Comparison of the Results of Primary Versus Repeat Hamstrings Surgical Lengthening in Cerebral Palsy
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Doubts About Primary Versus Repeat Hamstring Surgical Lengthening in Cerebral Palsy
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: Brachial Plexus Birth Injury: Epidemiology and Birth Weight Impact on Risk Factors
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Brachial Plexus Birth Injury: Epidemiology and Birth Weight Impact on Risk Factors
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Long-term Follow-up of Eosinophilic Granulomas of the Axial and Appendicular Skeleton Managed With Biopsy Alone
Conclusions: Unifocal osseous EGs have spontaneous healing potential and confirming the diagnosis by biopsy is enough to obtain good clinical and radiologic results without any additional surgical intervention. Type of Study: This was a therapeutic study. Level of Evidence: Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Selected Topics Source Type: research

An Updated Analysis of the Pediatric Section of the Orthopaedic In-Training Examination
Background: An updated analysis of the pediatrics section of the Orthopaedic In-Training Examination (OITE) is helpful for resident education and preparation for the OITE. The purpose of this study is to provide an updated evaluation of the pediatric category of the OITE, and to explore trends in question topics and taxonomy compared with the previously published analysis from 2011 to 2014. Methods: Five years (2015-2019) of OITE questions, answers, and references were reviewed. The number of pediatric questions per year was recorded, and questions were subcategorized based on topic tested. The presence or absence of ...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Selected Topics Source Type: research

What Should I Wear to Clinic? A National Survey of Pediatric Orthopaedic Patients and Parents
Background: A number of factors have been shown to affect how surgeons are subjectively viewed, including their appearance in clinic. Patient preference for pediatric orthopaedic surgeon attire has not previously been studied, nor has its influence on initial perception of the surgeon. Methods: At 5 pediatric regional sites across the United States, parents and patients presenting to the pediatric orthopaedic clinic were given anonymous surveys showing 8 photos of surgeons in different clinical dress including in business or scrub dress, each with or without white coat (WC). Subjects reported their demographics, singl...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Selected Topics Source Type: research

Single-incision Extraperiosteal Triple Innominate Osteotomy: Outcomes of an Updated Technique
Conclusions: In this dual-center retrospective series, the single-incision triple innominate osteotomy was extremely effective for improving acetabular coverage and stabilizing unstable hips in a variety of underlying diagnoses with an acceptably low rate of complications. Level of Evidence: Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Selected Topics Source Type: research

External Validation of an Algorithm to Predict Adjacent Musculoskeletal Infection in Pediatric Patients With Septic Arthritis
Conclusion: Although treatment algorithms are an attractive tool to guide clinicians and resource allocation, they need to take into account the local population characteristics before routine implementation. Level of Evidence: Level IV–retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Infection Source Type: research

Why Irrigate for the Same Contamination Rate: Wound Contamination in Pediatric Spinal Surgery Using Betadine Versus Saline
Conclusions: Positive cultures were similar across treatment and risk groups. The bacterial contamination of wounds before closure remains high regardless of irrigation type. A complete randomized controlled trial would be challenging to adequately power given the similarity of tissue positivity across groups. Level of Evidence: Level II—pilot randomized controlled trial. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Infection Source Type: research

Universal Screening for COVID-19 in Children Undergoing Orthopaedic Surgery: A Multicenter Report
Conclusions: Early results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients. Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery. Level of Evidence: Level II. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Infection Source Type: research

Is Proximal Fibula Epiphysiodesis Necessary When Performing a Proximal Tibial Epiphysiodesis?
Background: Controversy exists regarding the need for proximal fibular epiphysiodesis in conjunction with proximal tibial epiphysiodesis to prevent relative overgrowth of the fibula. The purpose of this study was to determine the incidence of relative fibular overgrowth in patients who had undergone proximal tibial epiphysiodesis with or without proximal fibular epiphysiodesis to manage leg-length discrepancy. Methods: We identified patients who had undergone proximal tibial epiphysiodesis, with or without concomitant fibular epiphysiodesis, followed to skeletal maturity, and with adequate scanograms to measure tibial...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Leg Length Discrepancy Source Type: research

Extramedullary Motorized Lengthening of the Femur in Young Children
Conclusions: Extramedullary placement of a magnetic expandable intramedullary lengthening nail can achieve lengthening of the femur without the use of external fixation. Considerations with this technique include careful planning of implant length relative to trochanteric-physeal distance, protection against knee subluxation during lengthening, and mitigating deformity of the regenerate. Off-label, extramedullary use of these devices can be considered to decrease the burdens of external fixation in young children. The technique begs the advent of future all-internal technology specifically designed for safe limb lengthen...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Leg Length Discrepancy Source Type: research

Hip Reconstruction in Nonambulatory Children With Cerebral Palsy: Identifying Risk Factors Associated With Postoperative Complications and Prolonged Length of Stay
Background: The purpose of this study is to examine the relationship between preoperative comorbidities, surgical complications, and length of stay (LOS) after hip reconstruction in nonambulatory children with cerebral palsy (CP). Methods: This single-center retrospective cohort study included 127 patients undergoing hip surgery between 2007 and 2016 who were diagnosed with CP (GMFCS IV/V). The cohort was 54% Gross Motor Function Classification System (GMFCS) V with an average age at surgery of 9 years (range, 3-19 y). Preoperative comorbidities included: presence of a gastrostomy tube, respiratory difficulty r...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Comparison of Staged Versus Same-day Bilateral Hip Surgery in Nonambulatory Children With Cerebral Palsy
Background: Bilateral hip reconstructions with osteotomies are commonly required in patients with severe cerebral palsy (CP) and dysplasia. These procedures can be performed by staging each hip surgery, separated by weeks to months, or by addressing both hips in a single-event surgery. The optimal timing of such surgery is yet to be determined. The purpose of this study was to retrospectively compare major complications between the staged and single-event approaches. Methods: Medical records of patients who underwent bilateral hip osteotomies, with at least one side including a pelvic osteotomy, were retrospectively r...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Patella Alta in Ambulatory Children With Cerebral Palsy: Prevalence and Functional Significance
Background: Gait dysfunction associated with patella alta (PA) in subjects with cerebral palsy (CP) has been presumed but not objectively established clinically or through biomechanical modeling. It is hypothesized that PA is associated with increasing level of motor impairment, increasing age, obesity, and worse stance phase knee kinematics and kinetics in children with CP. Methods: Retrospective case series of 297 subjects with CP studied in our Motion Analysis Center. Data analyzed included patient demographics (age, body mass index, CP classification), patella height (Koshino-Sugimoto Index), and knee kinematics a...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Distal Femoral Physeal Bar Resection Combined With Guided Growth for the Treatment of Angular Limb Deformity Associated With Growth Arrest: A Preliminary Report
Conclusions: Distal femoral physeal bar resection combined with tension-band hemiepiphysiodesis provides a viable option for the correction of angular deformities associated with physeal arrest. Longer follow-up is required to evaluate future growth of the distal femoral physis after this combined procedure. Level of Evidence: Level IV—therapeutic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Knee Source Type: research

Blount Disease and Obstructive Sleep Apnea: An Under-recognized Association?
Background: Obesity is strongly associated with both Blount disease and obstructive sleep apnea (OSA). Obesity increases risks for anesthetic and postoperative complications, and OSA can further exacerbate these risks. Since children with Blount disease might have both conditions, we sought to determine the perioperative complications and the prevalence of OSA among these children. Methods: Patients younger than 18 years undergoing corrective surgery for Blount disease were identified from 2 sources as follows: a retrospective review of records at a single institution and querying of the Kids’ Inpatient Database...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Knee Source Type: research

Delays in Obtaining Knee MRI in Pediatric Sports Medicine: Impact of Insurance Type
This study sought to report on the impact of insurance type on access to and results of knee MRI in pediatric sports medicine patients. Methods: A retrospective review of 178 consecutive pediatric sports medicine clinics was completed. Inclusion criteria: patients younger than 18 years, routine knee MRI ordered, sports medicine diagnosis, and insurance. Data included basic demographics, injury date, date and location (urgent care vs. clinic) of the first presentation, details of MRI ordering and approval, date and location of MRI follow-up, MRI results (negative, minor findings, major findings), and eventual treatment r...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Knee Source Type: research

Treatment for Clubfoot: Stockinette Versus Webril Cast Padding in the Ponseti Method
Conclusions: Webril and Stockinette paddings provide equivalent clubfoot deformity correction while applying a similar number of casts before tenotomy. Although minor skin complications were observed, these were not significantly different between groups. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Club Foot Source Type: research

Successful Ponseti-treated Clubfeet at Age 2 Years: What Is the Rate of Surgical Intervention After This?
Conclusions: In patients with idiopathic clubfoot who reached 2 years of age with successful outcomes from Ponseti cast treatment, ∼35% eventually underwent surgical intervention, mostly limited (a la carte), to regain or maintain a plantigrade foot. The most commonly performed procedures include tibialis anterior tendon transfer, posterior capsular release, plantar fascia release and repeat tendo-Achilles lengthening, either in isolation or in combination. However, before considering surgery, the need for these procedures can, and should, be minimized by recasting recurrent deformities using Ponseti method. Level o...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Club Foot Source Type: research

Increased Microvessel and Arteriole Density in the Contracted Side of the Relapsed Clubfoot
Conclusions: Increased microvessel and arteriole density in the contracted side of the relapsed clubfoot was noted. These processes are mediated by specific proangiogenic proteins that are overexpressed in the contracted tissue. These findings contribute to the etiology and the development of relapses in the treatment of clubfoot. Level of Evidence: Level II—analytical and prospective. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Club Foot Source Type: research

Image Distortion in Biplanar Slot Scanning: Part 2 Technology-specific Factors
Conclusions: This study demonstrates that there is minimal error due to image acquisition and measurement when using a biplanar slot scanner. Biplanar slot scanning technology tended to underestimate the size of the marker; however, the least accurate measurements only erred by 1.5% from the true length. This indicates that unlike traditional radiographs the sources of error in biplanar slot scanning images are not due to parallax and are likely due to patient-specific factors and rather than the technology itself. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research

Intraoperative Prone Radiographs During Scheuermann Kyphosis Correction Closely Estimate Standing Thoracic and Lumbar Parameters at 2 Years
Conclusions: TK on intraoperative prone radiographs during PSFI for SK should match the standing TK ∼6 weeks later. Intraoperative prone LL only slightly increases on early standing radiographs. Assuming a routine postoperative course, intraoperative radiographs slightly underestimate TK (by 3 degrees) and LL (by 8 degrees) on>2-year standing radiographs. These parameters (TK, LL, UIV-LIV) are visualized during surgery and should be used in future studies to predict long-term outcomes. Level of Evidence: Level IV—retrospective study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research

Thoracoscopic Vertebral Body Tethering for Adolescent Idiopathic Scoliosis: A Minimum of 2 Years’ Results of 21 Patients
Background: Anterior vertebral body tethering (VBT) is a growth modulating and fusionless treatment option that is considered as a new promising method for the management of adolescent idiopathic scoliosis (AIS). This prospective cohort study aimed to present the minimum 2-year results of anterior VBT applied to 21 skeletally immature patients with AIS. Methods: Twenty-one skeletally immature patients with a diagnosis of AIS were included. A decision to proceed with surgery was established after the detection of curve progression despite the brace (>40 degrees) with a minimum curve flexibility of 30%. Results: P...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research

Comparison of Early Definitive Fusion and Traditional Growing Rods in Early-onset Dystrophic Scoliosis in Neurofibromatosis Type 1: A Preliminary Report
Background: Early definitive spinal fusion (EF) has been widely recommended to avoid spinal deformity progression for early-onset scoliosis (EOS) with neurofibromatosis type 1 (NF-1). In contrast, growing rod (GR) procedure has recently been recommended for EOS associated with the dystrophic type NF-1. However, no studies have compared the surgical outcomes between EF and GR procedure for EOS with NF-1. The purpose of this study was to compare the surgical outcomes of EF versus GR for early onset and dystrophic scoliosis with NF-1. Methods: This was a retrospective multicenter study; 26 EOS patients with dystrophic ty...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research

Minimum 5-Year Follow-up on Graduates of Growing Spine Surgery for Early Onset Scoliosis
Conclusions: Five years following “graduation” from growing surgery for early onset scoliosis, there is progression of curve magnitude in both the coronal and sagittal planes up to 2 years, with no further progression at 5 years. A total of 21% of patients undergo at least 1 revision surgery, and average time to revision surgery is over 2 years from last planned surgery. Risk of revision surgery was higher in patients who underwent a spinal fusion as their definitive treatment strategy. Level Evidence: Level III—retrospective comparative. Type of Evidence: Therapeutic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research

Clinical Outcomes of Triplane Fractures Based on Imaging Modality Utilization and Management: A Systematic Review and Meta-analysis
Conclusions: Patients undergoing operative management of triplane fractures achieved comparable functional outcomes scores without an increased incidence of complications when compared with patients undergoing nonoperative treatment. Further investigations analyzing outcomes at middle and long-term follow-up are necessary to determine the clinical utility of CT and various treatment modalities for the management of triplane fractures. Level of Evidence: Level IV—Systematic review. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Lower Extremity Source Type: research

Characteristics and Hospital Costs of Spica Cast Treatment of Non–accidental-related Diaphyseal Femoral Fractures in Children Before Walking Age
Background: Fractures are one of the most common presentations of child abuse second only to soft tissue damage, with ∼60% of fractures being femur, humerus or tibia fractures. Although studies have shown increased health care costs associated with nonaccidental trauma (NAT), there is little data regarding the cost of NAT-associated fractures compared with accidental trauma (AT) related fractures. The purpose of this study was to consider the economic burden of NAT related femoral fractures compared with AT femoral fractures. Methods: We performed a retrospective study of children under the age of one with femoral...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Lower Extremity Source Type: research

Flexible Intramedullary Nailing of Femoral Shaft Fractures in Children Weighing ≥40 kg: A Systematic Review and Meta-analysis
Conclusions: Heavier children have worse radiographic outcomes and higher complication rates with the use of FIN for femoral shaft fractures. Additional research is needed to determine the effect of FIN material on clinical outcomes in heavier children, and the relationship between weight and other known risk factors for poor outcome in FIN, such as length stability. Level of Evidence: Level III—systematic review of level-III studies. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Lower Extremity Source Type: research

The Frequency of Mediastinal Injury in Acute Posterior Sternoclavicular Dislocations: A Multicenter Study
Conclusions: In this multicenter series of 125 APSCDs no injuries to the great vessels/mediastinal structures requiring intervention were identified. Although more than half of patients had evidence of extrinsic vascular compression at the time of injury, careful open reduction of acute injuries can be safely performed. Although vascular injuries following APSCD seem to be quite rare, vascular complications can be catastrophic. Treating providers should consider these data and their own institutional resources to maximize patient safety during the treatment of APSCD. Level of Evidence: Level III—therapeutic case...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Quantitative Analysis for the Change in Lengths of the Radius and Ulna in Missed Bado Type I Monteggia Fracture
Conclusions: In chronic MMF cases, the length of the ulna was shorter in the affected side than in the normal side. Therefore, ulnar lengthening is necessary to resolve this abnormal discrepancy and reduce the radial head. Because excessive ulnar lengthening has risks of postoperative complications, one of the surgical options is gradual ulnar lengthening or shortening osteotomy of the radius. Level of Evidence: Level III—Prognosis study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Surgical Reconstruction of Missed Monteggia Lesions in Children
Background: Chronic Monteggia lesions in children may cause pain, deformity, decreased range of motion, and neurological symptoms. Numerous surgical techniques have been advocated to reconstruct long-standing Monteggia injures in efforts to maximize long-term upper limb function. The purpose of this investigation was to assess the clinical and radiographic results of a modified surgical technique for missed Monteggia fracture-dislocations. Methods: A retrospective evaluation of 52 patients who underwent surgical reconstruction of missed Monteggia fracture-dislocations at a tertiary pediatric hospital was performed. Th...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Growth Disturbance Following Intra-articular Distal Radius Fractures in the Skeletally Immature Patient
Conclusions: Intra-articular distal radius fractures in skeletally immature patients have a considerably higher rate of physeal growth arrest than extra-articular physeal fractures. Following acute management aimed at restoring and preserving anatomic physeal and articular alignment, follow-up radiographs should be obtained to evaluate for physeal arrest in skeletally immature children. Patients and families should be counseled regarding the high rate of growth disturbance and the potential need for deformity correction in the future, particularly in younger children. Level of Evidence: IV—case series. (Source: ...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Coronal Remodeling Potential of Pediatric Distal Radius Fractures
Conclusions: Distal radius fractures have a large capacity to remodel in the pediatric population. This remodeling occurs in a predictable and reliable manner, even in the coronal plane. On the basis of this study, coronal angulation was shown to remodel at a rate of at least 2 degrees per month for the first 6 months following the injury, which should likely continue at a similar rate for the first year after the injury. Repeat manipulation is not indicated in skeletally immature patients where the maximum coronal angulation is (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Remodeling of Sagittal Plane Malunion After Pediatric Supracondylar Humerus Fractures
Conclusions: The authors rejected their null hypothesis. Children do have the capacity to remodel radiographically measurable sagittal plane malunion of SCHFs. Children younger than 5 years of age can remodel 100% displacement of the center of the capitellum, whereas those over 8 years of age have minimal remodeling capacity. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Appropriate Use Criteria for Treatment of Pediatric Supracondylar Humerus Fractures With Vascular Injury: Do Our Hospital Practice Patterns Agree With Current Recommendations?
Conclusions: Supracondylar fractures are the most common injury to the elbow seen in children and are variable in presentation and management. The pink, pulseless fracture continues to be a major topic for research and discussion due to the morbidity if not treated “appropriately.” The AUC were created to help guide practitioners when strong evidence is lacking. In this study at a single, pediatric hospital, there was variation and disagreement with “appropriateness” of treatments that were performed but this discrepancy did not result in any poor outcomes. Although the AUC do offer valuable guida...
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Pain Control and Medication Use in Children Following Closed Reduction and Percutaneous Pinning of Supracondylar Humerus Fractures: Are We Still Overprescribing Opioids?
Conclusions: Pediatric patients have been overprescribed opioids after operative treatment of supracondylar humerus fractures at our institution. Families who report pain scores>5 of 10 and/or persistent opioid use beyond postoperative day 5 warrant further clinical evaluation. Two of 3 pain outliers in this study experienced a minor postoperative complication. With appropriate parental counseling, satisfactory pain control can likely be achieved with acetaminophen and ibuprofen for most patients. If oxycodone is prescribed for breakthrough pain, then the authors recommend limiting to (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 10, 2020 Category: Orthopaedics Tags: Trauma Upper Extremity Source Type: research

Response to: Titanium Elastic Nails Are a Safe and Effective Treatment for Length Unstable Pediatric Femur Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Titanium Elastic Nails Are a Safe and Effective Treatment for Length Unstable Pediatric Femur Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Response to: Nonarticular Base and Shaft Fractures of Children’s Fingers: Are Follow-up X-rays Needed? Retrospective Study of Conservatively Treated Proximal and Middle Phalangeal Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Nonarticular Base and Shaft Fractures of Children’s Fingers: Are Follow-up X-rays Needed? Retrospective Study of Conservatively Treated Proximal and Middle Phalangeal Fractures
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Treatment of Closed Femoral Shaft Fractures in Children Aged 6 to 10
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Revisiting the Beighton Criteria: Does Ligamentous Laxity Testing Correlate With Shoulder Range of Motion Norms in a North American, Pediatric Population?
In this study, we establish normative data for shoulder range of motion and GLL in a healthy, diverse pediatric population and investigate whether Beighton testing correlates with shoulder ROM in children. Methods: Healthy subjects age 2 to 18 years with isolated lower extremity complaints were recruited. Passive shoulder ROM measurements for forward flexion (FF), abduction (ABD), internal rotation (IR), external rotation (ER), and extension (EXT) were obtained using a long-armed goniometer. The Beighton score was obtained, with a positive test defined as ≥5. Descriptive statistics were used to stratify data on the b...
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Selected Items Source Type: research

Electronic Consultation Systems: Impact on Pediatric Orthopaedic Care
Conclusions: This cross-sectional study demonstrates the effective and timely use of eConsult in pediatric orthopaedic surgery. It also shows a significant reduction in the number of in-person consultations required and demonstrates a high satisfaction rate by PCPs using the service. Clinical Relevance: In addition to the efficacy and time-sensitive care provided to the patients, the study shows that, professionally, 89% of PCPs found this service to be excellent or good. The broader implications of electronic consultation on overall quality of care, population health, and patient satisfaction requires further investi...
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Selected Items Source Type: research

Pediatric Chondroblastoma and the Need for Lung Staging at Presentation
Conclusions: This is the largest cohort of pediatric-exclusive chondroblastoma in the literature. Despite minor differences in management between the centers included, the recurrence rate was similar and there was no evidence of lung metastasis (0 in 130). The incidence of distant involvement in a true benign chondroblastoma in children is much lower than the 2% previously reported in the literature, and the need for routine chest staging should be revisited. Level of Evidence: Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Selected Items Source Type: research

Predicting Growth Quantitatively Through Proximal Tibia Radiograph Markers
Conclusions: We describe 3 measurements that can easily be obtained on an anteroposterior radiograph of the knee. We demonstrate that ratios of these variables can be measured reliably and correlate closely with remaining growth, independent of sex. Together, we believe that these factors will improve the accuracy of determining growth from lower extremity radiographs that include the proximal tibia. Clinical Relevance: This study provides a new quantitative technique to evaluate growth in the lower extremity, which can inform a range of conditions including adolescent idiopathic scoliosis, leg length discrepancy, cru...
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Lower Extremety Source Type: research

Guided Growth for Ankle Valgus Deformity: The Challenges of Hardware Removal
In this study, we reviewed the outcomes of guided growth procedures for correction of ankle valgus and related difficulty with hardware extraction. Methods: A retrospective review of patients with ankle valgus managed with transphyseal screw placement was performed. Clinical and radiographic data, including the lateral distal tibial angle (LDTA), type of screw placed, and time to correction was recorded. At hardware removal, we reviewed elements associated with difficult extraction defined as requiring the use of specialized screw removal/extraction sets or inability to remove the entirety of the screw. Results: One ...
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Lower Extremety Source Type: research

Can You Stall a Baclofen Pump During a Magnetic Rod Lengthening?
Discussion: As long as the baclofen pump is>1 cm away from the ERC, the pump will not stall, regardless of the length of time the ERC generates a magnetic field. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Screw Anterior Distal Femoral Hemiepiphysiodesis in Children With Cerebral Palsy and Knee Flexion Contractures: A Retrospective Case-control Study
Discussion: The AE group demonstrated statistically greater postoperative improvement in popliteal angle, knee flexion contracture, and peak knee extension during stance than the NAE group. Both procedures led to improvements in clinical and functional measures, indicating the validity of this approach as a means of correcting flexion contracture that is less invasive and allows immediate weight bearing. Level of Evidence: Level III—therapeutic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 12, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research