Normal Humeral Head Ossification in Pediatric and Adolescent Shoulders Can Mimic Hill-Sachs Lesions: A Magnetic Resonance Imaging–based Study
Conclusions:
False Hill-Sachs lesions were visualized on MRI in stage I to II proximal humerus ossification. Due to differential timing of skeletal maturation, males present with false Hill-Sachs lesions at a later age than females on average. When interpreting shoulder MRI for glenohumeral instability, clinicians should be cautious of false Hill-Sachs lesions, especially in younger patients with distinct greater tuberosity and HH ossification centers (stage I to II ossification).
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
Decrease in Residual Neurological Symptoms After Institutional Changes in Peripheral Nerve Block Use for Pediatric Knee Surgery
Background:
Peripheral nerve blocks (PNBs) have recently been associated with a higher incidence of complications than previously thought. We compared: (1) incidence of PNB-related residual neurological symptoms and (2) patient selection, operative practices, and anesthesia practices for pediatric knee surgery patients before and after changes in PNB administration at our institution.
Methods:
We compared data from pediatric patients who underwent knee surgery with PNBs from 2014 to 2016 (cohort 1; 100 patients) or 2017 to 2019 (cohort 2; 104 patients). Cohort 2 was treated after PNB administration was limited t...
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
Reinjury Rates in Adolescent Patients 2 Years Following ACL Reconstruction
Conclusions:
Adolescent patients who sustained ACLR graft failure had greater and more symmetric quadriceps strength at the time of return to sport compared with patients with no secondary injury. Objective measures of quadriceps strength at the time of the return-to-sport progression may not solely identify individuals that have a secondary ACL injury.
Study Design:
Level IV—retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
Minimum 2-Year Outcomes Following Arthroscopic Hip Labral Reconstruction in Adolescents and Young Adults
Background:
Labral repair is generally preferred when facing labral tears. When an irreparable labral tear in the context of femoroacetabular impingement syndrome is present, arthroscopic labral reconstruction has been proven to be a valid option for labral restoration. However, data on this procedure for the adolescent population is scarce. The purpose of the present study was to report minimum 2-year follow-up patient-reported outcome measures (PROMs) on adolescents and young adults following arthroscopic acetabular labral reconstruction.
Methods:
Data were prospectively collected and retrospectively reviewed ...
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
The Effect of Surgeon Experience on Outcomes Following Growth Friendly Instrumentation for Early Onset Scoliosis
Conclusions:
This study represents the first multicenter assessment of surgeon experience on outcomes in EOS. Overall, surgeon experience did not significantly influence UPROR, complication rates, EBL, or surgical time associated with GFI in this cohort of EOS patients.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Early Onset Scoliosis Source Type: research
Baclofen Pump Use: Complications After Growth-friendly Instrumentation for Early-onset Scoliosis
Conclusions:
Among patients with neuromuscular EOS, those with baclofen pumps are much more likely to experience complications within 1 year after GF spine surgery. They are also more likely to have deep surgical site infections, with S. aureus and P. aeruginosa being the most common causative organisms, and to require spinal rod removal.
Level of Evidence:
Level III—retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Early Onset Scoliosis Source Type: research
Epidemiological Study of Equestrian Trauma in Geneva
Conclusions:
Horse riding injuries occur more frequently and are more serious than in many other sporting activities. There is an urgent need to reassess preventive measures to reduce the incidence and severity of equestrian injuries.
Level of Evidence:
Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Validation of a Cost-effective Cast Saw Simulation-based Educational Module to Improve Cast Removal Safety
Conclusions:
This study provides valid evidence supporting a cost-effective, time-efficient, and easily reproducible educational simulation module that can objectively measure cast saw the performance in trainees. This model demonstrates construct validity and can distinguish novice from experienced cast saw users. It is sensitive enough to identify mistakes even in the most experienced cast saw users, creating a platform that can provide performance-based feedback to cast saw users of all experience levels.
Level of Evidence:
Level III—diagnostic test. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Unplanned Return to the Operating Room (UpROR) After Pediatric Diaphyseal Femoral Fractures
Conclusions:
Our findings indicate that children under the age of 5 years have a 5% risk of UpROR in the first 6 months after the fracture, mainly for repeat spica casting due to loss of reduction. Patients aged 5 years or older have an ∼6% risk of UpROR, mainly related to complications of flexible nails. The findings of this study are important when consulting families on different treatments of diaphyseal femoral fractures.
Level of Evidence:
Therapeutic level III—retrospective cohort study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
The Feasibility of Utilizing Malunion Criteria to Limit Radiographs After Spica Casting for Pediatric Femur Fractures
Conclusions:
Routine early postoperative radiographs may not be necessary for all pediatric femur fractures managed with closed reduction and spica casting. The value of this study is that it is the first to demonstrate the feasibility of limiting postoperative radiographs using a preoperative screening tool. However, the established femoral malunion criteria utilized in this study were limited in their predictive value, and further work is necessary to improve the sensitivity and specificity before widespread clinical application.
Level of Evidence:
Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
The Financial Burden of Nonoperatively Treated Pediatric Distal Radius Fractures: Medical Debt in Privately Versus Publicly Insured Patients
Background:
Patients with public health insurance have greater difficulty obtaining orthopaedic care than their privately insured counterparts because of lower reimbursements. However, the relationship between insurance status and financial burden for patients and treating institutions is unknown. We compared patient medical debt and uncompensated hospital costs by insurance type for pediatric patients who received nonoperative treatment for distal radius fractures (DRFs).
Methods:
We reviewed medical records of 100 pediatric patients (above 18 y) treated nonoperatively at our US academic hospital for DRFs fro...
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Omitting the Early Postoperative Follow-up in Uncomplicated Operative Supracondylar Humerus Fractures in Children Does Not Negatively Affect Outcomes
Conclusions:
Closed reduction and percutaneous pin fixation of otherwise uncomplicated closed SCH fractures have good outcomes and a very low complication rate at a level 1 pediatric trauma center. Early postoperative follow-up before the pin removal visit provides minimal utility in decreasing complications and may be safely omitted as long as the initial fracture fixation is deemed to be stable.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Standardizing a Postoperative Protocol for Supracondylar Humerus Fractures
Conclusions:
There were no differences in postoperative complications or outcomes between the patients in the liberal, intermediate, or conservative protocol groups. In an efficiency-focused era, we conclude that a standardized liberal protocol be considered at a busy orthopaedic center.
Level of Evidence:
This study is a level III therapeutic study. It is a retrospective study that compares the outcomes after following 1 of 3 different postoperative protocols. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - January 16, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
He likes it! Mikey likes it!
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - December 15, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research
“Open Reduction of Medial Epicondyle Fractures in the Pediatric Population: Supine Versus Prone Position”
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - December 15, 2021 Category: Orthopaedics Tags: Letters to the Editor Source Type: research
