Media Depiction of Birth Differences of the Upper Extremity: Accuracy of Shared Diagnoses
Conclusions:
Media and social media depictions of congenital upper extremity differences are frequently inaccurate, and our search demonstrated that the amniotic constriction band is the most commonly reported, inaccurate diagnosis. Accuracy of diagnosis in public media is important given the impact a diagnosis has on those viewing and sharing the images.
Level of Evidence:
Level IV, diagnostic. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Upper Extremity Source Type: research
Pitching Behaviors in Youth Fast-Pitched Softball: High Pitching Volumes With Unequal Pitch Counts Among Pitchers are Common
Conclusions:
Softball pitchers throw high volumes of pitches while also pitching multiple days consecutively. A disparity among pitchers on softball teams exists as 40% of team pitches are thrown by 1 player and over 80% of team pitches are thrown by the top 3 pitchers. These high-volume pitchers may be engaging in unsustainable pitching practices that could predispose to injury.
Level of Evidence:
Level IV—cross-sectional. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Sports Medicine Source Type: research
Pelvic Osteotomy in Patients With Previous Sacral-Alar-Iliac (SAI) Fixation
Introduction:
Patients with neuromuscular disease are at high risk for developing hip dysplasia and scoliosis. The purpose of this study was to investigate the technical challenges and outcomes of pelvic osteotomy in patients with prior sacral-alar-iliac (SAI) fixation.
Methods:
We reviewed clinical and radiographic records of patients aged 18 years and below who underwent pelvic osteotomy after SAI fixation. We recorded technical challenges during the osteotomy, time from SAI fixation to osteotomy, type of osteotomy, migration index, and distance from the SAI screw to the acetabulum. A 2-sample Wilcoxon rank-su...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Degree of Postoperative Curve Correction Decreases Risks of Postoperative Pneumonia in Patients Undergoing Both Fusion and Growth-friendly Surgical Treatment of Neuromuscular Scoliosis
Introduction:
Due to a combination of poor respiratory muscle control and mechanical lung compression secondary to spine and chest wall deformities, patients with neuromuscular (NM) early-onset scoliosis (EOS) are at a high risk for pulmonary complications including pneumonia. The purpose of this study is to examine the effect of surgical intervention on the prevalence and risk of postoperative pneumonia in patients with NM EOS.
Methods:
In this retrospective cohort study, pediatric (18 y old and below) patients with NM EOS undergoing index fusion or growth-friendly instrumentation from 2000 to 2018 were ident...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
A Review of Radiology Reports From Hip Surveillance Radiographs for Children With Cerebral Palsy
Conclusions:
Radiologic reporting of images completed for hip surveillance for children with CP was inadequate to allow for the detection of hip displacement. Reporting of MP was rare, particularly in community hospitals. If radiology reporting will be utilized for hip surveillance in children with CP, education of radiologists is required. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Prevalence and Risk Factors Associated With Pelvic Rod/Screw Radiographic Lucency Following Scoliosis Surgery in Spastic Cerebral Palsy: A Longitudinal Study
Conclusion:
In patients with spastic nonambulatory CP who had scoliosis treated with posterior spinal fusion from upper thorax to pelvis, the prevalence of pelvic rod/screw lucency is high. Persistent lucency>2 mm around pelvic implants is not clinically significant, does not warrant advanced imaging, or indicate a complication if stable over time and wider distally than proximally.
Level of Evidence:
Level III. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Neuromuscular Source Type: research
Early Postoperative Infections After Closed Reduction and Percutaneous Pinning in Type II and Type III Pediatric Supracondylar Humerus Fractures
Background:
Supracondylar humerus fractures (SCHF) are the most common elbow fracture type in children, and one of the most common pediatric fracture types overall. Excellent outcomes are generally reported with closed reduction and pinning (CRPP), but the technique involves leaving the pins outside the skin. External pins can act as a nidus for infection. We characterize the infection complications from SCHF treatment at a single-centre tertiary children’s hospital over 10 years. This is the largest series on infectious outcomes after CRPP of SCHF reported to date.
Methods:
Pediatric patients undergoing CRPP ...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
The Costs of Interfacility Transfers for Nonurgent Pediatric Supracondylar Fractures
Conclusion:
Patients with isolated Gartland type II supracondylar humerus fractures that are transferred emergently via ambulance are subjected to a significantly greater financial burden with no demonstrable improvement in the quality of their care, since prior research has shown these injuries can safely be treated on an outpatient basis. Potential options to help limit costs could include greater provider education, telemedicine and improved coordination of care.
Level of Evidence:
Level III (retrospective comparative study). (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Trends in Management of Pediatric Distal Radius Buckle Fractures
Background:
Distal radius buckle fractures (DRBFx) represent nearly half of the pediatric wrist injuries. DRBFx are stable injury patterns that can typically be successfully managed with brief immobilization. The purpose of this study was to evaluate opinions and preferences of pediatric orthopaedic specialists regarding the management of DRBFx.
Methods:
The POSNA Trauma Quality, Safety, and Value Initiative (QSVI) Committee developed a 20-question survey regarding the treatment of DRBFx in children. The survey was sent twice to all active and candidate POSNA members in June 2020 (n=1487). Questions focused on v...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Outcomes After Operative Treatment of Pediatric Monteggia Fracture-Dislocations: Comparison Between Open and Closed Injuries
Conclusion:
We present the largest single cohort of pediatric open Monteggia fracture-dislocation injuries to date. These injuries are predictive of poorer outcomes including trend toward increased time to union, increased risk of major complication, and can independently predict worse long-term patient-reported functional outcomes.
Level of Evidence:
Level III—these data represent a retrospective comparative study of clinical and functional outcomes. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Trauma Source Type: research
Construct Validity of Pediatric PROMIS Computerized Adaptive Testing Measures in Children With Adolescent Idiopathic Scoliosis
Background:
The use of patient-reported outcome measures, especially Patient-Reported Outcomes Measurement Information System (PROMIS) measures, has increased in recent years. Given this growth, it is imperative to ensure that the measures being used are validated for the intended population(s)/disease(s). Our objective was to assess the construct validity of 8 PROMIS computer adaptive testing (CAT) measures among children with adolescent idiopathic scoliosis (AIS).
Methods:
We prospectively enrolled 200 children (aged 10 to 17 y) with AIS, who completed 8 PROMIS CATs (Anxiety, Depressive Symptoms, Mobility, P...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research
Spinal Fusion in Pediatric Patients With Low Bone Density: Defining the Value of DXA
Conclusions:
Patients referred for DXA scans were more likely to be treated for low BMD, although there is no standardized system in place to determine which patients should get scans. Our research highlights the need to implement clinical protocols to optimize bone health preoperatively.
Level of Evidence:
Level II—retrospective prognostic study. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research
Posterior-only Resection of Single Hemivertebrae With 2-Level Versus >2-Level Fusion: Can We Improve Outcomes?
Conclusions:
Two-level and>2-level fusions can control congenital curves successfully. No differences existed in curve correction, proximal junctional kyphosis or complications between short and long-level fusion after HV resection. Both short and long level fusions are viable options and generate similar risk of revision. The decision should be individualized by patient and surgeon. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research
Sacral-Alar-Iliac (SAI) Fixation in Children With Spine Deformity: Minimum 10-Year Follow-Up
Conclusions:
SAI screws are a safe and effective method for pelvic fixation in children with spinal deformity. The outcomes at ≥10 years are satisfactory, with low rates of long-term complications and excellent postoperative correction and subsequent maintenance of coronal curvature and pelvic obliquity over time.
Level of Evidence:
Level IV. (Source: Journal of Pediatric Orthopaedics)
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research
Outcomes of Definitive Spine Fusion Using All-pedicle-Screw Constructs in Skeletally Immature Patients Aged 8 to 10 Years With Severe Idiopathic Early-Onset Scoliosis
Background:
The choice between growth-sparing techniques or definitive spine fusion for severe idiopathic early-onset scoliosis (IEOS) in skeletally immature patients aged 8 to 10 years represents a challenging dilemma. Although growth-sparing techniques show high complication rates in severe IEOS, the outcomes of definitive fusion in borderline skeletally immature patients with severe IEOS have not been investigated. We aimed to investigate the outcomes of early definitive fusion using all-pedicle-screw constructs in skeletally immature patients aged 8 to 10 years with severe IEOS.
Methods:
The inclusion criter...
Source: Journal of Pediatric Orthopaedics - July 13, 2022 Category: Orthopaedics Tags: Scoliosis Source Type: research
