Reproducibility of Radiographic Measurements Made in the Active Stages of Legg-Calvé-Perthes Disease: Evaluation of a Prognostic Indicator and an Interim Outcome Measure
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: Medial Epicondyle Fractures: Biomechanical Evaluation and Clinical Comparison of 3 Fixation Methods Used in Pediatric Patients
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Medial Epicondyle Fractures: Biomechanical Evaluation and Clinical Comparison of 3 Fixation Methods Used in Pediatric Patients
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Pediatric Distal Third Tibial Shaft Fractures: Are Short Leg Casts a Reasonable Option?
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Letter to the Editor With Respect to: Comparison of Short-leg and Long-leg Casts for the Treatment of Distal Third Tibial Shaft Fractures in Children, Barnett, Scott A. MD; Fontenot, Bailli BS; Leonardi, Claudia PhD; Gonzales, Joseph A. MD; Gargiulo, Dominic DO; Heffernan, Michael J. MD. March 2021 - Volume 41 - Issue 3 - pp. e259-e265
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Spinal Anesthesia Is Superior to General Anesthesia for Percutaneous Achilles Tenotomy in Infants
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

John Manley Roberts M.D. (1932 - 2020) Obituary
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Obituary Source Type: research

Seymour “Zeke” Zimbler M.D. (1934 - 2021) Obituary
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Obituary Source Type: research

Art and Pediatric Orthopaedics: Velazquez, an Artist of Stature
Diego Velazquez painted several dwarfs employed at the Royal Court of Spain and one of the best known among them is the painting of Sebastian de Morra, a court jester. The clarity of the painting enables the reader to make a diagnosis of achondroplasia. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Selected Topics Source Type: research

What’s New in Pain Management for Pediatric Orthopaedic Surgery
Conclusions: There have been many advances in pain management for pediatric patients following orthopaedic surgery. Rapid recovery surgical care pathways are associated with shorter length of stay and improved pain control in pediatric spine surgery. Opioid overprescribing continues to be common and information regarding safe opioid disposal practices should be routinely provided for pediatric patients undergoing surgery. Level of Evidence: Level IV—literature review. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Selected Topics Source Type: research

Validity, Responsiveness, and Reliability of the ACL-QOL in an Adolescent Population
Background: The anterior cruciate ligament quality of life (ACL-QOL) score is a disease-specific patient-reported outcome measure that assesses patients with ACL deficient and reconstructed knees. The ACL-QOL has demonstrated validity, responsiveness, and reliability in adult populations but has yet to be specifically evaluated in adolescent patients. The purpose of this study was to assess the validity, responsiveness, and reliability of the ACL-QOL in an adolescent population. Methods: Between 2010 and 2015, questionnaires from 294 consecutive adolescent patients consented for an ACL reconstruction were collec...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Operative Treatment of Cervical Spine Injuries Sustained in Youth Sports
Conclusions: The incidence of sports-related CSI requiring surgery is low with differences in age/sex, sport, and injury patterns. Older males with hyperflexion/axial loading injuries in contact sports were at greatest risk of SCI, complications, and permanent disability. Prevention campaigns, education on proper tackling techniques, and neck strength training are required in sports at high risk of hyperflexion/axial loading injury. Level of Evidence: Level III—retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Pilot Study Analysis of Serum Cytokines to Differentiate Pediatric Septic Arthritis and Transient Synovitis
Background: In pediatric patients, the presentation of the nontraumatic acutely painful joint/limb poses a diagnostic dilemma due to the similarity of presentations of the most likely diagnoses [septic arthritis (SA), transient synovitis (TS), osteomyelitis]. Current tools employed to differentiate these diagnoses rely on nonspecific inflammatory markers, radiologic imaging, and arthrocentesis. Diagnostic algorithms utilizing these clinical, radiographic, and biochemical parameters have produced conflicting results. The purpose of this study was to identify a serum-based inflammatory signature which can differentiate S...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Infection Source Type: research

The Impact of Operative Intervention in Pediatric Lyme Arthritis
Conclusions: Operative management of pediatric patients with Lyme arthritis is associated with increased resource utilization and costs while being similarly efficacious to nonoperative management. As the US Lyme epidemic expands, improved diagnosis and management of acute undifferentiated arthritis may prevent unneeded operative intervention. Level of Evidence: Level III—retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Infection Source Type: research

Functional Outcomes of Arthroscopic Os Trigonum Excision in Adolescents
This study intends to report functional outcomes of arthroscopic os trigonum excision in adolescents who failed conservative management, with the hypothesis that these younger patients would have similar, successful outcomes of adult patients. Methods: A retrospective study was performed on adolescents who underwent arthroscopic os trigonum excision at a single institution between 2011 and 2017. Patient demographic, clinical history, radiographic, and operative data were documented. Outcome measures included the Foot and Ankle Ability Measure (FAAM) score comprised of the Activities of Daily Living (ADL) and Sports ...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Lower Extremity Source Type: research

Effect of Screw Configuration on the Rate of Correction for Guided Growth Using the Tension-band Plate
This study investigated the effect of screw configuration on the rate of correction of coronal angular deformity of the knee joint in children who underwent guided growth using the tension-band plate. Methods: Consecutive patients (76 patients with 154 physes; mean age: 11.8±2.2 y) who underwent guided growth using the tension-band plate for coronal angular deformity (genu varum or genu valgum) were included. The mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, and screw angle were measured from the teleroentgenograms of preoperative and postoperative periodic follow-up...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Lower Extremity Source Type: research

Core Decompression and Bone Marrow Aspirate Concentrate in the Treatment of Femoral Head Avascular Necrosis in Pediatric Sickle Cell Disease: Can We Improve Natural History?
This study sought to report on a single surgeon’s outcomes for core decompression with BMAC injection in pediatric patients with AVN of the femoral head secondary to underlying SCD. Methods: A single-center, retrospective review was performed for pediatric patients undergoing core decompression with BMAC injection for femoral head AVN in patients with SCD with a minimum of 12-month follow-up. Demographic, radiographic, and clinical variable were collected. Patients were subdivided based upon presence of open femoral physes at the time of surgery. Successful treatment was defined as the ability to return to act...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Hip Source Type: research

What Are the Rate and Risk Factors for Developing a Complication With the Pavlik Method for the Treatment of Hip Dysplasia?
Background: The Pavlik method for the treatment of developmental dysplasia of the hip (DDH) has been proven successful for over 85 years. The high success rate and reproducibility have made it the mainstay of treatment. Methods: We performed a retrospective cohort study of patients with DDH treated with the Pavlik method between September 2016 and August 2018 with at least 24 months of follow up in a single academic center. We excluded patients with neuromuscular conditions, teratologic dislocations, and arthrogryposis. We identified and included a total of 307 patients in the analysis. There were 66 patients wi...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Too Loud for Comfort: A Simulated Evaluation of Cast Saw Noise
Background: Orthopaedic cast saws are an integral component to a pediatric orthopaedic practice but can also be associated with patient anxiety and noise exposure for patient. Although previous studies have deemed the noise generation from orthopaedic cast saws to be within safe occupational exposure levels, no study to date has compared the noise generation from a cast saw used in various exam room settings. Methods: A simulated fiberglass cast model was used. Noise generation was assessed using calibrated sound level meters with measurements performed at 18 inches, 36 inches, and 6 ft measured from the ...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Establishing Safety Parameters for Orthopaedic Cast Saw Blade Usage
Conclusions: When a Stryker 940 cast saw without vacuum is used to cut plaster casts, the ion-nitride blade should be changed frequently, at minimum after 60 casts have been split, or 30 casts have been bivalved. When a Stryker 940 cast saw with vacuum is used to remove fiberglass and plaster casts, the ion-nitride blade should be changed after removing 103 casts. A cast saw with an attached vacuum should be used whenever possible to minimize the risk of burning patients. Clinical Relevance: Determine how often a cast saw blade should be changed to minimize risk of burning patients. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Use of Digital Tomosynthesis in Assessing Accurate Medial Epicondyle Fracture Displacement as Compared With Conventional Radiography and Computed Tomography
Conclusion: DT is more accurate than conventional radiography (both AP and axial views) and as accurate as CT in assessing millimeters of displacement of medial epicondyle fracture fragments. Level of Evidence: Level IV—diagnostic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Surgical Treatment With Titanium Elastic Nail (TEN) for Failed Conservative Treatment of Acute Monteggia Lesions in Children
This study evaluated the results of intramedullary osteosynthesis with titanium elastic nail (TEN) in the surgical treatment of Monteggia lesions in children aged 12 and under. Methods: Patients who underwent surgery with the TEN method between 2013 and 2019 were screened retrospectively. The inclusion criteria were patients who failed conservative treatment, a history of acute trauma ( (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

How Much Opioid Do Kids Actually Need? A Prospective Study of Analgesic Prescribing and Postdischarge Opioid Use Among Pediatric Patients With Operative Fractures
Conclusions: Pain is consistently well controlled after operative pediatric fractures. Nearly all were prescribed opioids, while acetaminophen/NSAIDs were inconsistently prescribed and used. Opioid prescriptions are written for 4 to 5 times the amount needed. Prescribing ≤8 doses of opioid is adequate for acute pain through POD5 in 97% of patients. Poorly controlled pain should prompt early evaluation for possible complications. Level of Evidence: Level II—prospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Intraoperative Use of Robotics With Navigation for Pedicle Screw Placement in Treatment of Pediatric High-grade Spondylolisthesis: A Preliminary Report
Conclusions: This case-series demonstrates that RAN represents a viable option for HGS repair, indicated by high screw placement accuracy, safety, and L5-S1 slippage correction. Surgeons looking to adopt an emerging technique to enhance safety and correction of pediatric HGS should consider the RAN platform. Level of Evidence: Level IV—therapeutic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Spine Source Type: research

Entire-spine Magnetic Resonance Imaging Findings and Costs in Children With Presumed Adolescent Idiopathic Scoliosis
Conclusions: Entire-spine MRI for nonpreoperative indications including pain, abnormal radiographic curve appearance, and rapid curve progression has minimal utility for patients with AIS. For patients with neurological complaints, the NND a potentially treatment-altering finding with MRI is 34.4. Level of Evidence: Level II—diagnostic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Scoliosis Source Type: research

Surgical Outcomes of Obese Patients With Adolescent Idiopathic Scoliosis From Endemic Areas of Obesity in the United States
This study evaluates the effect of body mass index (BMI) percentile and socioeconomic status (SES) on surgical site infections (SSIs) and perioperative complications in patients with adolescent idiopathic scoliosis (AIS) treated with posterior spinal fusion (PSF). Methods: Eleven centers in the Southern US retrospectively reviewed postoperative AIS patients after PSF between 2011 and 2017. Each center contributed data to a centralized database from patients in the following BMI-for-age groups: normal weight (NW, 5th to (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Scoliosis Source Type: research

When Is a Growth-friendly Strategy Warranted? A Matched Comparison of Growing Rods Versus Primary Posterior Spinal Fusion in Juveniles With Early-onset Scoliosis
Conclusions: In juveniles aged 7 to 11 with EOS, on average GRs afford 2 cm of thoracic height over primary PSF at the cost of poorer deformity correction and additional complications and operations. Primary PSF affords an average of 2 cm of thoracic height gain; if an additional 2 cm will be impactful then GRs should be considered. However, in most juveniles the height gained may not warrant the iatrogenic stiffness, complications, and additional operations. Surgeons and families should weigh these benefits and harms when choosing a treatment plan. Level of Evidence: Level III—retrosp...
Source: Journal of Pediatric Orthopaedics - October 19, 2021 Category: Orthopaedics Tags: Scoliosis Source Type: research

Obese Children Have Different Forearm Fracture Characteristics Compared With Normal-weight Children
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Letter to the Editor Source Type: research

Bruegel and the Cost of the Bended Knee
In Pieter Bruegel’s painting, “The Seven Acts of Charity” he portrays 2 subjects with flexed knees. One of them cannot walk while the other can walk but does so with excessive energy expenditure. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Primary Bacterial Pyomyositis in Children: A Systematic Review
Conclusions: Primary pyomyositis should be considered in cases suggesting pediatric infection. Magnetic resonance imaging is the most commonly used imaging modality; however, ultrasound is useful given its accessibility and low cost. Medical management alone can be successful, but surgical treatment is often needed. The prognosis is favorable. Early diagnosis, appropriate medical management, and potential surgical drainage are required for effective treatment. Level of Evidence: Level IV—systematic review. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Determining C2 Pedicle Screw Placement Feasibility in the Pediatric Population: A Computed Tomographic Safe Zone Analysis
Conclusions: There is a considerable amount of anatomic variability within the pediatric C2 pedicles. Using this simple and accessible technique during the review of preoperative imaging, C2 pedicle screw placement may be considered in appropriately selected pediatric patients. Level of Evidence: Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

An Analysis of Online Ratings of Pediatric Orthopaedic Surgeons
Conclusions: Pediatric orthopaedic surgeons are frequently and highly rated, similar to other orthopaedic subspecialties. Surgeons in practice 1 to 10 years were found to have statistically higher ratings on some websites. Academic surgeons were found to have statistically higher ratings on some websites. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Selected Items Source Type: research

Physeal Abnormalities in Children With High-risk Neuroblastoma Intensively Treated With/Without 13-Cis-Retinoic Acid
Conclusions: Some children who were treated for high-risk neuroblastomas experienced multifocal physeal insults, probably due to the use of 13-CRA. Most lesions resolved spontaneously, but some led to bony deformity. If the lesions are not followed by premature physeal closure, there seems to be no further adverse effect of 13-CRA on leg length growth. Routine periodic screening for physeal status is needed for the patients with high-risk neuroblastomas using 13-CRA. Level of Evidence: Level IV—prognostic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Tumor Source Type: research

Assessment of the Viability and Union Feature of Diaphysis Reconstruction Using Pasteurized Tumor Bone and Intramedullary Free Fibular After Tumor Resection
Conclusions: Reconstruction using PTM combined with VFG is associated with good short-term biological activity as indicated by bone scintigraphy, a high union rate, and an acceptable complication rate. The technique is a useful reconstruction option for large segmental bone defects after tumor resection in lower extremities. Level of Evidence: Level IV—therapeutic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Tumor Source Type: research

Prospective Evaluation of Tarsal Coalition Excision Show Significant Improvements in Pain and Function
Conclusions: This prospective study demonstrated remarkable clinical improvements after tarsal coalition excision regardless coalition type, though postoperative courses differed between calcaneonavicular and talocalcaneal types. Finally, a subset of patients has ongoing activity limiting foot pain after coalition excision which could not be explained by the data in this study. Level of Evidence: Level II—prospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Foot and Ankle Source Type: research

Terminal Syme Amputation of the Great Toe in the Pediatric Population
Conclusions: Terminal Syme amputation was successful in treating pediatric patients who have recalcitrant onychocryptosis and paronychia. There was little functional consequence following terminal Syme amputation of the great toe in this patient population, making it an effective salvage procedure. Level of Evidence: Level IV—retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Foot and Ankle Source Type: research

Congenital Posteromedial Bowing of Tibia: Comparison of Early and Late Lengthening
Conclusions: In a large series of lengthenings in CPMBT, we found younger children presenting with large deformities and large projected length discrepancies could be safely lengthened with significantly lesser EFD and complications than in older children. Level of Evidence: Level IV—therapeutic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Knee/Tibia Source Type: research

Long-term Minimum 15-Year Follow-up After Lateral Discoid Meniscus Rim Preservation Surgery in Children and Adolescents
Conclusions: Overall, patient-reported outcomes were favorable at a minimum of 15-year follow-up after rim-preserving saucerization of LDM. While two thirds of patients were satisfied with their surgical outcomes, nearly half of patients underwent revision saucerization with or without meniscal repair. Subsequent long-term follow-up studies with objective outcome measures are important to further elucidate the natural history of LDM and understand how rim-preserving procedures may prevent the development of degenerative processes. Level of Evidence: Level IV—case series, prognostic study. (Source: Journal ...
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Knee/Tibia Source Type: research

Surgical Management of Medial Discoid Meniscus in Pediatric and Adolescent Patients
Conclusions: MDM is a rare diagnosis, representing 3% of all discoid menisci, with a nonspecific clinical manifestation. Operative management of symptomatic MDM typically involves saucerization and meniscal repair, when indicated, for concurrent tears. Symptom resolution is common short-term, but long-term outcomes include recurrent meniscal tears. Subsequent observational studies are important to evaluate long-term outcomes, such as arthritic changes, with the advancement of arthroscopic techniques for meniscal preservation. Level of Evidence: Level IV—retrospective case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Knee/Tibia Source Type: research

Hip Displacement in MECP2 Disorders: Prevalence and Risk Factors
Conclusions: The prevalence of HD in MECP2 disorders is comparable to cerebral palsy, associated with proxy measures of disease severity. These results can be used to develop hip surveillance programs for MECP2 disorders, allowing for timely management. Level of Evidence: Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

The Open Triradiate Cartilage: How Young Is Too Young for Total Hip Arthroplasty?
Conclusions: In this study, THA in patients with an open triradiate cartilage yielded significant clinical improvement, low complication rates and good initial implant survivorship at early follow up. Awaiting closure of the triradiate cartilage for concerns of decreased fixation and implant survivorship may be unnecessary. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Stability in Pelvic Triple Osteotomies in Children Using Resorbable PLGA Screws for Fixation
Conclusion: The present findings suggest that the modified TPO method, using resorbable PLGA screws, provides sufficient stability and appears to be a promising alternative to traditional TPO. Avoiding implant removal is a major benefit in a pediatric population. Resorbable screws enable the surgeon to place implants with more degrees of freedom since later implant removal is not a limiting factor. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Reliability and Validity of Visual Estimation of Femoral Head Hypoperfusion on Perfusion MRI in Legg-Calve-Perthes Disease
Conclusions: This study demonstrates the reliability and validity of visual estimation as a clinically applicable method for determining femoral head hypoperfusion. Our study is the first to measure the reliability of visual estimation and HipVasc with a large cohort of clinicians, specifically pediatric orthopaedic surgeons with varied experience in graphical software analysis. We recommend using visual estimation as a clinically applicable method to make treatment decisions, and its accuracy is comparable to HipVasc software analysis. Level of Evidence: Level III—diagnostic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Feasibility of Magnetic Resonance Angiography in Patients With Legg-Calvé-Perthes Disease
Conclusions: TRICKS-MRA provides well-defined images of the arterial supply to the proximal femoral epiphysis in children with LCPD, presenting a noninvasive and radiation-free alternative to conventional angiography. However, the TRICKS-MRA method used did not allow visualization of the ascending lateral epiphyseal segment of MCFA in the affected and the contralateral normal side. We believe that further advancement of this noninvasive imaging technique may open new opportunities for research aimed at evaluating the vascular supply of the femoral head in children. Level of Evidence: Level IV—case-control ...
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

Results of Early Proximal Femoral Osteotomy at Skeletal Maturity in Legg-Calvé-Perthes Disease: Implication for the Bypass of Fragmentation Stage
Conclusions: Our results show that 40.5% of patients who underwent early PFO bypassed the fragmentation stage. The degree of lateral pillar collapse was lower in patients with bypass. In addition, there were significantly more patients with more spherical femoral head in the bypass group. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Hip Source Type: research

The Impact of Cast Immobilization on Return to Daycare
Conclusions: The ability to RTD is dependent on immobilization type. Children with long leg and spica casts are disproportionately restricted when compared with other cast types. At minimum, surgeons should consider the socioeconomic implications of orthopaedic immobilization. There is also a need for orthopaedic involvement in policy formation at the local level to provide standardized guidelines for re-entry into childcare facilities following orthopaedic immobilization. Level of Evidence: Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Treatment Choice of Complete Distal Forearm Fractures in 8 to 14 Years Old Children
This study was performed to compare outcomes and costs between closed reduction with percutaneous pinning (CRPP) and closed reduction with casting in the treatment of complete distal forearm fractures in children 8 to 14 years old. Methods: A retrospective cohort study was performed of 175 displaced distal forearm fractures treated with 2 different methods in the emergency department of a children’s trauma center. One hundred and fourteen children were managed using CRPP. The remaining 61 were treated with closed reduction and casting. All patients had initial follow-up radiographs. The quality of reduction an...
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Factors That Drive Annual Variation in Pediatric Elbow Fracture Occurrence, Severity, and Resource Utilization
Conclusion: Increased daylight, while school was in session, was a major driver of the incidence of pediatric elbow fractures. While summer vacation conferred fewer fractures, these were of higher severity. As such, increased daylight correlated strongly with monthly resource utilization, including the need for emergency transportation and operative treatment. This study provides objective data by which providers and administrators can more accurately allocate resources. Level of Evidence: Level III—Retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Efficacy of Antibiotics in Supracondylar Fractures
Conclusions: Retrospective review of the incidence of infection in closed reduction and percutaneous pinning of supracondylar humerus fractures found no difference between patients who received preoperative antibiotics and those who did not receive preoperative antibiotics. Level of Evidence: Level III—therapeutic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Trauma Source Type: research

Evaluating Perioperative Complications Surrounding Supracondylar Humerus Fractures: Expanding Indications for Outpatient Surgery
Background: Supracondylar humerus (SCH) fractures are one of the most common pediatric orthopaedic injuries. Described using the Wilkins modification of the Gartland Classification system, current practice guidelines give moderate evidence for closed reduction and percutaneous pinning of type 2 and 3 injuries, but little evidence exists regarding the appropriate surgical setting for fixation. The goal of this study was to evaluate the perioperative complication profile of type 3 fractures with maintained metaphyseal contact and determine their suitability for outpatient surgery. Methods: Skeletally immature pati...
Source: Journal of Pediatric Orthopaedics - September 13, 2021 Category: Orthopaedics Tags: Trauma Source Type: research