Francisco Soldado, Trong-Quynh Nguyen, Juliana Rojas-Neira, Daniel Rodriguez-Ostuni, Abdelmounim Cherqaoui, Paula Díaz-Gallardo
BACKGROUND: The congenital insufficiency of the extensor tendon central slip of the fingers is a relatively rare condition, with only a few reported cases in pediatric patients, as described in 2 clinical series. In this study, we aimed to present the natural history of a significant number of untreated patients with this deformity. METHODS: This study has received institutional review board approval, and parents provided informed consent following the Declaration of Helsinki guidelines for biomedical research involving humans...
July 11, 2024: Journal of Pediatric Orthopedics
Vineet M Desai, Margaret Bowen, Jason B Anari, John M Flynn, Jaysson T Brooks, Brian Snyder, Brandon Ramo, Ying Li, Lindsay M Andras, Walter H Truong, Ryan Fitzgerald, Ron El-Hawary, Benjamin Roye, Burt Yaszay, Kenny Yat Hong Kwan, Amy McIntosh, Susan Nelson, Purnendu Gupta, Mark Erickson, Sumeet Garg, Patrick J Cahill
BACKGROUND: Neuromuscular early-onset scoliosis (N-EOS) often presents with a long sweeping thoracolumbar scoliosis and pelvic obliquity. With severe pelvic obliquity, the ribs come into contact with the high side of the pelvis, termed rib-on-pelvis deformity (ROP). The goal of this study is to evaluate whether ROP is associated with reported pain and other health-related quality of life (HRQOL) measures. We hypothesize that ROP is associated with increased pain and negative HRQOL. METHODS: A multicenter international registry was queried for all nonambulatory patients with N-EOS from 2012 to 2022...
July 11, 2024: Journal of Pediatric Orthopedics
Peter C Shen, Brendan A Williams, O Folorunsho Edobor-Osula, John S Blanco, Lindsay M Crawford, Dustin A Greenhill, Alexander H Griffith, Neil K Kaushal, David M Kell, Abhi Rashiwala, John A Schlechter, Evelyn S Thomas, Haley N Tornberg, Neeraj M Patel
BACKGROUND: Given the rare nature of tibial tubercle fractures, previous studies are mostly limited to small, single-center series. This results in practice variation. Previous research has shown poor surgeon agreement on utilization of advanced imaging, but improved evidence-based indications may help balance clinical utility with resource utilization. The purpose of this study is to quantify diagnostic practices for tibial tubercle fractures in a large, multicenter cohort, with attention to the usage and impact of advanced imaging...
July 9, 2024: Journal of Pediatric Orthopedics
Taylor Bradley, Mary Crowe, Hani Mayassi, Jay Patel, Junichi Tamai, Charles T Mehlman
OBJECTIVES: The first case report describing a pediatric fracture of the tibial tubercle was published in 1852 in the Medical Times and Gazette, a Journal of Medical Science, literature, criticism, and news. A century later, in 1955, Sir Watson-Jones introduced the first classification system for this fracture. Despite the existence of several classification systems for pediatric tibial tubercle fractures in the medical literature, a crucial aspect of their validation-reliability and reproducibility-has not yet been systematically evaluated...
July 3, 2024: Journal of Pediatric Orthopedics
Julia E Todderud, Todd A Milbrandt, Edward Floyd, Geoffrey Haft, Ron El-Hawary, Michael Albert, A Noelle Larson
BACKGROUND: Motion-sparing scoliosis surgeries such as the posterior dynamic distraction device (PDDD) are slowly increasing in use. However, there is limited clinical data documenting postoperative motion across the PDDD construct. With this cohort study, we aim to measure sagittal and coronal motion following PDDD. We hypothesize coronal and sagittal spinal motion will be partially preserved across the construct. METHODS: Retrospective review of prospectively collected data...
July 1, 2024: Journal of Pediatric Orthopedics
Sitanshu Barik, Pratik Shahare, Saurabh Sah
No abstract text is available yet for this article.
June 28, 2024: Journal of Pediatric Orthopedics
Adrian J Lin, Vivian Chen, Cynthis Wong, Benita Tamrazi, David L Skaggs, Kenneth D Illingworth, Michael J Heffernan, Lindsay M Andras
BACKGROUND: Children with neuromuscular early onset scoliosis (EOS) receive numerous radiographic studies both from orthopaedic and other specialties. Ionizing radiation doses delivered by computed tomography (CT) are reportedly 100 times higher than conventional radiography. The purpose of this study was to evaluate the number of radiographic studies ordered for neuromuscular EOS patients during their care. METHODS: Retrospective review at a tertiary children's hospital from January 2010 to June 2021 included all patients with neuromuscular EOS followed by an orthopaedic specialist for a minimum of 3 years...
June 28, 2024: Journal of Pediatric Orthopedics
Tristen N Taylor, Ally A Yang, Tiffany M Lee, Rioke M Diejomaoh, Callie S Bridges, J Herman Kan, Brian G Smith, Daniel R Cooperman
INTRODUCTION: The Greulich & Pyle (G&P) Radiographic Atlas of Skeletal Development uses hand x-rays obtained between 1926 and 1942 on children of Caucasian ancestry. Our study uses modern Caucasian, Black, Hispanic, and Asian children to investigate patterns of development as a function of percent final height (PFH). METHODS: A retrospective review, at a single institution, was conducted using children who received a hand x-ray, a height measurement taken within 60 days of that x-ray, and a final height...
June 28, 2024: Journal of Pediatric Orthopedics
Alexa J Karkenny, Allyn Morris, Cameron Smith, Jorden Xavier, Zeynep Seref-Ferlengez, Leila Mehraban Alvandi, I Martin Levy
BACKGROUND: Circumferential integrity of bivalved casts (cut twice longitudinally) can be restored by overwrapping with different materials. This study compared the mechanical properties of solid casts and bivalved casts overwrapped with semirigid fiberglass (SF), elastic bandages (EB), and rigid fiberglass (RF) using an overwrapped-bivalved cast-bone fracture (OBCBF) model. METHODS: This study used an MTS Bionix Servohydraulic system to test properties of OBCBF models in 4 conditions: intact Control made of RF (not bivalved or overwrapped), a Rigid overwrapped model made of a Control bivalved and overwrapped with RF, a Semirigid overwrapped model made of a Control bivalved and overwrapped with SF, and an Elastic model made of a Control bivalved and overwrapped with EB...
June 28, 2024: Journal of Pediatric Orthopedics
Claire Schaibley, Beltran Torres-Izquierdo, Zachary Meyer, Pooya Hosseinzadeh
INTRODUCTION: While the Ponseti method is the primary treatment for idiopathic clubfoot, its application in treating myelodysplastic clubfeet is less certain. Myelodysplastic clubfoot tends to be more severe and difficult to treat. Although the Ponseti method can initially correct these cases, there is conflicting evidence about recurrence rates and the need for additional treatment. This study aims to assess the effectiveness of the Ponseti method in treating myelodysplastic clubfeet compared with idiopathic clubfeet over a 20-year period...
June 27, 2024: Journal of Pediatric Orthopedics
Abigail N Padilla, Lindsay M Andras, Michael J Heffernan, Tishya A L Wren, Noah G Tyau, Eugene Kim, Robert M Kay
BACKGROUND: Posterior spinal fusion (PSF) and hip reconstruction are commonly indicated surgeries in children with cerebral palsy (CP), particularly those functioning at GMFCS levels IV and V. These are large and often painful procedures, and previous literature suggests that hip surgery is more painful than spine surgery in this patient population. The purpose of this study is to investigate pain scores and opioid use following hip and spine surgery in a large cohort of children with CP, including many patients who have undergone both types of surgery...
June 27, 2024: Journal of Pediatric Orthopedics
Ahmet Payas, Sabri Batin
BACKGROUND: Flatfoot (pes planus) is a decrease or loss of longitudinal medial arch height. The cause of symptomatic flatfoot occurring in adolescents is still unclear. In this study, the relationship between adolescent pes planus and foot bone shape was investigated. For this purpose, the volume and superficial area data of the foot bones of adolescent individuals with flatfoot deformity and individuals without any foot deformity were compared. METHODS: Between September 2022 and June 2023, 30 individuals with adolescent pes planus with a medial arch angle greater than 145 degrees and 30 individuals without any foot deformity were included in the study...
June 26, 2024: Journal of Pediatric Orthopedics
Lindley B Wall, David Clever, Lauren E Wessel, Douglas J McDonald, Charles A Goldfarb
BACKGROUND: Osteochondromas are benign osseous lesions often excised for pain, growth abnormalities, and aesthetic concerns. While characteristic clinical and radiographic features leave little diagnostic ambiguity in most cases of osteochondroma, pathologic analysis to confirm the diagnosis and screen for malignancy is routinely performed following surgical excision. The purpose of this study was to determine the clinical and economic value of routine pathologic analysis after osteochondroma excision in a pediatric population...
June 25, 2024: Journal of Pediatric Orthopedics
Sadettin Ciftci, Armagan C Ulusaloglu, M Wade Shrader, Mena T Scavina, William G Mackenzie, Robert Heinle, Kevin M Neal, Alec Stall, Jason J Howard
BACKGROUND: Spinal muscular atrophy (SMA) is caused by abnormalities of the survival motor neuron (SMN) 1 gene, leading to deficiency in SMN protein and loss of spinal cord alpha motor neurons. Newer disease-modifying agents (DMA) targeting the involved genes, including nusinersen and gene replacement therapies, have improved gross motor and respiratory function, but their impact on scoliosis development has not been established. This study aimed to determine risk factors for scoliosis development in SMA, specifically genetic severity and DMA use...
June 25, 2024: Journal of Pediatric Orthopedics
Pooya Hosseinzadeh, Beltran Torres-Izquierdo, Abhishek Tippabhatla, Jaime Denning, Upasani Vidyadhar, Julia Sanders, Rachel Goldstein, Keith Baldwin
BACKGROUND: Proximal humerus fractures (PHFx) constitute around 2% of all pediatric fractures. Although younger children with displaced fractures often undergo nonoperative treatments, optimal treatment for adolescents is not well defined. The study aimed to assess the outcomes of operative versus nonoperative treatment of displaced proximal humerus fractures in adolescents via a prospective multicenter study. METHODS: This prospective study assessed adolescents aged 10 to 16 years with displaced PHFx from 2018 to 2022 at 6 level 1 trauma centers...
June 24, 2024: Journal of Pediatric Orthopedics
Jill C Flanagan, Sonia Gilani, Anirejuoritse Bafor, Christopher A Iobst
OBJECTIVE: Reimbursement for surgical procedures is determined by a computation of the relative value unit (RVU) associated with CPT codes. It is based on the amount of work required to provide a service, resources available, and level of expertise involved. Given the evolution of changes in the limb lengthening field, we wanted to evaluate whether the RVU values were comparable across different orthopaedic subspecialties. Consequently, this study compares the work relative value unit (wRVU) totals of 3 common pediatric orthopaedic surgeries-arthroscopic ACL reconstruction, spinal fusion for adolescent idiopathic scoliosis, and antegrade femoral intramedullary limb lengthening...
June 21, 2024: Journal of Pediatric Orthopedics
Natalya E McNamara, Elaine Z Shing, Ameen Z Khalil, Erin M Tabish, Joseph T Featherall, Reece M Rosenthal, Travis G Maak, Stephen K Aoki, Justin J Ernat
OBJECTIVE: Patellar height changes after tibial tubercle osteotomy (TTO) have not yet been described. We aimed to evaluate whether TTO ± medial patellofemoral ligament reconstruction (MPFL-R) influences patellar height and tendon length, hypothesizing that TTO would decrease patellar height and tendon length. METHODS: A retrospective review was performed of skeletally mature adolescents (<18 y) receiving primary anteromedialization or medialization TTO ± MPFL-R...
June 21, 2024: Journal of Pediatric Orthopedics
Roland A Howard, Jose A Morales, Angel Ordaz, Tracey P Bryan, Eric W Edmonds
BACKGROUND: Disparity in surgical care of patellar instability patients has not been fully investigated in the adolescent Hispanic population. This demographic has been shown to have differences in their care, including a lower rate of surgical treatment for patellar instability. Socioeconomic factors have been cited as a factor that influences patient outcomes and its relationship with ethnicity in context of patellar instability has not been evaluated. METHODS: Review performed of patients <19 years of age who underwent MPFL reconstruction between September 2008 and December 2015...
June 21, 2024: Journal of Pediatric Orthopedics
Amerendra Kumar Singh, Parmanand Gupta, Siddarth Kamath, Devendra Moturu, Jonathan Reddy, Siddardha Moka, Ravi Jethwa, Sumukh Shail, Dhiren Ganjwala, Hitesh Shah
OBJECTIVE: To the best of our knowledge, there is no study comparing the inter and intraobserver reliability of current classifications for postseptic hip sequelae in children. The current study aims to assess the interobserver and intraobserver reliability of four current classifications and identify hips that could not be classified in each classification system. METHODS: The hip radiographs of 148 consecutive children with sequelae of sepsis of the hip from 2 centers were assessed after a minimum of 2 years of follow-up after sepsis...
June 20, 2024: Journal of Pediatric Orthopedics
Ridge Maxson, Christopher R Leland, Prashant Meshram, Sarah I Goldfarb, Laurence Okeke, Edward G McFarland
BACKGROUND: Dog walking is associated with a significant injury burden among adults, but the risk of injury associated with dog walking among children is poorly understood. This study describes the epidemiology of children treated at US emergency departments for injuries related to leash-dependent dog walking. METHODS: The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed to identify children (5 to 18 years of age) presenting to US emergency departments between 2001 and 2020 with dog walking-related injuries...
June 19, 2024: Journal of Pediatric Orthopedics
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