Time to Completion of Pediatric PROMIS Computerized Adaptive Testing Measures and the SRS-22r in an Adolescent Idiopathic Scoliosis Population
Conclusions: In this pediatric orthopaedic cohort, completion of 8 PROMIS CATs demonstrated minimal test-taker burden and time required for completion. These findings support rapid and easily integrable PROMIS CATs in clinical practice to aid in increased delivery of efficient, patient-centered care. Level of Evidence: III, cross-sectional study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - September 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research

Height Gain After Spinal Fusion for Idiopathic Scoliosis: Which Model Fits Best?
Conclusions: Four of the 5 models demonstrated moderate correlation and had good external validity compared with their development cohorts. Although the Spencer model was the best fitting, the clinical significance of the difference in height predictions compared with other models was low. The Watanabe model was the second best fitting and had the simplest formula, making it the most convenient to use in a clinical setting. We offer a simplified equation to use in a preoperative clinical setting based on this data—ΔHeight (mm)=0.77*(preoperative coronal angle−postoperative coronal angle). Level of Evidence: ...
Source: Journal of Pediatric Orthopaedics - September 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research

Trends in the Utilization of Implants in Index Procedures for Early Onset Scoliosis From the Pediatric Spine Study Group
This study examines the history and trends regarding the use of growth-friendly devices for index surgical procedures in EOS patients within the Pediatric Spine Study Group database. Methods: All index growth-friendly implants were queried from registry inception until October 2020. EOS etiology, device/implant type, and geographic area/institution for each procedure were recorded. Results: From 1994 to 2020, 2786 patients underwent index surgery at a mean age of 6.2±2.9 years. There were 908 traditional growing rods (TGR) (32.3%), 922 vertical expandable prosthetic titanium rib devices (VEPTR) (33.1%), 5 hy...
Source: Journal of Pediatric Orthopaedics - September 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research

Prospective Evaluation of a Treatment Protocol Based on Fracture Displacement for Pediatric Lateral Condyle Humerus Fractures: A Preliminary Study
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Does Surgical Experience Decrease Radiation Exposure in the Operating Room?
No abstract available (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Prevertebral Soft Tissue Thickness of the Cervical Spine in Children: An Insensitive but Specific Aid in the Diagnosis of Occult Trauma
Conclusions: PVST measurements exhibit poor sensitivity but good specificity as indicators for the diagnosis of occult cervical trauma in children. Negative values do not exclude injury; positive values suggest further evaluation. Levels of Evidence: Level III (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Noninvasive Hemoglobin Monitoring for Postoperative Pediatric Orthopaedic Patients: A Preliminary Study
Background: Hemoglobin (Hgb) levels are frequently checked through venipuncture [invasive hemoglobin (iHgb)] in pediatric orthopaedic patients after high blood loss procedures. This needlestick may causes further anxiety and fear in hospitalized children. Noninvasive hemoglobin (nHgb) monitoring has been effectively utilized in the adult intensive care and postoperative total joint arthroplasty setting. nHgb monitoring has not yet been validated in children for routine postoperative Hgb assessment in pediatric orthopaedics. Methods: In this prospective study, 46 pediatric orthopaedic patients were enrolled who w...
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

Art and Pediatric Orthopaedics: Ribera, an Artist for the Downtrodden
Jusepe de Ribera’s most famous artistic works consisted of the bizarre such as mutilated bodies and social outcasts, with one being of a Neapolitan beggar boy with upper and lower limb joint contractures. Although the etiology of the boy’s contractures in The Clubfoot has been debated, we present a case for arthrogryposis with a unilateral clubfoot as the most likely diagnosis. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Selected Topics Source Type: research

The Effects of Lower Extremity Rotational Malalignment on Pediatric Patient-reported Outcomes Measurement and Information System (PROMIS) Scores
This study was a retrospective cohort, single institution, and consecutively recruited cases series. We identified 47 children over a 3-year period who were evaluated at the motion analysis center at our tertiary care hospital, with increased torsion of the femur or tibia. After exclusions, 25 children with IRM, documented PROMIS data and gait analysis were considered. Results: Femoral malrotation had a significant relationship with female gender (P=0.001) and increased BMI (P (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Lower Extremity Source Type: research

Distal Femur Growth Modification Surgery Is Associated With Higher Surgical Wound Complication Rate
Conclusion: Surgical wound complication was associated with growth modification surgeries using plates or staples at the distal femur. Our results alert orthopaedic surgeons to this minor but unneglectable problem. Transphyseal screws may be the implant of choice for guided growth and epiphysiodesis at the distal femur in older children, considering the lower risks of wound complication. Level of Evidence: Level III, retrospective comparative study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Lower Extremity Source Type: research

Comparison of Shoulder Motion Measurements by Visual Estimate, Goniometer and Motion Capture
Conclusions: Both GH CBA and HT ER measures demonstrated substantial variability between measurement types, but only HT ER joint angles were significantly different. In addition, more than three-quarters of external rotation Mallet scores were misclassified by the physician. Motion capture measurements offer the benefit of less susceptibility to patients’ compensatory and/or out-of-plane movements and should be considered for clinical assessment of shoulder range of motion in children with BPBI. If motion capture is unavailable, the use of a goniometer provides more accurate clinical measures of shoulder motion than ...
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Hand and Upper Extremity Source Type: research

Mid-term to Long-term Follow-up Results of Reconstruction for Thumb Radial Polydactyly
Conclusions: In mid-term to long-term experience, sequelae such as joint instability, joint stiffness, and remaining deformity cannot be neglected. An unstable MP joint may result if the DIP joint remains stiff or has a lower ROM. Level of Evidence: Level IV—therapeutic studies. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Hand and Upper Extremity Source Type: research

Barriers to Discharge After Hip Reconstruction Surgery in Non-ambulatory Children With Neurological Complex Chronic Conditions
Background: Hip reconstruction surgery in patients with neurological complex chronic conditions (CCC) is associated with prolonged hospitalization and extensive resource utilization. This population is vulnerable to cognitive, developmental, and medical comorbidities which can increase length of stay (LOS). The aims of this study were to characterize barriers to discharge for a cohort of children with neurological CCC undergoing hip reconstruction surgery and to identify patient risk factors for prolonged hospitalization and delayed discharge. Methods: Retrospective chart review of nonambulatory patients with ne...
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research

Patient-Reported Outcome Measurement Information System (PROMIS) Scores in Pediatric Idiopathic Toe Walkers
Background: Idiopathic toe walking (ITW) can result in early contact with the health care system and be distressing for patients and their families. The natural history of ITW is poorly characterized. Deciding how and when to intervene can be difficult. Patient-reported outcomes are utilized in the clinical setting to assess patient factors and indications that may better inform treatment plans. Patient-Reported Outcomes Measurement Information System (PROMIS) is an instrument designed to collect patient-reported outcomes. Minimum clinically important differences in PROMIS metrics have been established to facilitate...
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research

Effect of Postoperative Femoral Neck Shaft Angle on Femoral Head Sphericity Following Proximal Femoral Osteotomy in Legg-Calve-Perthes Disease
Background: Herein, we aimed to examine the relationship between the postoperative neck shaft angle (NSA) and the Stulberg outcome at skeletal maturity in patients with Legg-Calvé-Perthes disease (LCPD) who underwent proximal femoral varus osteotomy (PFVO) and to determine the optimal angle of varization. Methods: In this retrospective study, we analyzed the data of 90 patients aged older than 6 years at the time of diagnosis with LCPD who underwent PFVO at our institution between 1979 and 2014. Univariate and multivariate logistic regression analyses were used to examine the effects of variables on the spheric...
Source: Journal of Pediatric Orthopaedics - August 11, 2022 Category: Orthopaedics Tags: Hip Source Type: research