Efficacy and Safety of “Sleeper Plate” in Temporary Hemiepiphysiodesis and the Observation of “Tethering”
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Efficacy and Safety of “Sleeper Plate” in Temporary Hemiepiphysiodesis and the Observation of “Tethering”: Are the Benefits Worth the Risks?
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Best Practice Guidelines for Surgical Site Infection in High-risk Pediatric Spine Surgery: Definition, Prevention, Diagnosis, and Treatment
Conclusions: We present a set of updated consensus-based BPGs for defining high-risk and preventing, diagnosing, and treating SSI in high-risk pediatric spine surgery. We believe that this BPG can limit variability in practice and decrease the incidence of SSI in pediatric spine surgery. Level of Evidence: Not applicable. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Mini-open Anterior Pelvic Osteotomy and Spica Casting for Primary Closure of the Pelvis in Infants With Classic Bladder Exstrophy
The objective of this study was to investigate the efficacy and safety of mini-open Salter-like anterior pelvic osteotomy followed by spica casting as an adjunct to urological reconstruction in infants with classic bladder exstrophy (CBE). Methods: Twenty-eight infants with CBE were operated upon according to the following protocol: initial bilateral mini-open Salter-like osteotomies followed by urological reconstruction and subsequent spica casting for 3 to 4 weeks. Postoperative clinical and radiologic assessments of wound complications and union were done, respectively. During subsequent follow-ups, the foot prog...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

The Influence of Retrograde Femoral Nail Removal With and Without Interpositional Fat Grafting on Distal Femoral Physeal Behavior: A Sheep Study
Conclusions: Femurs undergoing retrograde implant placement were significantly shorter when compared with control limbs in sheep sacrificed at 3 months, whereas differences were nominal in sheep sacrificed at 5 months after retrograde implant removal, suggesting growth inhibition with nail removal improved with time. Fat grafting across the distal femoral physis did not result in a significant difference in femoral lengths. Histologic evidence at 5 months revealed early development of a bone bridge, emphasizing the importance of follow-up to skeletal maturity in patients treated with retrograde nailing across an open p...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Motorized Plate Lengthening of the Femur in Children: A Preliminary Report
Conclusions: Limb lengthening with motorized internal plates is feasible for young children with congenital femoral deficiency for whom intramedullary lengthening is unsafe or if external fixation is to be avoided. However, the fundamental principles of distraction osteogenesis and risks of lengthening for congenital discrepancies remain unchanged. Specific considerations herein include: careful planning of implant length and positioning, adjacent joint protection with adjunctive means, and mitigating deformity of the regenerate during distraction. Level of Evidence: Level IV, retrospective case series. (Source:...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Copping Coping With the Braced Limbs
Harold Copping illustrated an edition of Charles Dickens’ classic, “A Christmas Carol.” One of the paintings of Bob Cratchit and Tiny Tim in the book shows Tiny Tim wearing braces on his lower limbs. Several diagnoses of Tiny Tim’s ailment have been suggested in the past but based on the details of Copping’s painting we suggest that he had rickets. The above-knee braces with uprights only on the lateral side of the limbs may have been given to prevent genu valgum, a common deformity in childhood rickets. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Evaluating Information About Osteochondritis Dissecans Shared Across Social Media Platforms
Conclusion: Patients with OCD and their families seek information about their condition and treatment on online sources including social media. Although social media provides a supportive community to share and receive advice, the quality of information shared in these groups is a subject for concern. Increasing physician involvement and awareness of the information shared across social media platforms may improve accuracy of information and content available to patients. Clinical Relevance: It is important for physicians treating patients with OCD to be aware of all sources of information and support, including...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Tibial Tuberosity Fracture: A Highly Selective Injury
Conclusion: Black race is a previously unreported, strong independent risk factor for TTF. Male sex and age 13 to 15 are also strong risk factors for TTF, making this a highly selective fracture. Level of Evidence: Prognostic Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research

How Much Will My Child’s ACL Reconstruction Cost? Availability and Variability of Price Estimates for Anterior Cruciate Ligament Reconstruction in the United States
Conclusion: Price estimates for pediatric sports medicine procedures can be challenging to obtain, even for the educated consumer. Top-ranked hospitals and hospitals in the Northeast region may charge more than their counterparts. In all areas, self-pay discounts can be substantial if they can be identified but they potentially create an information disadvantage for unaware patients needing to pay out-of-pocket. Study Design: Economic; Level of Evidence II What is Known about the Subject: Previous studies have highlighted the importance of value-based health care decisions and deficits of price transparen...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research

Vascular Safe Zone During Percutaneous Pinning of the Distal Femur
This study describes a radiologic vascular safe zone that is easily visualized during surgery (wherein the superficial femoral vessels are safely posterior). Methods: Patients ≤16 years old with magnetic resonance imaging of one or both femora between 2005 and 2020 were retrospectively reviewed. The “at-risk level” (ARL) was defined as the distal-most axial image with a femoral vessel anterior to the posterior condylar axis. A standardized retrograde lateral-to-medial pin was templated. A correlation matrix and least squares regression identified age and physeal width (PW) as ideal independent variables. A vas...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Trauma Source Type: research

Virtual Reality Reduces Fear and Anxiety During Pediatric Orthopaedic Cast Room Procedures: A Randomized Controlled Trial
This study evaluates the effectiveness of VR as a distraction tool for decreasing fear, anxiety, and pain in pediatric patients undergoing common outpatient orthopaedic procedures. Methods: A total of 210 patients were recruited from a single orthopaedic clinic between October 2017 and July 2019. Patients were randomized to the VR group or to the control group (standard of care). Outpatient procedures included cast and/or pin removals. Primary outcome measures were collected preprocedure and postprocedure using validated surveys, and included: fear (Children’s Fear Scale), anxiety (Children’s Anxiety Meter-State...
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Trauma Source Type: research

“You’re O.K. Anesthesia”: Closed Reduction of Displaced Pediatric Forearm and Wrist Fractures in the Office Without Anesthesia
Conclusions: Closed reduction of angulated pediatric wrist and forearm fractures in the office without anesthesia can achieve satisfactory reductions and high caregiver satisfaction while eliminating the risks and complications associated with pediatric anesthesia. Level of Evidence: Level IV Case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Trauma Source Type: research

A Modern Day Timeline for In-Hospital Monitoring in Perfused, Pulseless Pediatric Supracondylar Humerus Fractures
This study is a retrospective review of a prospectively maintained database of all operatively treated supracondylar humerus fractures from a tertiary pediatric hospital from 2013 to 2019. All patients without a palpable pulse were included. We excluded patients with (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Trauma Source Type: research

The COVID-19 Pandemic: Effects on Pediatric Fracture Patterns in the Emergency Department and Subspecialty Follow-up Care
Conclusions: We found differences in fracture prevalence, mechanisms, and follow-up care during the pandemic. Time to subspecialty follow-up care was longer during pandemic phased reopening despite overall fewer fractures. Plans to absorb postponed visits and efficiently engage redeployed staff may be necessary to address difficulties in follow-up orthopaedic management during public health crises. Level of Evidence: Level II. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - October 20, 2022 Category: Orthopaedics Tags: Trauma Source Type: research