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Improved Patient-reported Outcomes in Patients Aged 16 and Younger at Two Years After Anterior Cruciate Ligament Reconstruction Despite Relatively High Rates of Reinjury and Repeat Surgery. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-30 Stephen A Doxey,Rebekah M Kleinsmith,Fernando A Huyke-Hernández,Adam Schweitzer,Arthur J Only,Marc Tompkins,Christopher Y Kweon,Brian P Cunningham
BACKGROUND Anterior cruciate ligament reconstruction (ACLR) in adolescent patients, particularly those aged 16 and under, are increasingly common procedure that lacks robust clinical and patient-reported outcome (PRO) data. The purpose of this study was to report 2-year PROs of patients receiving ACLR aged 16 or younger using the single assessment numerical evaluation (SANE) and knee injury and osteoarthritis
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Medial Patellofemoral Ligament Reconstruction With or Without Tibial Tubercle Osteotomy in Carefully Selected Patients Results in a 5% Revision Rate: A Preliminary Analysis. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-30 Crystal A Perkins,Anthony C Egger,Michael T Busch,Asahi Murata,Samuel C Willimon
PURPOSE The purpose was to assess the outcomes of medial patellofemoral ligament (MPFL) allograft reconstruction with or without tibial tubercle osteotomy (TTO) in adolescents, with a focus on evaluating demographic and imaging characteristics on outcomes. METHODS A single-institution retrospective study was performed of patients ages 12 to 19 years who underwent MPFL reconstruction +/- TTO for the
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Total Hip Arthroplasty in Teenagers: A Systematic Literature Review. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-29 Jens P Te Velde,George S Buijs,Matthias U Schafroth,Rachid Saouti,Gino M M J Kerkhoffs,Arthur J Kievit
BACKGROUND Total hip arthroplasty (THA) in teenagers is generally avoided. Nevertheless, recent THA procedures in a very young patient show improved functional outcomes and implant survival, resulting in lower revision rates. This review aims to present an overview of the available literature on THA in teenagers and to provide evidence to inform caregivers. METHODS In this systematic review, studies
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Genu Valgum in Pediatric Patients Presenting With Patellofemoral Instability. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-28 Julia C Kirby,Hunter Jones,Benjamin L Johnson,Madison E Brenner,Philip L Wilson,Henry B Ellis
BACKGROUND Lower extremity valgus is a commonly described factor associated with patellofemoral instability (PFI) and, if identified before skeletal maturity, can be treated with guided growth. The prevalence of valgus alignment in the pediatric and adolescent PFI population is largely unknown. PURPOSE The aim of this study was to report the prevalence of valgus alignment in adolescent patients presenting
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Closing-wedge Osteotomies: Can We Do and Teach Better? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-27 Daniel Weltsch,Michaela Juels,Kevin Yining Chen,Nakul Talathi,Mauricio Silva,Rachel M Thompson
BACKGROUND Wedge osteotomies are ubiquitous in pediatric orthopaedics and limb deformity surgery; however, there is no universally preferred methodology for these procedures. This study aims to determine the relative accuracy and effectiveness of several measuring and marking methods to guide best practices for wedge-shaped osteotomies in long bones. METHODS An observational cohort study was completed
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CRP Predicts the Need to Escalate Care After Initial Debridement for Musculoskeletal Infection. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-24 Stephanie N Moore-Lotridge,Joshua R Daryoush,Colby C Wollenman,Joseph T Gibian,Samuel R Johnson,Isaac P Thomsen,Jonathan G Schoenecker
BACKGROUND Musculoskeletal infections (MSKIs) are a major cause of morbidity in the pediatric population and account for nearly 1 in every 10 consultations with a pediatric orthopaedic provider at a tertiary care center. To prevent or deescalate the risk of adverse medical and musculoskeletal outcomes, timely medical intervention in the form of antibiotics and potential surgical debridement is required
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Great Toe Interphalangeal Fusion for Hallux Valgus Interphalangeus Deformity in Young Patients. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-24 David E Westberry,Emily R Shull,Branum Layton
OBJECTIVES The purposes of this study were to examine indications, radiographic outcomes, and clinical complications for primary arthrodesis of the great toe interphalangeal (IP) joint in young patients. BACKGROUND Hallux valgus interphalangeus deformity of the great toe is uncommon in the pediatric population and often requires fusion of the IP joint. METHODS A retrospective review of patients, ages
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Improved Comfortability and Satisfaction of Hybrid-mesh Casts in the Conservative Management of Pediatric Supracondylar Humeral Fractures: A Randomized Controlled Trial. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-23 Eric Jia Yong Ong,Nicole Kim Luan Lee,Neeraj Mishra,Stacy Wei Ling Ng,Zackary Kerk Hsiang Chua,Lam Kai Yet,Mohammad Ashik Bin Zainuddin,Kevin Boon Leong Lim,Arjandas Mahadev,Kenneth Pak Leung Wong
BACKGROUND Cast immobilization is the mainstay of treatment for stable pediatric supracondylar humeral fractures (SCHFs). In recent years, a waterproof and breathable hybrid-mesh (HM) cast has emerged and been marketed to address common complaints such as itch, skin irritation, and malodor. Hence, this randomized controlled trial seeks to assess the overall satisfaction, comfort, and clinical outcomes
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Inter-physician Communication in Pediatric Orthopaedics: What do Pediatricians Want to Hear From us? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Ravi Rajendra,Shay Laporte,Claudia Leonardi,R Carter Clement
BACKGROUND Pediatric orthopaedic surgeons often communicate with general pediatric providers to facilitate patient care, but little data exist on communication preferences. This study investigates pediatric provider preferences regarding when they would like to receive patient updates from pediatric orthopedists, which communication modalities they prefer, and what information they like to receive
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Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Yi-Meng Yen,Young-Jo Kim,Henry B Ellis,Ernest L Sink,Michael B Millis,Ira Zaltz,Wudbhav N Sankar,John C Clohisy,Jeffrey J Nepple,
BACKGROUND Surgical treatment for adolescent patients with femoroacetabular impingement (FAI) is increasing. The purpose of this study was to determine the clinical outcomes of FAI surgery in a multicenter cohort of adolescent patients and to identify predictors of suboptimal outcomes. METHODS One hundred twenty-six adolescent hips (114 patients < 18 years of age) undergoing surgery for symptomatic
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Functional Walker Boots are Preferred to Synthetic Casts by Patients and Carers in the Management of Pediatric Stable Ankle Injuries. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Matthew James Hampton,Camila Hilton,Nicolas Nicolaou,Mark J Flowers
INTRODUCTION Traditionally children who presented with a stable ankle injury have been managed in a below-knee synthetic cast. No previous study has investigated patient and parents/carer preference between synthetic casts and walker boots. METHODS Children aged between 6 and 16 years who presented with stable ankle injuries (ankle sprains, small fragment avulsions, and fibular Salter-Harris 1 injuries)
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Management of Lateral Condyle Humeral Fracture Associated With Elbow Dislocation in Children. A Retrospective International Multicenter Cohort Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Julio Javier Masquijo,Milca Sanchez Ortiz,Agustina Ponzone,Lucas Fernández Korosec,Alexandre Arkader
OBJECTIVES Lateral humeral condyle fractures account for 12% to 17% of all distal humerus fractures in children, and usually occur as an isolated injury or are associated with radial neck and/or proximal ulna fractures. The presentation with a concomitant dislocation of the elbow is rare. Therefore, literature on young patients with this uncommon combination is sparse and mostly limited to case reports
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Obesity Increases Risk for Wound Complications After Pediatric Foot Surgery: A Retrospective Cohort Review Using the NSQIP-Pediatric Database. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Farzam Farahani,Joel A Rodriguez,Dane K Wukich,Jacob R Zide,Anthony I Riccio
BACKGROUND As the incidence of childhood obesity continues to rise, so too does the number of obese children who undergo foot surgery. As the childhood obesity epidemic rolls on, pediatric orthopaedic surgeons will encounter obese patients with even greater frequency. Therefore, a comprehensive understanding of the risks associated with obesity is valuable to maximize patient safety. The purpose of
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Reapplication of the Pavlik Harness for Treatment of Developmental Dysplasia of the Hip After Initial Pavlik Harness Failure. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-20 Yohei Tomaru,Makoto Kamegaya,Takashi Saisu,Reiko Murakami,Akitoshi Sakuma,Yasuhiro Oikawa,Jun Kakizaki,Yuko Segawa,Yuta Tsukagoshi,Hiroshi Kamada,Masashi Yamazaki
OBJECTIVE The Pavlik harness (PH) has been widely used as the standard treatment for infants with developmental dysplasia of the hip (DDH). When the initial application of the PH fails, alternative treatments, such as closed reduction, open reduction, and reapplication of the PH will be considered. Compared with other treatments, reapplication of the PH offers certain advantages, including simplicity
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Anterior Distal Femoral Hemiepiphysiodesis Does Not Change Pelvic Tilt in Children With Cerebral Palsy. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-16 Alison M Hanson,Tishya A L Wren,Susan A Rethlefsen,Eva Ciccodicola,Boris Rubel,Robert M Kay
BACKGROUND Anterior distal femoral hemiepiphysiodesis (ADFH) is a surgical treatment choice to correct flexed knee gait and fixed knee flexion deformities in children with cerebral palsy who are skeletally immature. Increased anterior pelvic tilt has been reported after surgeries that correct knee flexion deformities, including hamstring lengthening (HSL) and distal femoral extension osteotomies, but
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The Optimal Age for Surgical Management of DDH Differs by Treatment Method. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-16 Rachael Martino,Patrick Carry,Jordyn Adams,Aaron Brandt,Ernest Sink,Courtney Selberg
BACKGROUND There is a lack of consensus on the optimal age for specific surgical interventions for developmental dysplasia of the hip. We compared radiographic and clinical outcomes among patients who were treated with closed reduction (CR), open reduction (OR), and open reduction with concomitant pelvic osteotomy (ORP) for the treatment of a dislocated hip. We sought to identify the optimal age at
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An Analysis of Negative One-star Patient Reviews and Complaints for Pediatric Orthopaedic Surgeons throughout the United States: A Retrospective Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-16 Kyle J Hitchman,Anthony N Baumann,Wyatt R Glasgow,Karla G Rivera,Albert T Anastasio,Kempland C Walley,Keith D Baldwin
OBJECTIVE Patients commonly use physician review websites when choosing a surgeon for an elective procedure. Although data exist regarding other orthopaedic specialties, no study has investigated one-star reviews for pediatric orthopaedic surgeons. The goal of this retrospective study was to classify the factors contributing to one-star reviews of pediatric orthopaedic surgeons to identify which areas
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Don't Throw Away the Handout: Efficacy of Patient Education in Pediatric Orthopaedic Trauma. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-16 Hannah Chi,Toshali Katyal,Laura A Carrillo,Jennifer O'Donnell,Ishaan Swarup
BACKGROUND Printed educational materials (PEMs) have been used for patient education in various settings. The purpose of this study was to determine the readability, understandability, and actionability of trauma-related educational material from the Pediatric Orthopaedic Society of North America (POSNA, Orthokids), as well as determine its efficacy in educating pediatric orthopaedic trauma patients
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Serum Titanium Levels Remain Elevated But Urine Titanium is Undetectable in Children With Early Onset Scoliosis Undergoing Growth-Friendly Surgical Treatment: A Prospective Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-13 Kameron Shams,Sahil Jha,Jennylee Swallow,Michelle S Caird,Frances A Farley,Matthew Stepanovich,Ying Li
BACKGROUND Elevated serum titanium levels have been found in patients with early onset scoliosis (EOS) treated with traditional growing rods (TGR), magnetically controlled growing rods (MCGR), and vertical expandable prosthetic titanium rib (VEPTR). No studies have investigated whether serum titanium remains persistently elevated and if titanium is excreted. Our purpose was to compare serum titanium
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Clinical Outcomes and Associated Pathologies Following Pediatric Traumatic Hip Dislocations: A Systematic Review of the Literature. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-10 Anthony N Baumann,Laura C M Ndjonko,Jonathan G Schoenecker,Keith D Baldwin
INTRODUCTION Pediatric traumatic hip dislocations are a rare condition that can have devastating short and/or long-term outcomes and associated pathologies (APs), including associated injuries (AIs) and long-term adverse events (LTAEs), with negative long-term sequelae. Currently, there are little data that exist on the rate of APs, with the most notable being avascular necrosis (AVN), for pediatric
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Manipulation Under Anesthesia is Safe and Effective for Management of Early Postoperative Knee Arthrofibrosis in Adolescent Patients. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-08 Alejandro Marquez-Lara,William Padget,Eric J Wall,Shital N Parikh
BACKGROUND Management of postoperative knee arthrofibrosis can be challenging and the preferred time for intervention remains controversial. The purpose of this study is to evaluate the safety and efficacy of early (<3 mo postoperatively) manipulation under anesthesia (MUA) for the treatment of knee arthrofibrosis in adolescent patients. We hypothesized that early MUA could restore normal knee motion
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Magnetically Controlled Growing Rods Graduation: Lessons From a Single-center Series of 48 Patients. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-06 Ron Gurel,Etay Elbaz,Amit Sigal,Roy Gigi,Hila Otremski,David E Lebel,Dror Ovadia
BACKGROUND Magnetically controlled growing rod (MCGR) treatment for early-onset scoliosis (EOS) has become a widely utilized method of deformity control, but long-term follow-up reports are sparse. We evaluated the outcomes of a large group of consecutive pediatric patients diagnosed with EOS who were treated by MCGR to the endpoint of definitive spinal fusion in a single center. We hypothesized that
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Twelve to Twenty-year Follow-up of Dega Acetabuloplasty in Patients With Developmental Dysplasia of the Hip: Is it as Effective as Expected? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-11-01 Murat Danişman,Gökay Dursun,İsmail Aykut Koçyiğit,Caglar Yilgor,Mehmet Cemalettin Aksoy
BACKGROUND Although Dega acetabuloplasty is widely used for the treatment of developmental dysplasia of the hip, there is a paucity of data on long-term outcomes. The purpose of the study was to evaluate the rate of residual acetabular dysplasia after Dega acetabuloplasty. METHODS Patients of a previously reported consecutive series of 35 patients (43 hips) operated by a single surgeon were recontacted
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Refracture Following Operative Treatment of Pediatric Both Bone Forearm Fractures. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-31 Akbar Nawaz Syed,Leta Ashebo,J Todd R Lawrence
INTRODUCTION Both bone forearm fractures are common injuries in children. Most can be treated with reduction and casting. Those that fail nonoperative management can be treated with a plate or intramedullary fixation; however, refracture remains a problem. The goal of this study is to evaluate the refracture rate in both bone forearm fractures based on the mode of fixation. METHODS Institutional board
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The Reliability of the Modified Fels Knee Skeletal Maturity System. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-30 Ryan J Furdock,Kristie J Sun,Bryan Ren,Matthew Folkman,Michael P Glotzbecker,Jochen P Son-Hing,Allison Gilmore,Christina K Hardesty,R Justin Mistovich,Raymond W Liu
BACKGROUND The recently described Modified Fels knee skeletal maturity system (mFels) has proven utility in prediction of ultimate lower extremity length in modern pediatric patients. mFels users evaluate chronological age, sex, and 7 anteroposterior knee radiographic parameters to produce a skeletal age estimate. We developed a free mobile application to minimize the learning curve of mFels radiographic
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Medium-term Results After Femoral Head Resection and Subtrochanteric Valgus Osteotomy in Children and Adolescents With Neuromuscular Disorders. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-26 Madeleine Marowsky,Oliver Jungesblut,André Strahl,Ralf Stücker,Martin Rupprecht
BACKGROUND Various salvage surgical procedures for painful hip dislocation in adolescent patients with cerebral palsy exist. To date, no significant differences among these surgical techniques have been described. In our institution the McHale procedure is the standard of care for painful chronically dislocated hips with or without deformity of the femoral head in patients with cerebral palsy. This
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Socioeconomic, Racial, and Insurance Disparities in Clinical Outcomes After Surgery Among Patients With Idiopathic Scoliosis. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-23 Patrick Thornley,Sarah Garner,Kenneth J Rogers,Petya Yorgova,Peter G Gabos,Suken A Shah
BACKGROUND Socioeconomic status (SES), race, and insurance type correlate with initial curve severity for patients with idiopathic scoliosis, but less is known regarding how these variables impact surgical outcomes. The objectives of this study were to determine the influence of SES, race, and insurance on preoperative appointment attendance, likelihood of obtaining a preoperative second opinion, brace
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Femur Fractures in 5 Individuals With Pantothenate Kinase-associated Neurodegeneration: The Role of Dystonia and Suggested Management. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-23 Laken Behrndt,Allison Gregory,Katrina Wakeman,Alison Freed,Jenny L Wilson,Robert Spaull,Manju A Kurian,Santosh Mordekar,James A Fernandes,Susan J Hayflick,Penelope Hogarth,Scott Yang
BACKGROUND Pantothenate kinase-associated neurodegeneration (PKAN) is a rare, neurodegenerative disorder that manifests with progressive loss of ambulation and refractory dystonia, especially in the early-onset classic form. This leads to osteopenia and stress on long bones, which pose an increased risk of atraumatic femur fractures. The purpose of this study is to describe the unique challenges in
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Ipsilateral Healthy-segment Response to Leg Length Discrepancy. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-23 John G Birch,Marina R Makarov,Chan-Hee Jo
BACKGROUND Few studies address frequency or magnitude of healthy lower-extremity segment response to ipsilateral companion segment shortening. We sought to document and quantify this occurrence in a variety of pediatric etiologies. METHODS We reviewed the medical record and radiographs of patients undergoing epiphysiodesis to manage leg length discrepancy. Inclusion criteria for this study were leg
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Use of Surgical Adjuvants Does Not Decrease Recurrence of Aneurysmal Bone Cysts in Surgical Intervention With Pediatric Patients. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-10 Brandon S Gettleman,Abigail N Padilla,Shourya Kumar,Tishya A L Wren,Joseph Miller,Bruce R Pawel,Vernon T Tolo,Alexander B Christ
BACKGROUND Aneurysmal bone cysts (ABCs) are benign active tumors often requiring intralesional curettage with or without adjuvants. The primary aim of this study was to analyze whether recurrence is influenced by the use of surgical adjuvants in pediatric patients with ABCs. Secondary aims examined recurrence rates based on age, sex, and physeal contact. METHODS A retrospective review was performed
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Can We Control Lateral Shoulder Balance Through Proximal Thoracic Curve Correction in Lenke Type 2 Adolescent Idiopathic Scoliosis? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-10 Hyung Rae Lee,Chang Ju Hwang,Sang Yun Seok,Hyun Wook Gwak,Jae Hwan Cho,Dong-Ho Lee,Choon Sung Lee
BACKGROUND Proximal thoracic curve (PTC) correction has been considered to prevent lateral shoulder imbalance in Lenke Type 2 adolescent idiopathic scoliosis (AIS) patients; however, postoperative shoulder imbalance (PSI) commonly occurs despite these strategies with PTC correction. We investigated the hypothesis that PTC correction would not directly affect PSI in the majority of Lenke type 2 AIS
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What Are the Psychosocial Effects of Pavlik Harness Treatment? A Prospective Study on Perceived Impact on Families and Maternal-Infant Bonding. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-09 Morgan G Batley,Alex L Gornitzky,Sulagna Sarkar,Wudbhav N Sankar
BACKGROUND The Pavlik harness (PH) is the most common treatment for infants with developmental dysplasia of the hip. Although success rates are high when used appropriately, brace treatment may impact family function and parental bonding. The purpose of this study was to prospectively determine how PH treatment affected these psychosocial variables. METHODS This is a prospective, single-surgeon study
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Wide Resection for Pediatric Extremity Vascular Malformation-A Tertiary Hospital's Experience. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-09 Kenneth P L Wong,Tessa W X Tan,Lester W M Chan,Arjandas Mahadev,Mathew H W Cheng
BACKGROUND Vascular malformations of the extremities (VM) are common benign lesions that tend to grow throughout the patient's lifetime. They can cause various issues like pain, swelling, and even limb length discrepancies. Sclerotherapy was the preferred treatment choice in previous studies. However, sclerotherapy and many other treatments have the potential to result in higher recurrence rates. Surgical
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Waterproof Hip Spica Casts for Pediatric Femur Fractures. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-06 Jessica L Churchill,Trinity A Kronk,Mark J Adamczyk,Miraides F Brown,Todd F Ritzman,Lorena V Floccari
BACKGROUND Hip spica casting is the treatment of choice for femur fractures in children ages 6 months to 5 years. Traditional spica (TS) casting utilizes cotton padding that precludes patient bathing. Waterproof (WP) casting has inherent advantages, including clearance for bathing and improved family satisfaction. This study examines the safety and efficacy of WP hip spica casting for the treatment
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Pediatric Fractures Associated With Riding Bicycles: A National 20-year Analysis. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-06 William H Huffman,Radhika Gupta,Steven R Ayotte,J Todd R Lawrence
BACKGROUND Biking is a popular childhood activity with an intrinsic risk of injury. While advocacy groups have promoted protective equipment to help mitigate these risks, trends in the national health burden of fractures associated with biking in the pediatric population have not been explored in depth. METHODS The National Electronic Injury Surveillance System database was queried between 2001 and
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Impact of Social Determinants of Health on Adolescent Idiopathic Scoliosis Curve Severity. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-05 Kevin J Orellana,Julianna Lee,Daniel Yang,Lucas Hauth,John M Flynn
INTRODUCTION Social determinants of health have been shown to influence the health and outcomes of pediatric patients. Adolescent idiopathic scoliosis (AIS) may be particularly sensitive to such factors as early diagnosis and treatment can obviate the need for surgical intervention. The purpose of this study was to analyze the effect that social determinants of health have on the severity of AIS at
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Coated Cast Saw Blades Decrease Blade Temperature During Cast Removal. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-05 Michael R E Stevens,Andrew M Kirk,Brandon S Collofello,Brian T Muffly,Vincent W Prusick
BACKGROUND Thermal injuries can occur during cast removal with an oscillating saw. The purpose of this study is to describe the effect of blade material, blade wear, and cast material on blade temperature. METHODS Short arm plaster and fiberglass casts were cured overnight and bivalved with either new or worn stainless-steel or tungsten-disulfide coated blades. Blade use was defined as removing 1 short
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Recovery of Gait in Children and Adolescents After Pediatric Femoral Shaft Fracture Treated with Intramedullary Nail Fixation: A Longitudinal Prospective Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-04 Marianne Flinck,Jacques Riad
BACKGROUND Femoral shaft fractures in school-aged children are commonly treated with intramedullary nail fixation. Outcomes such as time to healing, alignment and non-union, leg length discrepancy, and refractures, and other complications are often reported based on radiographic findings. There are limited reports on physical function, including objective quantitative measures. The aim was to study
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Comparison of Gait and Functional Outcomes Between Open and Arthroscopic Treatment of Adolescent and Young Adult Femoroacetabular Impingement. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-04 William Z Morris,Alex Loewen,Sophia Ulman,Ben Johnson,Daniel J Sucato,David A Podeszwa,Henry B Ellis
BACKGROUND Management of femoroacetabular impingement (FAI) through an arthroscopic or surgical hip dislocation (SHD) approach has been shown to have similar clinical success and patient-reported outcomes. However, there are limited data comparing functional outcomes. The purpose of this study was to compare gait and functional outcomes of adolescent/young adult patients with FAI treated by either
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Metaphyseal Fracture Displacement is Predictive of Intra-articular Diastasis in Adolescent Triplane Ankle Fractures. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-02 Dustin A Greenhill,Surya N Mundluru,Robert W Gomez,Joseph Romero,Anthony I Riccio
BACKGROUND Triplane fractures are rare enough that large homogeneous series to support management decisions are lacking. During initial evaluation, the addition of computed tomography (CT) to conventional radiographs=conventioanl X-ray does not always alter the patient's clinical course. Therefore, routine use of CT is controversial. This study aims to: (1) clarify quantitative relationships between
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The Evaluation of Serum Metal Ion Levels and Metallosis in Graduated Patients With Magnetically Controlled Growing Rods. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-02 Flavia Alberghina,Robin McManus,Cillian Keogh,Henry Turner,David Moore,Jacques Noël,Jim Kennedy,Patrick Kiely
BACKGROUND Magnetically controlled growing rods (MCGR) aim to control curve progression while limiting surgical burden in children with early-onset scoliosis. Systemic and local distribution of metal debris has been documented in children with spinal implants. The aim of the study was to assess serum metal ion levels and local metal debris-related changes at the conclusion of MCGR treatment. METHODS
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Response to: Pediatric Fractures: Does Vitamin D Play a Role? Concerns That Message May be Misleading. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-10-02 Alexa J Karkenny
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Does Screening Ultrasound Timing in Developmental Dysplasia of the Hip Need to be Adjusted for Moderate Preterm and Near-term Infants: A Prospective Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-29 Claire Hockett,Laura M Mayfield,Corey S Gill,Harry K W Kim,Daniel J Sucato,David A Podeszwa,Chan-Hee Jo,William Z Morris
INTRODUCTION An initial screening ultrasound is essential for patients at higher risk of developmental dysplasia of the hip (DDH) due to breech presentation or a family history of DDH. The American Academy of Pediatrics recommends screening ultrasounds to be performed after 6 weeks of age to reduce the rate of false positives. However, there is limited evidence regarding whether these screening ultrasounds
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Quantifying Risk Factors for Slipped Capital Femoral Epiphysis and Postslip Osteonecrosis. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-29 Natalie L Zusman,Rachel Y Goldstein,Jung U Yoo
BACKGROUND Slipped capital femoral epiphysis (SCFE) is a disorder of the proximal femoral physis occurring in late childhood and adolescence. Previously postulated risk factors include obesity and endocrinopathies. The purpose of this investigation was to identify risk factors for developing SCFE, as well as postslip osteonecrosis (ON), among the United States pediatric population. METHODS A national
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Correlations Between Eight Comprehensive Skeletal Maturity Systems in a Modern Peripubertal Pediatric Population. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-28 Kallie J Chen,Amog Mysore,Ryan J Furdock,Abdus Sattar,Margaret A Sinkler,Michael P Glotzbecker,Raymond W Liu
BACKGROUND Several skeletal maturity systems allow for accurate skeletal age assessment from a wide variety of joints. However, discrepancies in estimates have been noted when applying systems concurrently. The aims of our study were to (1) compare the agreement among 8 different skeletal maturity systems in modern pediatric patients and (2) compare these discrepancy trends qbetween modern and historic
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Active Treatment of Pediatric Ganglia of the Wrist: What is the Risk of Recurrence? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-25 Samuel Cohen-Tanugi,Scott Dart,Christopher Chadderdon
BACKGROUND Ganglion cysts are the most common soft tissue mass in the hand and wrist in both adults and children. More is known about wrist ganglia and their treatment outcomes in adults than in children. Current literature to guide the management of pediatric wrist ganglia is limited. The purpose of this study is to report on the rates of recurrence of pediatric wrist ganglia after active intervention-aspiration
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The Duration of Hardware Retention After Radiologic Union of Surgically Treated Femoral Neck Fractures in Children May Predict the Aggravation or Occurrence of Avascular Necrosis of the Femoral Head or Neck After Hardware Removal. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-22 WenTao Wang,QianQian Mei,YueMing Guo,Bo He,HaiBo Mei,YiQiang Li,Federico Canavese,ShunYou Chen
BACKGROUND The incidence of aggravation or occurrence of avascular necrosis (AVN) following hardware removal in surgically treated pediatric femoral neck fractures who achieved radiologic consolidation is unknown. This study aimed to investigate the risk factors for this complication. METHODS Seventy-one pediatric (mean age: 9.8±3.9 y) were retrospectively analyzed. Risk factors (age, sex, laterality
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Anterior Cruciate Ligament Tears in the Adolescent Population: Injury Demographics and Risk of Reinjury Among High School Athletes. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-20 Bhargavi Maheshwer,Andrew Paliobeis,Penelope Halkiadakis,Sreenivas Konda,Jacob G Calcei,James E Voos
BACKGROUND The incidence of anterior cruciate ligament (ACL) injuries is increasing among the adolescent population with a peak occurring in the high school age range. PURPOSE To characterize recent epidemiologic trends of ACL injuries, ACL reconstruction (ACLR), and retear rates in high school adolescents based on age, participating sport, and mechanism of injury. STUDY DESIGN Retrospective case series
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Self-reported Health-related Quality of Life in Adolescents With Cerebral Palsy. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-20 Nancy Lennon,Faithe Kalisperis,Chris Church,Tim Niiler,Freeman Miller,Isabel Biermann,Jennifer Davey,Julieanne P Sees,M Wade Shrader
BACKGROUND Happiness, comfort, and motor function contribute to satisfaction with life for individuals with cerebral palsy (CP). Evidence-based medical care can improve motor function and physical health of youth with CP. Less is known about medical care and its relationship to health-related quality of life (HRQOL) in adolescents and young adults with CP. This study aimed to describe HRQOL among adolescents
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Intraoperative Neuromonitoring for Spines at Risk During Nonspine Surgery: A 9-Year Review. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-19 Madeleine E Jackson,Amanda K Galambas,Jennifer M Bauer
BACKGROUND Patients with certain spinal anomalies are at risk for rare but devastating spinal cord injuries under anesthesia. We created a Spine at Risk (SAR) program to evaluate and recommend precautions for such patients, including intraoperative neuromonitoring (IONM) use for the highest-risk patients. We aimed to review all monitored nonspine procedures to determine rate of potential spinal cord
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Outcome Prediction Model Following Proximal Femoral Osteotomy in Legg-Calvé-Perthes Disease Using Machine Learning Algorithms. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-19 Sungmin Kim,Jong-Keun Seon,Bonggyun Ko,Jun-Hyuk Lim,Woo-Chan Song,Gyo Rim Kang,Yonggwan Shin,Sung-Taek Jung
BACKGROUND The purpose of the current study was (1) to analyze various factors that may be associated with the outcomes of Legg-Calvé-Perthes disease (LCPD), and (2) to develop and internally validate machine learning algorithms capable of providing patient-specific predictions of which patients with LCPD will achieve relevant improvement in radiologic outcomes after proximal femoral varus osteotomy
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The Pressure Is on: Dorsal Versus Volar Univalves for Long-arm Casts. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-19 Dallyn Udall,Remy Zimmerman,Tracey Bastrom,John Schlechter
BACKGROUND Fiberglass casts are routinely used to treat fractures of the upper extremity. When posttraumatic edema is anticipated, the cast is often valved to hopefully prevent potential complications, especially compartment syndrome. Due to volar forearm compartments being most involved with upper extremity compartment syndrome, volar skin surface pressures (SSP) are paramount. Despite past literature
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Fracture Patterns and Mortality in Osteopetrosis: A 7-year Retrospective Analysis from Türkiye's National Registry. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-19 Olgun Bingöl,Niyazi Erdem Yaşar,Güzelali Özdemir,Şenol Bekmez,Mehmet Salih Söylemez,Ebru Dumlupinar,Mustafa Okan Ayvali,Naim Ata,M Mahir Ülgü,Şuayip Birinci,İzzet Bingöl
BACKGROUND The aim of this study is to determine the demographic data, fracture treatment methods, and medical treatments of patients diagnosed with osteopetrosis in the national registry. METHODS Patients with International Classification of Diseases (ICD)-10 code Q78.2 for osteopetrosis between January 1, 2016 and April 11, 2023 were retrospectively reviewed. Data on sex, age at time of diagnosis
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Management of Pediatric and Adolescent Sublime Tubercle Injuries: Isolated and Complex Patterns Demonstrate Distinct Etiologies and Radiographic Outcomes. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-13 Brendon C Mitchell,Sarah A Fogleman,Alyssa N Carroll,Bryan T Leek,Eric W Edmonds,Jan Fronek,Andrew T Pennock
BACKGROUND The aim of this study was to assess the patient demographics, epidemiology, mechanism of injury, and natural history of sublime tubercle avulsion injuries. METHODS A multicenter retrospective study was performed in which sublime tubercle avulsion injuries were identified by surgeon records and database query of radiology reports. Demographic data and imaging were reviewed for each case,
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Abduction Bracing Following Anterior Open Reduction for Developmental Dysplasia of the Hip Does Not Improve Residual Dysplasia or Reduce Secondary Surgery. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-13 Arnav Kak,William Z Morris,Laura M Mayfield,Chan-Hee Jo,Harry K W Kim
BACKGROUND Abduction bracing is commonly used following open reduction and spica casting of developmental dysplasia of the hip. However, there is little evidence to support or refute this practice that carries associated cost and burden for families. The purpose of this study was to determine the efficacy of abduction bracing after open reduction in improving the acetabular dysplasia and reducing the
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Intrarater and Interrater Reliability of Radiographic Characteristics in Skeletally Immature Patients With Anterior Cruciate Ligament Tears: A PLUTO Study Group Reliability Study. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-11 Crystal A Perkins,Ryan P Coene,Patricia E Miller,Chris N Anderson,Kianna D Nunally,Shital N Parikh,Michael T Busch,Henry G Chambers,Melissa A Christino,Frank A Cordasco,Eric W Edmonds,Peter D Fabricant,Theodore J Ganley,Daniel W Green,Benton E Heyworth,John Todd R Lawrence,Matthew J Matava,Lyle J Micheli,Matthew D Milewski,Jeffrey Nepple,Andrew T Pennock,Paul M Saluan,Kevin G Shea,Eric J Wall,Samuel
BACKGROUND Radiographic measurements of limb alignment in skeletally immature patients with anterior cruciate ligament (ACL) tears are frequently used for surgical decision-making, preoperative planning, and postoperative monitoring of skeletal growth. However, the interrater and intrarater reliability of these radiographic characteristics in this patient population is not well documented. HYPOTHESIS
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Disparate Impact: How Does Social Deprivation Affect Patient-reported Outcomes After ACL Reconstruction in Children and Adolescents? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-11 Sara N Kiani,Patrick England,Alex L Gornitzky,Christopher B Renjilian,Brendan A Williams,Theodore J Ganley
BACKGROUND Research has indicated that lower socioeconomic status is associated with delays in the treatment of anterior cruciate ligament (ACL) injuries; however, there is a paucity of literature evaluating its association with patient-reported outcomes (PROs). Using the Area Deprivation Index (ADI), a validated proxy for socioeconomic status, the study aimed to determine how relative socioeconomic
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Do Children With Medicaid Insurance Have Increased Revision Rates 5 Years After Posterior Spinal Fusions? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-09 Harold G Moore,Sahiti D Patibandla,Anna M McClung,Jonathan N Grauer,Daniel J Sucato,Carol A Wise,Megan E Johnson,Karl E Rathjen,Amy L McIntosh,Brandon A Ramo,Jaysson T Brooks
BACKGROUND Socioeconomic disparities in musculoskeletal care are increasingly recognized, however, no studies to date have investigated the role of the insurance carrier on outcomes after posterior spinal fusion (PSF) with segmental spinal instrumentation for adolescent idiopathic scoliosis (AIS). METHODS A US insurance dataset was queried using the PearlDiver Mariner software for all patients aged
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Is There a Benefit to Rigid Fixation in Calcaneal Lengthening Osteotomy in Painful Pediatric Idiopathic Flatfoot Deformity? Comparing Results of Kirschner Wire Versus Plate Fixation. J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-09 Abhishek Tippabhatla,Beltran Torres-Izquierdo,Matthew William,Daniel Pereira,Zachary Meyer,Pooya Hosseinzadeh
INTRODUCTION Flexible flatfoot (FF) is a common pediatric condition that is mostly asymptomatic, and surgical intervention is only considered when painful FF is refractory to conservative treatment. Calcaneal lengthening osteotomy (CLO) is one of the most commonly used procedures to address painful FF. Traditionally, Kirschner wires (K-wires) were used for fixation, but there has been a recent increase
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How Often Do Patients Presenting With Severe Adolescent Idiopathic Scoliosis Have Underlying Hip Dysplasia? J. Pediatr. Orthop. (IF 1.7) Pub Date : 2023-09-09 Tristen N Taylor,Callie S Bridges,Anthony T Duruewuru,Andrew C Sher,Scott B Rosenfeld,Brian G Smith,J Herman Kan
INTRODUCTION Adolescent idiopathic scoliosis radiographic screening will often include the hips. The purpose of this study is to evaluate the prevalence of hip dysplasia by lateral center edge angle (LCEA) on scoliosis radiographs in patients presenting with severe range (>45 deg) idiopathic curves. METHODS We reviewed 200 consecutive patients (400 hips) with idiopathic scoliosis with major coronal