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Journal of Pediatric Orthopedics

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https://www.readbyqxmd.com/read/29227374/collateral-ligament-knee-injuries-in-pediatric-and-adolescent-athletes
#1
Dennis E Kramer, Patricia E Miller, Iman K Berrahou, Yi-Meng Yen, Benton E Heyworth
BACKGROUND: The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. METHODS: Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29227373/incidence-of-meniscal-entrapment-and-associated-knee-injuries-in-tibial-spine-avulsions
#2
Jason T Rhodes, Peter C Cannamela, Aristides I Cruz, Meredith Mayo, Alexandra C Styhl, Connor G Richmond, Theodore J Ganley, Kevin G Shea
BACKGROUND: Tibial spine avulsions (TSA) have historically been treated as isolated injuries. Data on associated injuries are limited with existing literature reporting wide ranging incidences. The purpose of this multicenter study was to (1) describe the incidence of meniscal entrapment and associated knee injuries in TSA and to (2) compare surgical and magnetic resonance image (MRI) findings for these injuries. Our hypothesis is that tibial spine injuries are not usually isolated injuries, and other meniscal, ligament, and cartilage injuries may be present...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29227372/osteofibrous-dysplasia-of-the-tibia-in-children-outcome-without-resection
#3
Daniel Westacott, Peter Kannu, Jennifer Stimec, Sevan Hopyan, Andrew Howard
BACKGROUND: The proposed association between osteofibrous dysplasia and adamantinoma has led some to advocate resection of the entire lesion, which can require major subsequent reconstruction. However, this link remains unproven and there is some support in more recent literature for a less aggressive approach. This study aims to describe our experience managing pediatric tibial osteofibrous dysplasia with such an approach and to report functional outcomes in children treated thus. METHODS: A total of 28 cases of osteofibrous dysplasia in 25 patients were managed at a referral center for pediatric bone tumors with observation in the first instance, then limited surgical intervention if required to address pain and deformity...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29227371/a-quality-improvement-initiative-reduces-cast-complications-in-a-pediatric-hospital
#4
Julie Balch Samora, Walter P Samora, Kevin Dolan, Kevin E Klingele
BACKGROUND: Casts, while frequently used as routine treatment in pediatric orthopaedic practice, are not without complications. At our large tertiary care pediatric hospital, the baseline rate of all casting complications was 5.6 complications per 1000 casts applied (0.56%). We tested the hypothesis that we could use quality improvement (QI) methodology to decrease the overall cast complication rate and improve patient care. METHODS: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act cycles, to decrease our cast complication rate...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29227370/c1-c2-pedicle-screw-fixation-for-pediatric-atlantoaxial-dislocation-initial-results-and-long-term-follow-up
#5
Zhi-Da Chen, Jin Wu, Cheng-Wu Lu, Wen-Rong Zeng, Zhuan-Zhi Huang, Bin Lin
BACKGROUND: There are few studies reporting the use of atlantoaxial pedicle screws and the long-term effects of C1-C2 posterior fusion in children. Our study is to investigate the initial results of C1-C2 pedicle screw fixation for pediatric atlantoaxial dislocation (AAD) and assessed spontaneous change of postoperative radiography after a long-term follow-up period. METHODS: Posterior pedicle screw fixations were performed in 21 pediatric patients with AAD. All the patients underwent implant removal 1 year after their initial surgery and had regular follow-up with an average duration of 76...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29219855/determining-hinge-abduction-in-legg-calv%C3%A3-perthes-disease-can-we-reliably-make-the-diagnosis
#6
Benjamin J Shore, Patricia E Miller, Ira Zaltz, Perry L Schoenecker, Wudbhav N Sankar
BACKGROUND: Although hinge abduction is recognized as an important finding in children with Legg-Calvé-Perthes disease, variable diagnostic criteria exist. The purpose of this study was (1) to test the interobserver and intraobserver agreement of the current definition of hinge abduction and (2) to develop consensus regarding key diagnostic features that could be used to improve our diagnostic criteria. METHODS: Four orthopaedic surgeons with subspecialty pediatric hip interest independently assessed 30 randomly ordered cases of Legg-Calvé-Perthes disease...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29219854/reconstruction-of-the-scapula-in-pediatric-and-adolescent-patients-after-total-scapulectomy-a-report-of-10-patients-treated-by-extracorporeal-irradiation-and-reimplantation-of-the-scapula
#7
Ahmed M El Ghoneimy, Mohamed S Zaghloul, Iman Zaky, Hala Taha, Ahmed Elgammal, Magdy El Sherbiny, Nehal Kamal
BACKGROUND: Ewing sarcoma of the scapula is uncommon. Restoration of shoulder function after total scapulectomy is challenging. Extracorporeal irradiation and reimplantation is a well-known method of biological reconstruction in orthopaedic oncology; yet very few reports in the literature describe its specific use in tumors of the scapula. PATIENTS AND METHODS: Ten patients with the diagnosis of Ewing sarcoma of the scapula were surgically treated by total scapulectomy and extracorporeal irradiation and reimplantation of the scapula...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29176457/a-frame-free-vascularized-fibular-graft-and-femoral-lengthening-for-osteosarcoma-pediatric-patients
#8
Megan Cashin, Christopher Coombs, Ian Torode
BACKGROUND: Pediatric limb reconstruction after resection of a malignant tumor presents specific challenges. Multiple surgical techniques have been used to treat these patients. This paper describes a staged surgical technique for the reconstruction of large distal femoral defects due to tumor resection in skeletally immature patients. METHODS: Three pediatric patients with osteosarcoma of the distal femur underwent staged reconstruction. Neoadjuvant chemotherapy was followed by en bloc tumor resection and immediate reconstruction of the distal femoral defect with a vascularized free fibular autograft utilizing a unique A-frame construct combined with intramedullary nail fixation...
November 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29166293/applicability-of-the-calcaneal-apophysis-ossification-staging-system-to-the-modern-pediatric-population
#9
Samuel Q Li, Allen D Nicholson, Daniel R Cooperman, Raymond W Liu
BACKGROUND: The calcaneal apophysis ossification staging system is a novel method for assessing skeletal maturity. However, it was created using the same historic patient population that was used to create the Greulich and Pyle atlas of the hand and wrist, predominantly white children. It is unclear if the calcaneal apophysis ossification staging system is still applicable to the modern pediatric population and to children of other races. METHODS: We retrospectively studied 1327 benign lateral foot x-rays from modern white and black children...
November 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189474/pediatric-acl-reconstruction-and-return-to-the-operating-room-revision-is-less-than-half-of-the-story
#10
Christopher J DeFrancesco, Eileen P Storey, John M Flynn, Theodore J Ganley
BACKGROUND: Although there are several causes of unplanned return to the operating room (RTOR) following pediatric anterior cruciate ligament (ACL) reconstruction (ACLR), prior outcomes studies focus primarily on the risk of graft failure. We sought to comprehensively describe indications for RTOR in pediatric primary ACLR patients, estimate associated rates of RTOR, and assess the impact of concomitant meniscal procedures on these rates. METHODS: This retrospective cohort study considered patients who underwent primary ACLR at an urban, pediatric tertiary care hospital between 2013 and 2015...
November 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189538/what-s-new-in-pediatric-sports-conditions-of-the-knee
#11
Aristides I Cruz, Connor G Richmond, Marc A Tompkins, Ann Heyer, Kevin G Shea, Jennifer J Beck
BACKGROUND: Sports injuries are common in pediatric and adolescent patients and the evaluation and treatment of these injuries continues to evolve. The purpose of this review is to provide a comprehensive appraisal of the literature, highlighting recent updates on sports-related knee injuries in the pediatric athlete. We specifically examined literature on tibial spine fractures, osteochondritis dissecans (OCD) of the knee, and patellar instability. Because of the volume of literature on the subject, pediatric, and adolescent anterior cruciate ligament injuries were not included in this review...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189537/bipolar-sealer-devices-used-in-posterior-spinal-fusion-for-neuromuscular-scoliosis-reduce-blood-loss-and-transfusion-requirements
#12
Christina K Hardesty, Zachary L Gordon, Connie Poe-Kochert, Jochen P Son-Hing, George H Thompson
BACKGROUND: Reducing perioperative blood loss and the need for transfusions in patients undergoing spinal surgery is especially important for those with neuromuscular disorders. These patients require extensive spino-pelvic exposure and are often medically fragile. We have used Amicar to decrease blood loss since 2001. As an effort to further reduce blood loss and transfusions, we use a bipolar sealer device (Aquamantys) as an adjunct to electrocautery. We present the results of our first 64 neuromuscular patients to show the efficacy of the device...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189536/incidence-of-fractures-from-perioperative-blood-pressure-cuff-use-tourniquet-use-and-patient-positioning-in-osteogenesis-imperfecta
#13
Brian T Sullivan, Adam Margalit, Vaibhav S Garg, Dolores B Njoku, Paul D Sponseller
BACKGROUND: Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI. METHODS: We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189535/torsional-growth-modulation-of-long-bones-by-oblique-plating-in-a-rabbit-model
#14
David E Lazarus, Christine L Farnsworth, Megan E Jeffords, Nikolas Marino, Jericho Hallare, Eric W Edmonds
BACKGROUND: There is evidence that oblique tension band plating can affect torsional growth in long bones. This study sought to determine if the torsional growth could be modulated based on the angles of the tension band plating and whether or not oblique plating affected overall longitudinal growth. METHODS: New Zealand White rabbits (10.5 wk old) had one screw placed on the metaphyseal side and one on the epiphyseal side of both medial and lateral sides of the right knee distal femoral physis...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189534/pediatric-orthopaedic-surgeons-dissatisfied-in-on-call-practices-despite-improving-call-conditions-the-2015-posna-membership-survey-regarding-trauma-care
#15
Allison Lind, Kevin Latz, Mark R Sinclair, David D Williams
BACKGROUND: To examine the current trends in trauma call coverage of pediatric orthopaedic surgeons in North America and to identify predictors of surgeon on-call satisfaction. METHODS: In 2015, ∼1200 active members of the Pediatric Orthopaedic Society of North America (POSNA) were surveyed regarding emergency room on-call practices. In total, 410 members completed the survey with a response rate of 35%. Information collected included call frequency, practice setting and satisfaction with call...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189533/experimental-induction-of-physeal-injuries-by-fracture-drill-and-ablation-techniques-analyses-of-immunohistochemical-findings
#16
Helen E Gruber, Nomaan Ashraf, Michael D Cox, Jane A Ingram, Megan Templin, John Michael Wattenbarger
BACKGROUND: Although physeal fractures and physeal bars can result in significant clinical consequences to growth and development of the injured physis, little orthopaedic research has focused upon this topic. Our objective was to extend a previously developed rat model to examine the immunohistochemical features following surgical application of techniques disrupting the physis. METHODS: Physes were surgically disrupted using fracture (control), epiphyseal scrape (ES), or epiphyseal drill (ED)...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189532/pediatric-supracondylar-humerus-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-pediatric-level-1-trauma-center
#17
Joanne H Wang, William Z Morris, Blaine T Bafus, Raymond W Liu
OBJECTIVES: The purpose of this study was to characterize management of supracondylar humerus fractures (SCHFs) at a level 1 trauma center and identify factors contributing to divergence in management from American Academy of Orthopedic Surgeons (AAOS) the Appropriate Use Criteria (AUC) recommendations. METHODS: A query revealed 556 patients with diagnoses of SCHF between 2013 and 2015 at a pediatric level 1 trauma center. Patients were excluded if they were younger than 2 years of age, older than 12 years of age, were polytrauma patients, or if there was not sufficient clinical or radiographic documentation, resulting in 449 patients...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189531/characterization-of-american-football-injuries-in-children-and-adolescents
#18
Patrick J Smith, Anthony M Hollins, Jeffrey R Sawyer, David D Spence, Shane Outlaw, Derek M Kelly
BACKGROUND: As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern. METHODS: Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189530/outcomes-of-hip-arthroscopy-in-adolescents-a-comparison-of-acute-versus-chronic-presentation-two-year-minimum-follow-up
#19
Lyall Ashberg, John P Walsh, Leslie C Yuen, Itay Perets, Edwin O Chaharbakhshi, Benjamin G Domb
BACKGROUND: Hip arthroscopy has been shown to be effective in managing various hip pathologies, including labral tears in adolescent patients. The purpose of this study was to ascertain whether outcomes of hip arthroscopy in patients under the age of 18 treated for labral tears differ depending on whether the presentation was acute or chronic. We also present the outcomes of the largest prospectively collected study on hip arthroscopy performed for labral tears in adolescents. METHODS: Patient reported outcome scores (PROs) for 194 patients undergoing hip arthroscopy for hip pathology, who were 18 or under at the time of surgery were prospectively collected and retrospectively reviewed...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189529/trends-in-management-and-complications-of-anterior-cruciate-ligament-injuries-in-pediatric-patients-a-survey-of-the-prism-society
#20
Charles A Popkin, Margaret L Wright, Andrew T Pennock, Laura A Vogel, Ajay Padaki, Lauren H Redler, Christopher S Ahmad
BACKGROUND: Anterior cruciate ligament (ACL) injuries have been recognized and treated with increasing frequency in children and adolescents. ACL reconstruction (ACLR) in skeletally immature patients has unique considerations and there is a large practice variation in the management of these injuries. The purpose of this study was to survey the members of the Pediatric Research in Sports Medicine (PRiSM) Society regarding their experience with the management and complications of pediatric ACL injuries...
November 16, 2017: Journal of Pediatric Orthopedics
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