Outpatient Opioid Prescribing Habits in Pediatric Patients With Bone Sarcomas After Undergoing Primary Tumor Resection
Conclusion:
Multiple factors were associated with increased opioid use including preoperative opioid use, longer postoperative stay in the hospital, metastatic disease, and primary sarcomas in the pelvis. The patient’s sex, body mass index, race, type of insurance, type of surgery performed, reoperation during the same admission and use of nonopioid adjuvants had no effect on opioid use. The results of this study can be used to stratify the average opioid requirement of pediatric patients undergoing primary bone sarcoma resection.
Level of Evidence:
Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Tumor Source Type: research
Intramedullary Nailing for Lower Limb Polyostotic Fibrous Dysplasia in Children: A Long-term Follow-up Study
Conclusion:
Lower limb IN—that was repeated in younger children during growth—provided satisfactory long-term results in most of our patients, with fracture and deformity prevention and pain control, regardless of the high rate of complications that mainly affected the femoral cases. Missing scheduled follow-ups was the main predictor of a poor result.
Level of Evidence:
Level IV—case series. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Tumor Source Type: research
Validation of a Novel Magnetic Resonance Imaging Classification for Osteochondritis Dissecans of the Knee
Conclusion:
The validity and clinical utility of the newer 3-group Kocher classification for knee OCD is comparable to that of the well-established 5-group Hefti classification. Both systems help determine lesion stability and characteristics on MRI, which correlate closely to arthroscopic findings. This simplified classification system, with less uncertainty, provides a foundation for further outcomes research to develop an evidence-based algorithm for effective surgical management of OCD lesions of the knee.
Level of Evidence:
Level II—diagnostic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
Incidence of Deep Vein Thrombosis in Cerebral Palsy Following an Orthopaedic Surgical Event
Conclusions:
VTE is a relatively rare occurrence after orthopaedic surgery in pediatric patients with CP, but when it occurs, a full hematologic workup for a congenital hypercoagulable condition is indicated. Based on the low incidence of thigh thrombosis, routine pharmacological or intermittent mechanical calf compression is not recommended. A careful clinical and family history should be performed to identify patients with possible genetic hypercoagulable conditions who would merit prophylaxis.
Level of Evidence:
Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Use of Vancomycin Powder in Spinal Deformity Surgery in Cerebral Palsy Patients is Associated With Proteus Surgical Site Infections
Discussion:
In CP patients undergoing pediatric spinal deformity surgery, the use of vancomycin powder was independently associated with increased risk for proteus infections. Further study into antibiotic regimens for spinal deformity surgery in the CP population should be performed.
Level of Evidence:
Level III—retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Hip Pain in Patients With Spinal Muscular Atrophy: Prevalence, Intensity, Interference, and Factors Associated With Moderate to Severe Pain
Conclusions:
Hip pain was moderate to severe in 14% of patients with SMA. Obesity, hip contractures, surgical correction of scoliosis, and hip dislocations were independently associated with pain. Although mean pain intensity was low, hip pain interfered with daily activities, including prolonged sitting, sleep, and transfers.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Observation Versus Cast Treatment of Toddler’s Fractures
This study compares short-term clinical and radiographic outcomes of toddler’s fractures treated with long leg casting versus observation.
Methods:
Patients with toddler’s fractures were offered enrollment and randomization at diagnosis. Because many families opposed randomization, a preference arm was added after one year. All subjects were analyzed as a prospective cohort. Radiographs were obtained at diagnosis and 4 weeks. A modified Oxford Ankle Foot Questionnaire for Children (OAFQ-C) and family satisfaction survey were collected at diagnosis, 4 and 8 weeks. Scores were analyzed using mixed effect models. F...
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Impacts of Fracture Types on Success Rate of Closed Reduction and Percutaneous Pinning in Pediatric Lateral Condyle Humerus Fractures Displaced >4 mm
Conclusions:
Milch classification is more important than Song classification in the success rate of CRPP when treating LCHFs displaced>4 mm. Milch type II LCHFs are recommended to be treated with CRPP, while Milch type I LCHFs are recommended to be treated with ORIF. The current study confirm Song’s initial report that closed reduction can be successful and should be attempted for fractures with such displacement rather than going directly to ORIF.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Hold the Antibiotics: Are Preoperative Antibiotics Unnecessary in the Treatment of Pediatric Supracondylar Humerus Fractures?
Background:
Supracondylar humerus (SCH) fracture is the most common elbow injury in children and often treated with closed reduction and percutaneous pinning (CRPP). There is little published evidence supporting or refuting the use of perioperative prophylactic antibiotics for SCH CRPP in the pediatric population. The purpose of this study is to evaluate the rate of surgical site infection for patients with and without preoperative antibiotics.
Methods:
A retrospective chart review was conducted of patients less than or equal to 16 years from 2012 to 2018 who underwent primary CRPP. Open fractures, multilimbed p...
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Pediatric Supracondylar Humerus Fracture AAOS Appropriate Use Criteria: Does Treatment at a Pediatric Level I Trauma Center Comply?
Conclusions:
The treatment approach implemented at a single level 1 trauma center was in concordance with the appropriate use criteria treatment recommendations in a significant majority of cases. Fractures not treated according to “Appopriate” recommendations were primarily type IIA injuries, and were treated with closed reduction and casting instead of the recommended closed reduction and percutaneous pinning.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Outcomes of Pediatric Scaphoid Nonunions Treated With Distal Radius Cancellous Autograft
Conclusions:
Pediatric scaphoid fracture nonunions that undergo ORIF using nonvascularized distal radius cancellous autograft have favorable rates of consolidation and functional outcomes. Surgeons should consider this source of grafting in operative management of scaphoid nonunions in children and adolescents.
Level of Evidence:
Level IV, therapeutic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Hand and Wrist Source Type: research
Long-Term Outcomes After Treatment for Type B Ulnar Polydactyly
Conclusion:
While ligation and surgical excision result in similar function and esthetics, patient satisfaction is higher after surgery. Furthermore, a significant number of patients fail ligation and ultimately undergo surgery for symptomatic neuroma or persistent polydactyly. Counseling parents of patients with type B ulnar polydactyly should include these considerations to assist them in selecting the best treatment for their child.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Hand and Wrist Source Type: research
Dynamic Supination in Congenital Clubfoot: A Modified Delphi Panel Approach to Standardizing Definitions and Indications for Treatment
Conclusions:
Consensus statements from the Delphi panel can guide diagnosis and treatment of dynamic supination in clubfoot deformity relapse, including clinical decision making regarding preoperative casting, surgical approach, and postoperative immobilization. Near-consensus and indeterminate statements may be used to direct future areas of investigation.
Level of Evidence:
Level V. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Foot and Ankle Source Type: research
The Efficacy of Intra-articular Subtalar Steroid Injection for Symptomatic Talocalcaneal Coalitions: A 30-Year Single Institution Experience
Purpose:
While intra-articular steroid injection has been used anecdotally in patients with symptomatic talocalcaneal coalitions recalcitrant to traditional conservative modalities, the ability of this treatment to provide symptomatic relief and obviate or delay surgical intervention remains unknown. The purpose of this study is, therefore, to assess the treatment efficacy of intra-articular subtalar steroid injection in children with symptomatic talocalcaneal coalitions.
Methods:
A retrospective study of all patients with isolated subtalar coalitions was performed at a single pediatric orthopaedic institution o...
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Foot and Ankle Source Type: research
What is New in Pediatric Orthopaedic Foot and Ankle
Conclusions:
Treatment strategies for children with foot and ankle pathology are continually evolving. We review many of the most recent publications with the goal of improving understanding of these pathologies and highlighting current best practices.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - April 18, 2022 Category: Orthopaedics Tags: Foot and Ankle Source Type: research
