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Journal of Pediatric Orthopedics

Eric Davis, Kathryn Williams, Travis H Matheney, Brian Snyder, Karen J Marcus, Benjamin J Shore
BACKGROUND: Heterotopic ossification (HO) is a well-recognized complication of proximal femoral resection (PFR) surgery in children with cerebral palsy (CP). Although single-dose radiation prophylaxis (SDRP) has been shown to be effective at lowering the rates of HO following adult total hip arthroplasty; there has been limited study examining the efficacy of SDRP for HO prevention in children with CP undergoing PFR. The purpose of this study was to assess the efficacy of SDRP in children with CP undergoing PFR...
December 12, 2018: Journal of Pediatric Orthopedics
Dustin A Greenhill, Shawn Funk, Marilyn Elliot, Chan-Hee Jo, Brandon A Ramo
BACKGROUND: Either casting or in situ fixation (to prevent displacement) are recommended for minimally displaced pediatric lateral condyle fractures of indeterminate stability with ≤2 mm lateral displacement and narrowed fracture extension to the epiphyseal articular cartilage. This study compares casting only, acute prophylactic in situ pinning, and surgery if casting fails due to displacement. METHODS: In total, 738 fractures at a level 1 trauma center between 2008 and 2014 were reviewed...
December 8, 2018: Journal of Pediatric Orthopedics
Kemble K Wang, Tom F Novacheck, Adam Rozumalski, Andrew G Georgiadis
BACKGROUND: Fixed knee flexion deformity is common in children with neuromuscular disorders. Anterior guided growth (AGG) of the distal femur can achieve gradual correction in patients who are skeletally immature. Little outcome data are available on this procedure. METHODS: This is a retrospective matched cohort study. Forty-two knees (26 patients) underwent AGG surgery at our institution between 2007 and 2017. All patients underwent instrumented 3-dimensional gait analysis (3DGA)...
December 8, 2018: Journal of Pediatric Orthopedics
Emmalynn J Sigrist, Nicole E George, Adrienne M Koder, Chukwuweike U Gwam, Jennifer I Etcheson, Martin J Herman
BACKGROUND: Management of pediatric femoral shaft fractures remains controversial, particularly in children between the ages of 6 and 10. In the current push toward cost containment, hospital type, and surgeon subspecialization have emerged as important factors influencing this treatment decision. Thus, in the present study, we use a nationwide pediatric inpatient database to compare the: (a) incidence; (b) demographic characteristics; (c) hospital costs; (d) length of stay; and (e) treatment method of pediatric closed femoral shaft fractures admitted to general versus children's hospitals...
December 8, 2018: Journal of Pediatric Orthopedics
Venkat Kavuri, Gurpal Pannu, Matthew Moront, Peter Pizzutillo, Martin Herman
BACKGROUND: Safe and effective clearance of the pediatric cervical spine presents a challenging problem due to a myriad of reasons, which has often led to further imaging studies such as computed tomographic (CT) scans being performed, exposing the pediatric patient to significant radiation with a potential increased cancer risk. The goal of this study is to develop an effective algorithm for cervical spine clearance that minimizes radiation exposure. METHODS: A cervical spine clearance protocol had been utilized in our institution from 2002 to 2011...
November 30, 2018: Journal of Pediatric Orthopedics
Sally J Tennant, Aresh Hashemi-Nejad, Peter Calder, Deborah M Eastwood
BACKGROUND: Bilateral developmental dysplasia of the hip (DDH) is believed to have a worse outcome than unilateral DDH with the optimal treatment unclear. To define indications for treatment we report a retrospective series of 92 hips (46 patients) who underwent closed reduction (CR) and/or open reduction (OR). METHODS: A total of 58 hips in 29 patients underwent attempted CR using our standardized protocol. In the same 12 year time period, 54 hips in 27 patients underwent an OR...
November 20, 2018: Journal of Pediatric Orthopedics
Michelle C Welborn, Joseph Ivan Krajbich, Charles D'Amato
BACKGROUND: Correction of severe scoliosis through distraction-based techniques poses a challenge. Magnetically controlled growing rod (MCGR) hardware complications are common with a 27.8% to 46.7% revision rate in under 2 years. Loss of correction and diminishing returns are the norm. Treatment of severe scoliosis with halo-gravity traction (HGT) before MCGR has not been previously reported. The purpose of this study was to assess initial correction, maintenance of correction, and complication rate in patients with severe scoliosis treated with and without HGT before MCGR...
November 20, 2018: Journal of Pediatric Orthopedics
Alison J Dittmer, Domingo Molina, Cale A Jacobs, Janet Walker, Ryan D Muchow
INTRODUCTION: Following closed reduction and initial casting of pediatric forearm fractures, loss of reduction (LOR) occurs in ∼5% to 75% of fractures. Sugar-tong splinting has been shown to maintain acceptable reduction in pediatric distal radius fractures while potentially avoiding issues associated with circumferential casting. We hypothesized that the sugar-tong splint would be an acceptable method for initial immobilization to prevent LOR in distal, mid-shaft, and proximal pediatric forearm fractures...
November 20, 2018: Journal of Pediatric Orthopedics
Jesua Law, Jonathan H Shahbazian, Michael J Elliott
BACKGROUND: Magnetic growing rods are being utilized more frequently in children with early-onset scoliosis. Many of these children have multiple medical problems and additional medical devices implanted that utilize similar magnetic technology, including vagal nerve stimulator (VNS) devices. There is some concern that the external remote controller (ERC) used to control the magnetic growth rod will interact with these devices during lengthening procedures. We believe there are safe parameters which allow the magnetic growth rod ERC to be utilized in patients with an implanted VNS...
November 20, 2018: Journal of Pediatric Orthopedics
Masoumeh Abbasi, Soodeh Shahsavari
No abstract text is available yet for this article.
November 20, 2018: Journal of Pediatric Orthopedics
Jue Cao, Brandon S Smetana, Patrick Carry, Kathryn M Peck, Gregory A Merrell
BACKGROUND: Controversy exists with regard to the amount of fracture displacement that warrants surgical fixation of medial epicondyle fractures. Inaccurate determination of degree of displacement on plain radiographs may account for the disputed management. Recently, a novel distal humerus axial radiograph technique has been developed to improve the accuracy of radiographs. The purposes of the study are 2-fold; to identify the anatomic orientation of the medial elbow epicondyle physis in children and to compare the accuracy of determining fracture displacement between axial radiographs and standard anterior-posterior (AP) radiographs in a cadaveric medial epicondyle fracture model...
November 20, 2018: Journal of Pediatric Orthopedics
Mitchel R Obey, Joseph Lamplot, Ena D Nielsen, Lindsay M Andras, Megan Mignemi, Jeffrey Sawyer, John M Flynn, Stephen A Albanese, Pooya Hosseinzadeh
BACKGROUND: Pediatric orthopaedic surgery has become increasingly subspecialized over the past decade. The purpose of this study was to analyze the volume of pediatric sports medicine cases performed by surgeons applying for the American Board of Orthopaedic Surgeons (ABOS) Part II certification exam over the past decade, comparing caseloads according to the type(s) of fellowship completed. METHODS: The ABOS database was reviewed for all surgeons applying for the ABOS Part II certification exam from 2004 to 2014...
November 20, 2018: Journal of Pediatric Orthopedics
Heiko M Lorenz, Lena Braunschweig, Batoul Badwan, Katharina Groenefeld, Marina M Hecker, Konstantinos Tsaknakis, Jasmin Grote, Anna K Hell
PURPOSE: Magnetically controlled implant systems have been established to treat severe progressive spinal deformity in children. The purpose of this study was to evaluate (1) the ratio between achieved and expected distraction length, (2) the complication rate and its risk factors as well as (3) the correlation of the distraction length and the length of the spine. METHODS: A total of 40 patients with an average follow-up of 34 (14 to 57) months were prospectively included in the study...
November 16, 2018: Journal of Pediatric Orthopedics
Noppachart Limpaphayom, Eitan Kohan, Aaron Huser, Malgorzata Michalska-Flynn, Sara Stewart, Matthew B Dobbs
BACKGROUND: Physical therapy (PT) alone is not always effective for treatment of congenital muscular torticollis (CMT). The adjunctive use of botulinum toxin (BTX) injection into the sternocleidomastoid, followed by PT, could provide correction and avoid more invasive surgery. Aims of the study were to review clinical and caregiver-reported outcomes of children with resistant CMT treated by BTX injection combined with a guided-PT program. METHODS: Medical records of consecutive children with resistant CMT treated by our protocol between 2010 and 2015 were reviewed...
November 16, 2018: Journal of Pediatric Orthopedics
Adam Margalit, Ethan Cottrill, Derek Nhan, Lingjia Yu, Xin Tang, Jan Fritz, R Jay Lee
BACKGROUND: The spatial order of physeal maturation around the distal tibia has been shown to place adolescent patients at risk for certain transitional injuries, such as Tillaux or triplane fractures. Less is known about physeal maturation around the knee. The purpose of this study was to establish the spatial order of physeal maturation in the normal human knee using magnetic resonance imaging (MRI). METHODS: We retrospectively collected all knee MRI scans from patients presenting to our institution from January 2004 to January 2014...
November 16, 2018: Journal of Pediatric Orthopedics
Elizabeth W Hubbard, Rachel M Thompson, Chan-Hee Jo, William A Pierce, Anthony I Riccio, Robert L Wimberly
BACKGROUND: It has been shown that retrograde titanium flexible intramedullary nails (Ti FIN) provide superior resistance to bending compared to antegrade Ti FIN in distal femur fractures. The purpose of this study was to compare resistance to torsional and bending forces of stainless steel (SS) FIN, with or without a locking screw, and Ti FIN in distal third femoral shaft fractures. We hypothesize that locked retrograde SS FIN will demonstrate greater resistance to both bending and torsional forces...
November 16, 2018: Journal of Pediatric Orthopedics
Susan E Nelson, Christopher J DeFrancesco, Wudbhav N Sankar
BACKGROUND: The burden of surgical treatment for infantile developmental dysplasia of the hip (DDH) is unknown. We aimed to investigate the epidemiology of operative DDH reductions in the United States and identify potential at-risk populations. METHODS: The Healthcare Utilization Project Kids' Inpatient Database (1997 to 2012) were analyzed. International Classification of Diseases (ICD-9) codes identified inpatient hospitalizations for DDH reductions excluding neuromuscular cases...
November 16, 2018: Journal of Pediatric Orthopedics
Albane B R Maggio, Xavier Martin, Anne Tabard-Fougère, Christina Steiger, Romain Dayer, Cécile Delhumeau, Dimitri Ceroni
BACKGROUND: Loss of bone mineral mass and muscle atrophy are predictable consequences of cast-mediated immobilization following wrist and forearm fractures. This study aimed to prospectively determine whether previously reported lower bone mineral mass following immobilization for wrist and forearm fractures in children and teenagers had recovered at 6- and 18-month follow-up. METHODS: We recruited 50 children and teenagers who underwent a cast-mediated immobilization for a forearm or wrist fracture...
November 16, 2018: Journal of Pediatric Orthopedics
Zachary I Meyer, Paul Krucylak, Michelle Mo, Mark L Miller, Lindley B Wall
BACKGROUND: Opioids are a commonly utilized component of pain management following pediatric extremity fractures, yet an increasing number of adolescents and children are falling victim to their negative effects. The purpose of this study was to examine opioid use in the pediatric fracture population by determining and comparing the average hospital opioid dosage utilized in the operative pediatric elbow and femur fractures and determining and comparing the average dose prescribed following operative treatment of elbow and femur fractures...
November 13, 2018: Journal of Pediatric Orthopedics
Jennifer M Bauer, Petya Yorgova, Geraldine Neiss, Kenneth Rogers, Peter F Sturm, Paul D Sponseller, Scott Luhmann, Jeff B Pawelek, Suken A Shah
BACKGROUND: Modern treatment of early onset scoliosis (EOS) includes implantation of traditional growing rods (TGR) or magnetically controlled growing rods (MCGR) for posterior-based distraction if nonoperative treatment plans failed. The recent MCGR innovation has largely been expected to improve patient and family burden by avoiding frequent return to the operating room. At least one study has shown no HRQoL difference between TGR and MCGR, but none have specifically investigated a cohort of conversion patients whose families have experienced both...
November 9, 2018: Journal of Pediatric Orthopedics
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