Response to: Pediatric Type II Supracondylar Humerus Fractures: Factors Associated With Successful Closed Reduction and Immobilization
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Pediatric Type II Supracondylar Humerus Fractures: Factors Associated With Successful Closed Reduction and Immobilization
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: The Song Classification Is Reliable and Guides Prognosis and Treatment for Pediatric Lateral Condyle Fractures: An Independent Validation Study With Treatment Algorithm
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

The Song Classification Is Reliable and Guides Prognosis and Treatment for Pediatric Lateral Condyle Fractures: An Independent Validation Study With Treatment Algorithm
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Seasonal Variation in Parental Satisfaction With Pediatric Orthopaedics
Conclusions: The provision of pediatric spine care in a region with 4 distinct seasons received lower parental satisfaction scores during the winter than during the summer and fall. This seasonal variation is an additional source of bias in the measurement of satisfaction with health care. Level of Evidence: Level II—retrospective study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Assessing the Impact of the Pediatric Orthopaedic Society of North America (POSNA) Visiting Scholar Program
This study aims to outline the educational and leadership activities pursued by the alumni of the POSNA-COUR Visiting Scholars Program. We hypothesized that there may be a discrepancy between visiting scholar interest level and actual participation in key follow-up educational and leadership activities. Methods: A 32-question online survey developed by the POSNA-COUR committee was electronically delivered to the POSNA-COUR visiting scholarship recipients from 2007 to 2019. The survey inquired about scholars’ educational background, clinical practice, and academic interests. Respondents also reported educationa...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Refilling Opioid Prescriptions After Pediatric Orthopaedic Surgery: An Analysis of Incidence and Risk Factors
Background: Understanding which pediatric patients seek opioid refills is crucial as prescription opioid use in childhood is associated with an increased risk of future opioid misuse. Orthopaedic surgeons are optimally positioned to lead the charge in addressing the opioid epidemic. The aim of this study was to describe the incidence of and risk factors associated with requiring opioid refills after pediatric orthopaedic surgery in children. Methods: This retrospective case-control study included 1413 patients aged 0 to 18 years that underwent orthopaedic surgery at a single tertiary care children’s hospit...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Primary Septic Arthritis Among Children 6 to 48 Months of Age: Implications for PCR Acquisition and Empiric Antimicrobial Selection
Conclusions: K. kingae was the most commonly identified pathogen among 6-month to 4-year-old children. The Kingella and other identified pathogens in this study serve to guide empiric antimicrobial recommendations for this age range. Because of similarities between children with septic arthritis because of K. kingae and those with no identified pathogen, it is likely that an unrecognized burden of Kingella resides in culture negative cases, particularly if no PCR is sent. Systematic evaluation, including PCR acquisition, and a high index of suspicion for K. kingae are recommended to thoroughly evaluate septic arthritis...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Intraoperative Neurological Monitoring in Lower Limb Surgery for Patients With Mucopolysaccharidoses
Conclusions: Patients with MPS undergoing LE orthopaedic surgery may be at risk for SCI, particularly if the procedures are long or are expected to have large EBL. One hypothesis for the etiology of SCI in this setting is hypoperfusion of the upper thoracic spinal cord due to prolonged intraoperative or postoperative hypotension. IONM during these procedures may mitigate the risk of SCI by identifying real-time changes in spinal cord function during surgery, inciting a change in the surgical plan. Level of Evidence: Level III—retrospective comparative series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Metabolic Source Type: research

Pseudo-Protrusio Acetabular Deformity in Osteogenesis Imperfecta Patients
Background: Osteogenesis imperfecta (OI) can develop a protrusio acetabuli deformity. However, the authors observed a pseudo-protrusio-type acetabular deformity (PPAD) on 3-dimensional computed tomography (3D-CT). Hence, we systematically reviewed 3D-CT and pelvis radiographs of OI patients and report the incidence and patterns of acetabular deformity in OI patients and the associated radiographic signs. Methods: The study included 590 hips of 295 OI patients, who were older than 5 years, and did not have a pelvic fracture. The incidence of a deformed acetabulum (center-edge angle>40 degrees) and its correlat...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Metabolic Source Type: research

Modern Day Scurvy in Pediatric Orthopaedics: A Forgotten Illness
Conclusion: The pediatric orthopaedic surgeon should have an increased awareness about the diagnosis of scurvy when consulted on a child with bone pain or inability to walk. The most common orthopaedic presentation was the refusal to bear weight, the most common radiographic finding was the metaphyseal line of increased density (Frankel sign) and treatment with vitamin c supplementation was excellent in all cases. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Metabolic Source Type: research

Management and Complications in Nonoperative Fractures of the Tibial Spine: A Systematic Review
Effective options exist for acute nonoperative management of anterior tibial spine fractures, yet there exists a paucity of literature describing long-term outcomes for these patients. This systematic review thus aims to consolidate management strategies and complications for patients with nonoperative anterior tibial spine fractures. In accordance with PRISMA guidelines, 5 databases (CINAHL, MEDLINE, EMBASE, Cochrane, and Pubmed) were searched and screened in duplicate. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Of 485 studies identified in the initial sea...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Decreasing Radiation Exposure in Pediatric Clavicle and Metatarsal Fractures: A QI Initiative
Background: Protecting the pediatric population from unnecessary medical radiation is an important public health initiative. Efforts have been made to reduce radiation exposure in the treatment of pediatric fractures without compromising quality of care. Using a standardized protocol for imaging of pediatric clavicle and metatarsal fractures is a reliable method for reducing pediatric radiation exposure in the management of these fractures. Methods: In the year 2015, the senior author altered follow-up imaging practices for 2 common pediatric fractures: metatarsal and clavicular. Initial radiographic evaluation ...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Patient-reported Outcomes Measurement Information System (PROMIS) Scores for Children With Brachial Plexus Birth Injury
Background: Patient-reported Outcomes Measurement Information System (PROMIS) for pediatrics is a validated patient-reported or parent-proxy–reported outcomes assessment tool used to evaluate health-related quality of life in children and adolescents with chronic medical conditions. The health-related quality of life of children with brachial plexus birth injury (BPBI) as measured by PROMIS is not well understood. We hypothesized that children with BPBI would report impaired upper extremity (UE) function but normal mobility, pain interference, and peer relationships compared with a reference pediatric population,...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Midterm Outcomes After Open Arthrolysis for Posttraumatic Elbow Stiffness in Children and Adolescents
This study evaluated the midterm outcomes after open arthrolysis in children and adolescents with posttraumatic elbow stiffness. Methods: Data of 31 children and adolescents with posttraumatic elbow stiffness following open arthrolysis with or without hinged external fixation from 2010 to 2014 were retrospectively analyzed. Their mean age was 15 (range: 6 to 19) years. At baseline and the follow-up (>4 y), we evaluated the outcomes (range of motion and Mayo Elbow Performance Index) and postoperative complications (pain, ulnar nerve symptoms, infections, and instability) and analyzed the association between...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Comparison of Short-leg and Long-leg Casts for the Treatment of Distal Third Tibial Shaft Fractures in Children
Background: Long-leg casts (LLCs) are an established treatment for pediatric tibial shaft fractures including fractures involving the distal third. There is a paucity of literature assessing the use of short-leg cast (SLC) for tibial shaft fractures. The purpose of this study was to determine if SLC were as effective as LLC for the treatment of pediatric distal third tibial shaft fractures. Methods: A retrospective review was conducted on consecutive distal third tibial shaft fractures treated at a tertiary pediatric hospital from 2013 to 2018. Exclusion criteria included midshaft and proximal fractures of the t...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Risk Factors for Failure of Cast Treatment in Displaced Pediatric Tibial Shaft Fractures
Conclusions: The TPI>0.855 and postreduction translation>18% are independent risk factors for redisplacement of tibial shaft fractures in children. Although the gap index can be useful, the cast index is not an appropriate tool for these fractures. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Do We Really Need to Worry About Calcaneocuboid Subluxation During Lateral Column Lengthening for Planovalgus Foot Deformity?
Conclusions: Both sagittal and rotatory subluxation seem to occur at the CC joint after LCL regardless of pin stabilization. As a single pin would be expected to limit pure translation while having little effect on rotation, it is possible that the rotational changes identified on 3-dimensional imaging are interpreted as dorsal translation when viewed 2 dimensionally using plain radiography. Consideration should therefore be given to CC stabilization with 2 pins during LCL to prevent this rotatory subluxation. Level of Evidence: Level V—cadaver study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Lower Extremety Source Type: research

Crawford Type IV Congenital Pseudarthrosis of the Tibia: Treatment With Vascularized Fibular Grafting and Outcome at Skeletal Maturity
Conclusion: This study reports the largest single center experience of CPT cases treated with VFG. Free VFG is an excellent treatment option for CPT. Best results are achieved when the procedure is performed at or before the age of 3 years, in the absence of previous surgeries, and with the use of intramedullary fixation. The resulting LLD and the degree of ipsilateral ankle valgus increase with age until skeletal maturity, however, tibial deformity does not remodel and should be corrected at any age if it is excessive. Donor side mild ankle valgus may occur despite sound tibiofibular synostosis. Level of Evidence: ...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Lower Extremety Source Type: research

Surgical Release of Gluteal Fibrosis in Children Results in Sustained Benefit at 5-Year Follow-up
This study assesses the 5-year postoperative range of motion (ROM) and functional outcomes for Ugandan children who underwent surgical release of GF. Methods: A retrospective cohort study of children who underwent release of GF in 2013 at Kumi Hospital in Eastern Uganda. Functional outcomes, hip ROM, and scar satisfaction data were collected for all patients residing within 40 km of the hospital. Results: One hundred eighteen children ages 4 to 16 at the time of surgery were treated with surgical release of GF in 2013 at Kumi Hospital. Of those 118, 89 were included in this study (79.5%). The remaining...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Intraobserver and Interobserver Reliability of the Peritubercle Lucency Sign in Slipped Capital Femoral Epiphysis
This study aimed to assess intraobserver and interobserver reliability for detecting the presence or absence of the peritubercle lucency sign. Methods: Thirty-five radiographs were presented to 6 fellowship-trained pediatric orthopaedic surgeons on 2 separate occasions 30 days apart, ensuring that the images were shown in a different order on the second exposure. Both times the reviewers recorded whether the peritubercle lucency sign was present or absent in each of the radiographs. Statistical analysis was performed to determine the intraobserver and interobserver reliability. Results: In the intraobserver a...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Acetabular Coverage Decreases at the End of Skeletal Growth: A 3DCT Study of Healthy Hips
Conclusions: The relative femoral head coverage by the acetabular lunate cartilage reduced with increasing age, suggesting the growth of the femoral head outpaces the acetabular lunate cartilage’s growth. This was more prominent in females. This study has important implications for expected acetabular coverage changes in the latter aspects of pediatric and adolescent development. Level of Evidence: Level III—diagnostic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Preoperative 3D Modeling and Printing for Guiding Periacetabular Osteotomy
Conclusion: This study demonstrates that for PAO surgery, 3D modeling and printing allow the surgeon to accurately create a reproducible surgical plan to obtain predetermined postoperative hip coverage parameters. This new technology has the potential to improve preoperative/intraoperative decision making for hip dysplasia and other complex disorders of the hip. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Is There a Benefit to Weaning Pavlik Harness Treatment in Infantile DDH?
Background: Following successful treatment of developmental hip dysplasia with a Pavlik harness, controversy exists over the benefit of continued harness use for an additional “weaning” period beyond ultrasonographic normalization versus simply terminating treatment. Although practitioners are often dogmatic in their beliefs, there is little literature to support the superiority of 1 protocol over the other. The purpose of this study was to compare the radiographic outcomes of 2 cohorts of infants with developmental hip dysplasia treated with Pavlik harness, 1 with a weaning protocol and 1 without. Metho...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Hip Source Type: research

The Incidence of Vertebral Exostoses in Multiple Hereditary Exostoses and Recommendations for Spinal Screening
Conclusions: Based on the results of this cohort, vertebral exostoses are common in MHE, and screening MRI of the entire spine can be used to determine which patients need close observation. If a more selective screening protocol is utilized, an entire spine MRI could be obtained for patients who desire increased physical activity levels or for patients with both pelvis and rib exostoses. At a minimum, treating physicians should monitor patients with MHE closely for neurological symptoms and have a low threshold to obtain advanced spinal imaging. Level of Evidence: Level III—diagnostic. (Source: Journal of...
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Spine Source Type: research

What is the Optimal Surgical Method for Achieving Correction and Avoiding Neurological Complications in Pediatric High-grade Spondylolisthesis?
Conclusions: RIF and IFIS show similar radiologic outcomes. RIF shows a higher rate of unplanned return to surgery, pseudarthrosis and persisting neurological changes. Level of Evidence Level III—retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Spine Source Type: research

Is There Value in Venous Thromboembolism Chemoprophylaxis After Pediatric Scoliosis Surgery? A 28-Year Single Center Study
Conclusions: The risk of symptomatic VTE is extraordinarily low after pediatric spinal deformity surgery. Mechanical prophylaxis is sufficient in most cases. Further multi-center studies may help identify patient specific risk factors. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Scoliosis/Kyphosis Source Type: research

Congenital Scoliosis of the Pediatric Cervical Spine: Characterization of a 17-Patient Operative Cohort
Conclusions: Congenital scoliosis of the cervical spine is a complex process. The spinal deformity of this nature can be managed successfully with carefully planned and executed surgical correction. Level of Evidence: Level IV—retrospective review. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Scoliosis/Kyphosis Source Type: research

Growth-friendly Spinal Instrumentation in Marfan Syndrome Achieves Sustained Gains in Thoracic Height Amidst High Rates of Implant Failure
Conclusions: This is the largest report on patients with EOS and MFS. All subtypes of growth-friendly constructs reduced curve progression in this cohort, but complications and reoperations were nearly universal; patients were particularly plagued by implant failure and migration. Further collaborations are needed to enhance understanding of optimal timing and fixation constructs for those with MFS and other connective tissue diseases. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Scoliosis/Kyphosis Source Type: research

Congenital Kyphosis: Progressive Correction With an Instrumented Posterior Epiphysiodesis: A Preliminary Report
Conclusion: Posterior instrumented fusion and epiphysiodesis is safe and effective. The epiphysiodesis effect occurs in 5/6 of cases, and our data suggests that the procedure is associated with an acceptable blood loss and a low incidence of neurological complications. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - February 10, 2021 Category: Orthopaedics Tags: Scoliosis/Kyphosis Source Type: research

Pediatric Medial Epicondyle Fracture Management: A Systematic Review
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to Letters to the Editor Regarding “Pediatric Medial Epicondyle Fracture Management: A Systematic Review”
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Impact of Transverse Ultrasound Images on the Classification and Treatment of Pediatric Lateral Humeral Condyle Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: Impact of Transverse Ultrasound Images on the Classification and Treatment of Pediatric Lateral Humeral Condyle Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: “Quantity,” “Quality” and “Distribution Pattern” of Neo Vascular System: Is it the Time to Come Back to Aristotle Categories?
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

“Quantity,” “Quality,” and “Distribution Pattern” of Neovascular System: Is It the Time to Come Back to Aristotle Categories?
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Morbidity of Nerve Transfers for Brachial Plexus Birth Injury: A Systematic Review
Conclusion: Nerve transfers are a well-recognized treatment strategy for patients with BPBI and have an acceptable risk profile in the short term. Full hypoglossal nerve transfers for BPBI are of historical interest. Donor site morbidity is grossly underreported. This review highlights the need for more objective and systematic reporting of donor site outcomes, and the need for longer term follow-up in these patients. Level of Evidence: Systematic review. Level III—therapeutic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Selected Topics Source Type: research

Treatment of Chronic Hematogenous Osteomyelitis in Children With Antibiotic Impregnated Calcium Sulphate
Conclusions: The authors found that single-stage debridement in conjunction with antibiotic impregnated calcium sulphate was an effective means of treating CHOM in children, with effective eradication of infection in every case. Level of Evidence: Level IV—Retrospective case series. See instructions for authors for a complete description of levels of evidence. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Selected Topics Source Type: research

Role of the Pubic Symphysis in Osseous Pelvic Development: A Novel Model of Bladder Exstrophy in Rabbits
Background: It has been posited that the osseous pelvic anomalies seen in patients with classic bladder exstrophy (CBE) result from disruption of the pubic symphysis. This hypothesis, however, has not been tested. In the present animal study, our objective was to determine whether the tension of the pubic symphysis helps maintain the shape of the pelvic ring, or whether the growing bones maintain a ring shape even without the tension of the symphysis. Methods: In total, 12 neonatal New Zealand White rabbits underwent pubic symphysiotomy (experimental group, n=9) or sham surgery (control group, n=3) on days 3 or ...
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Selected Topics Source Type: research

What’s New in Pediatric Orthopaedic Tumor Surgery
Conclusions: There are many, varied, and creative procedures in the realm of limb salvage, though there remains a lack of high-level evidence to support some of the more novel procedures. In regards to benign bone tumors, despite a more solid base of literature, there still does not seem to be consensus as to the best treatment. In particular, there continue to be many schools of thought on the treatment of benign bone cysts. Research in the basic science arena and systemic therapies are advancing in exciting ways in regards to pediatric sarcoma. Orthopaedic oncologic research specific to the pediatric population overa...
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Tumor Source Type: research

Hand Bone Age Radiography: Comparison Between Slot-scanning and Conventional Techniques
Background: Determination and longitudinal monitoring of progressive skeletal maturity are essential in the management of children with scoliosis. Although different methods for determining skeletal maturity exists, the most widely practiced method relies on the ossification pattern of the bones of the hand and wrist, which is traditionally acquired using conventional techniques and after the acquisition of the spine using the low-dose slot-scanning technique. Whereas the existing published literature has published promising results on the use of the slot-scanning technique to acquire these hand and wrist radiographs, ...
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Spine Source Type: research

Safety and Feasibility of Cervical Pedicle Screw Insertion in Pediatric Subaxial Cervical Spine Without Navigation: A Retrospective Cohort Study
Conclusions: CPS insertion in pediatric subaxial cervical spine without neuronavigation is safe, feasible, and effective in carefully selected cases. Biomechanical advantages of CPS can be extended to the pediatric subaxial cervical spine. Level of Evidence: Level IV—retrospective cohort. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Spine Source Type: research

Preoperative and Postoperative, Three-dimensional Gait Analysis in Surgically Treated Patients With High-grade Spondylolisthesis
Conclusions: Preoperative gait abnormalities exist in HGS and can be objectively analyzed with gait analysis. Surgical intervention may successfully resolve these gait abnormalities and gait analysis is a useful tool to assess the outcome of surgery and quantify an otherwise intangible benefit of surgical intervention. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Spine Source Type: research

Are Postcast Removal X-rays and a Second Follow-up Necessary in the Treatment of Nondisplaced Supracondylar Humerus Fractures?
Conclusion: This study suggests that postcast removal x-rays and routine follow-up after cast removal rarely change patient management and may not be necessary in the treatment of nondisplaced pediatric supracondylar humerus fractures. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Plate Versus Lag Screw Only Fixation of Unstable Ankle Fractures Involving the Fibula in Adolescent Patients
Conclusions: Lag screw only fixation is a safe and effective procedure for noncomminuted, oblique fibula fractures in the adolescent population as demonstrated by equivalent fracture healing rates without loss of reduction and similar outcome scores. Given these comparable results with the additional benefits of shorter surgical time and less symptomatic implants, lag screw only fixation should be considered as a viable treatment alternative to traditional lateral plating in the adolescent population. Level of Evidence: Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Twenty-two Years of Pediatric Musculoskeletal Firearm Injuries: Adverse Outcomes for the Very Young
Conclusions: Over one fourth of survivors of musculoskeletal firearm injuries had an adverse outcome. Children 10 years and above represent the majority of firearm injuries in our population; however, when injured, those below 10 years are more likely to have an adverse outcome. Level of Evidence: Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Ankle Morphology and Juvenile Osteochondritis Dissecans (JOCD) of the Talus: Is There an Association? An MRI Study
Purpose: Factors that contribute to the development of juvenile osteochondritis dissecans (JOCD) of the talus are poorly understood. Some authors suggest that a higher loading of the affected zone may be a cofactor in osteochondral lesions. Therefore, the purpose of the study is to evaluate any association between ankle morphology and talus JOCD using morphologic parameters from magnetic resonance images. Our hypothesis is that ankles with JOCD lesions would have differences in the anatomy compared with age and sex-matched unaffected ankles. Methods: We evaluated a total of 75 extremities. There were 22 patients...
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Quadriceps Strength Is Influenced by Skeletal Maturity in Adolescents Recovering From Anterior Cruciate Ligament Reconstruction
Conclusions: After ACLR, adolescent patients with open physes had higher quadriceps strength compared with patients with closed physes. Overall, those skeletally less mature patients actually fared better on the functional strength tests, suggesting that functional recovery is not hindered by the presence of an incompletely closed physis. Level of Evidence: Level III—retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Can Chiari Osteotomy Favorably Influence Long-term Hip Degradation in Multiple Epiphyseal Dysplasia and Pseudoachondroplasia?
Conclusions: The Chiari osteotomy is a satisfying solution for severe symptomatic hip lesions in MED and PSACH patients. At long-term follow-up, this procedure lessens pain and improves hip function, which delays total hip arthroplasty indication. Level of Evidence: Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Greater Trochanter Height: A Quantitative Predictor of Skeletal Maturity
Background: The purpose of this investigation was to develop a quantitative and reproductible method for estimating skeletal maturity based on measurements of the height of the bony greater trochanter (GT) using timing to 90% of final height as a gold standard. Methods: Bony GT height was measured using serial anteroposterior pelvic radiographs in 76 healthy pediatric patients obtained from the Bolton-Brush (BB) Study with corresponding Greulich-Pyle (GP) bone ages. Chronologic age at 90% of final height was calculated. GT height was then measured in 300 contemporary patients aged 4 to 18 years, evenly divided b...
Source: Journal of Pediatric Orthopaedics - January 16, 2021 Category: Orthopaedics Tags: Hip Source Type: research