning. The purpose of this study was to find out if re-displacement of a reduced stable metaphyseal both-bone fracture of the distal forearm in a child could be prevented by stabilisation with Kirschner wires.
    Methods: Consecutive children aged <16 years with a displaced metaphyseal both-bone fracture of the distal forearm (n = 128) that was stable after reduction were randomised to AEC with or without percutaneous fixation with Kirschner wires. The primary outcome was re-displacement of the fracture.
    Results: A total of 67 children were allocated to fracture reduction and AEC and 61 to reduction of the fracture, fixation with Kirschner wires and AEC. The follow-up rate was 96% with a mean follow-up of 7.1 months. Fractures treated with additional pinning showed less re-displacement (8% vs. 45%), less limitation of pronation and supination (mean limitation 6.9 (± 9.4)° vs. 14.3 (± 13.6)°) but more complications (14 vs. 1).
    Conclusions: Pinning of apparent stable both-bone fractures of the distal forearm in children might reduce fracture re-displacement. The frequently seen complications of pinning might be reduced by a proper surgical technique.
    MeSH term(s) Bone Wires ; Casts, Surgical ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal/instrumentation ; Fracture Fixation, Internal/methods ; Fracture Healing ; Humans ; Male ; Netherlands/epidemiology ; Prospective Studies ; Radiography ; Radius Fractures/diagnostic imaging ; Radius Fractures/epidemiology ; Radius Fractures/therapy ; Range of Motion, Articular ; Time Factors ; Treatment Outcome ; Ulna Fractures/diagnostic imaging ; Ulna Fractures/epidemiology ; Ulna Fractures/surgery ; Ulna Fractures/therapy
    Language English
    Publishing date 2013-04
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2012.11.001
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  9. Article ; Online: Early conversion to below-elbow cast for non-reduced diaphyseal both-bone forearm fractures in children is safe: preliminary results of a multicentre randomised controlled trial.

    Colaris, Joost W / Reijman, Max / Allema, Jan Hein / Biter, L Ulas / Bloem, Rolf M / van de Ven, Cees P / de Vries, Mark R / Kerver, Albert J H / Verhaar, Jan A N

    Archives of orthopaedic and trauma surgery

    2013  Volume 133, Issue 10, Page(s) 1407–1414

    Abstract: Introduction: This multicentre randomised controlled trial was designed to explore whether 6 weeks above-elbow cast (AEC) or 3 weeks AEC followed by 3 weeks below-elbow cast (BEC) cause similar limitation of pronation and supination in non-reduced ... ...

    Abstract Introduction: This multicentre randomised controlled trial was designed to explore whether 6 weeks above-elbow cast (AEC) or 3 weeks AEC followed by 3 weeks below-elbow cast (BEC) cause similar limitation of pronation and supination in non-reduced diaphyseal both-bone forearm fractures in children.
    Materials and methods: Children were randomly allocated to 6 weeks AEC or to 3 weeks AEC followed by 3 weeks BEC. The primary outcome was limitation of pronation and supination after 6 months. The secondary outcomes were re-displacement of the fracture, complication rate, limitation of flexion and extension of wrist and elbow, cast comfort, cosmetics, complaints in daily life and assessment of radiographs.
    Results: A group of 23 children was treated with 6 weeks AEC and 24 children with 3 weeks AEC and 3 weeks BEC. The follow-up rate was 98 % with a mean follow-up of 7.0 months. The mean limitation of pronation and supination was 23.3 ± 22.0 for children treated with AEC and 18.0 ± 16.9 for children treated with AEC and BEC. The other study outcomes were similar in both groups.
    Conclusions: Early conversion to BEC is safe in the treatment of non-reduced diaphyseal both-bone forearm fractures in children.
    Level of evidence: Multicentre randomised controlled trial, Level II.
    MeSH term(s) Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Elbow Joint/physiology ; Female ; Follow-Up Studies ; Humans ; Immobilization/instrumentation ; Immobilization/methods ; Male ; Manipulation, Orthopedic ; Radius Fractures/therapy ; Range of Motion, Articular ; Recovery of Function ; Time Factors ; Treatment Outcome ; Ulna Fractures/therapy ; Wrist Joint/physiology
    Language English
    Publishing date 2013-10
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial
    ZDB-ID 80407-1
    ISSN 1434-3916 ; 0003-9330 ; 0344-8444
    ISSN (online) 1434-3916
    ISSN 0003-9330 ; 0344-8444
    DOI 10.1007/s00402-013-1812-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Conversion to below-elbow cast after 3 weeks is safe for diaphyseal both-bone forearm fractures in children.

    Colaris, Joost W / Allema, Jan Hein / Biter, L Ulas / Reijman, Max / van de Ven, Cees P / de Vries, Mark R / Bloem, Rolf M / Kerver, Albert J H / Verhaar, Jan A N

    Acta orthopaedica

    2013  Volume 84, Issue 5, Page(s) 489–494

    Abstract: Background: It is unclear whether it is safe to convert above-elbow cast (AEC) to below-elbow cast (BEC) in a child who has sustained a displaced diaphyseal both-bone forearm fracture that is stable after reduction. In this multicenter study, we wanted ... ...

    Abstract Background: It is unclear whether it is safe to convert above-elbow cast (AEC) to below-elbow cast (BEC) in a child who has sustained a displaced diaphyseal both-bone forearm fracture that is stable after reduction. In this multicenter study, we wanted to answer the question: does early conversion to BEC cause similar forearm rotation to that after treatment with AEC alone?
    Children and methods: Children were randomly allocated to 6 weeks of AEC, or 3 weeks of AEC followed by 3 weeks of BEC. The primary outcome was limitation of pronation/supination after 6 months. The secondary outcomes were re-displacement of the fracture, limitation of flexion/extension of the wrist and elbow, complication rate, cast comfort, complaints in daily life, and cosmetics of the fractured arm.
    Results: 62 children were treated with 6 weeks of AEC, and 65 children were treated with 3 weeks of AEC plus 3 weeks of BEC. The follow-up rate was 60/62 and 64/65, respectively with a mean time of 6.9 (4.7-13) months. The limitation of pronation/supination was similar in both groups (18 degrees for the AEC group and 11 degrees for the AEC/BEC group). The secondary outcomes were similar in both groups, with the exception of cast comfort, which was in favor of the AEC/BEC group.
    Interpretation: Early conversion to BEC cast is safe and results in greater cast comfort.
    MeSH term(s) Adolescent ; Casts, Surgical ; Child ; Child, Preschool ; Elbow ; Female ; Fracture Fixation/methods ; Fractures, Ununited/etiology ; Humans ; Infant ; Male ; Postoperative Complications/etiology ; Pronation/physiology ; Radiography ; Radius Fractures/diagnostic imaging ; Radius Fractures/physiopathology ; Radius Fractures/surgery ; Supination/physiology ; Treatment Outcome ; Ulna Fractures/diagnostic imaging ; Ulna Fractures/physiopathology ; Ulna Fractures/surgery
    Language English
    Publishing date 2013-10-31
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2180677-9
    ISSN 1745-3682 ; 1745-3674
    ISSN (online) 1745-3682
    ISSN 1745-3674
    DOI 10.3109/17453674.2013.850010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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