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Journal of Pediatric Orthopedics

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https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#1
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106674/open-surgical-release-of-posttraumatic-elbow-contracture-in-children-and-adolescents
#2
Samantha L Piper, Lisa L Lattanza, Tony S Shen, Lindley B Wall, Charles A Goldfarb
BACKGROUND: Posttraumatic elbow contractures in children and adolescents are challenging to manage, and studies investigating surgical treatment are limited by the rarity of this condition. Small case series have shown variable gains in immediate and long-term elbow arc of motion after open surgical release. We reviewed our experience with open surgical release of posttraumatic elbow contracture in patients <21 years old at 2 institutions. METHODS: A retrospective chart review identified patients who underwent posttraumatic open elbow contracture release by 2 surgeons at 2 institutions between 2006 and 2013...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#3
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28098581/timing-of-pavlik-harness-initiation-can-we-wait
#4
Jill E Larson, Anay R Patel, Brian Weatherford, Joseph A Janicki
BACKGROUND: Developmental dysplasia of the hip is effectively treated with a Pavlik harness (PH) within the first 6 months of life. Over 80% of unstable hips in the newborn period will naturally stabilize by 2 months of age. If there is no difference in the effectiveness of initiating PH treatment at 1 week compared with 4 weeks of age, waiting may allow the hips to naturally stabilize and avoid treatment. The purpose of this study is to evaluate whether the timing of PH implementation influences its effectiveness in the treatment of developmental dysplasia of the hip...
January 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060181/predicting-periarticular-infection-in-children-with-septic-arthritis-of-the-hip-regionally-derived-criteria-may-not-apply-to-all-populations
#5
Christian A Refakis, Alexandre Arkader, Keith D Baldwin, David A Spiegel, Wudbhav N Sankar
BACKGROUND: The management of septic arthritis of the hip in children can be complicated by the presence of additional coexisting periarticular infections (PAIs). Criteria predicting the presence of PAI have recently been proposed by Rosenfeld and colleagues with the goal of using magnetic resonance imaging (MRI) efficiently in the workup of septic arthritis. The purpose of this study was to determine the applicability of recently published predictive criteria for PAI (developed in the Southwestern United States using a variety of joints) to septic arthritis of the hip treated at a large Northeastern tertiary care center...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060180/new-single-stage-double-osteotomy-for-late-presenting-infantile-tibia-vara-a-comprehensive-approach
#6
Edward Abraham, David Toby, Michelle Welborn, Cory W Helder, Angela Murphy
BACKGROUND: Successful surgical treatment of late-presenting infantile tibia vara (ITV) patient requires the correction of oblique deformities. The purpose of this study was to report on a new comprehensive approach to correct and prevent recurrence of these deformities with a single procedure. METHODS: Medical records of 23 consecutive children (7 to 18 y) with advanced ITV (29 knees) were retrospectively reviewed after a mean of 7.3 years postoperatively (range, 2 to 22 y)...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060179/uniplanar-versus-fixed-pedicle-screws-in-the-correction-of-thoracic-kyphosis-in-the-treatment-of-adolescent-idiopathic-scoliosis-ais
#7
Siddharth A Badve, Ryan C Goodwin, David Gurd, Thomas Kuivila, Swamy Kurra, William F Lavelle
BACKGROUND: The aim of surgical treatment of scoliosis is to obtain fusion of the spinal column, balanced in the coronal and sagittal planes. Great success has been attained with coronal correction; however, the sagittal profile has received less attention, resulting in little correction of sagittal plane alignment. The purpose of this study was to compare uniplanar and fixed pedicle screws in the correction of the thoracic sagittal alignment in the treatment of adolescent idiopathic scoliosis (AIS)...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060178/assessment-of-splints-applied-for-pediatric-fractures-in-an-emergency-department-urgent-care-environment
#8
Joshua M Abzug, Brandon S Schwartz, Aaron J Johnson
BACKGROUND: Fractures are common in the pediatric population. The initial evaluation is rarely by an orthopaedic surgeon, but commonly an emergency room or urgent care center physician/extender. This typically involves splint application by a nonorthopaedist to immobilize the extremity and provide stabilization. Iatrogenic injuries from inappropriate splint placement are a potential public health and legal concern that can lead to complications. The primary purpose of this study was to prospectively evaluate the adequacy of all splints placed on patients who presented to a pediatric orthopaedic office; secondary outcomes included assessing prevalence and types of complications that were associated with inadequate splints...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060177/influence-of-insurance-type-on-the-access-to-pediatric-care-for-children-with-distal-radius-torus-fractures
#9
Harrison Potak, Christopher A Iobst
BACKGROUND: Previous literature has demonstrated that pediatric orthopaedic patients with private insurance have less difficulty obtaining appointments than those with Medicaid. Not all injuries of an orthopaedic nature, however, require specialist care. This study evaluated the willingness of pediatricians to provide care for minor orthopaedic injuries and whether or not the patient's insurance status influenced the decision to provide care. METHODS: Ninety-nine pediatric primary care offices were randomly selected from 2 regions in Florida...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28060176/bone-morphogenetic-proteins-in-pediatric-spinal-arthrodesis-a-statewide-analysis-of-trends-and-outcome-of-utilization
#10
Benedict U Nwachukwu, William W Schairer, Ting Pan, Roger F Widmann, John S Blanco, Daniel W Green, Stephen Lyman, Emily R Dodwell
INTRODUCTION: Bone morphogenetic protein (BMP) is considered off-label when used to augment spinal arthrodesis in children and adolescents. There is a paucity of longer-term information on BMP use in this population. The purpose of this study was to determine the rate of BMP utilization in pediatric spinal arthrodesis, assess factors associated with BMP use in this population, and evaluate long-term outcome. METHODS: Spinal arthrodeses in patients 18 years and younger performed in New York State between 2004 and 2014 were identified through the Statewide Planning and Research Cooperative System database...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28027146/gradual-deformity-correction-in-blount-disease
#11
Stephanie W Mayer, Elizabeth W Hubbard, Dan Sun, Robert K Lark, Robert D Fitch
BACKGROUND: Blount disease is a disorder of the posteromedial proximal tibial physis which causes a progressive varus, procurvatum, and internal rotation deformity of the tibia. Untreated, it can cause significant limb malalignment. The goal of this study is to evaluate the results of correction of Blount disease using types of external fixation. METHODS: We conducted a retrospective review of 41 patients (51 limbs) who underwent correction of Blount disease with an Ilizarov external fixator or a Taylor spatial frame (TSF) by a single surgeon...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#12
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28027144/orthopaedic-surgery-in-dystonic-cerebral-palsy
#13
Francesco C Blumetti, Jenny Chia Ning Wu, Federica Barzi, Matthias W Axt, Mary-Clare Waugh, Paulo Selber
BACKGROUND: Outcomes after orthopaedic interventions in patients with dystonic cerebral palsy (DCP) are historically regarded as unpredictable. This study aims to evaluate the overall outcome of orthopaedic surgery in children with DCP. METHOD: Children with DCP who underwent lower limb orthopaedic surgery with a minimum follow-up of 12 months were included. Data collected included age at time of surgery, surgical procedures performed, Gross Motor Function Classification System (GMFCS) level, and Barry Albright Dystonia Scale (BADS) score...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009802/benign-osteolytic-lesions-in-children-with-previously-normal-radiographs
#14
Emily Tan, Charles T Mehlman, Michael Baker
BACKGROUND: Benign bone tumors are common in children and are usually diagnosed incidentally or after pathologic fractures. However, case reports of children with lytic lesions with previously normal radiographs are rare. This series presents several such cases. METHODS: This was a retrospective case series of 8 benign osteolytic lesions in 8 pediatric patients (5 female and 3 males). All have previous radiographs of the effected extremity showing no pathology. All participants were at a single institution...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009801/classification-of-cruciate-ligament-dysplasia-and-the-severity-of-congenital-fibular-deficiency
#15
Janet L Walker, Todd A Milbrandt, Henry J Iwinski, Vishwas R Talwalkar
BACKGROUND: Dysplasia of the cruciate ligaments has been found in many patients with congenital fibular deficiency. A recent classification system has shown that radiographic tibial spine changes can predict the hypoplasia and aplasia of the cruciate ligaments. We used this radiographic classification to determine the frequency of these abnormalities and how they correlate with the severity of fibular deficiency and lateral femoral condylar hypoplasia. METHODS: Using a hospital database search for fibular deficiency, 99 patients ≥6 years with unilateral fibular deficiency were identified...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009800/is-there-value-in-having-radiology-provide-a-second-reading-in-pediatric-orthopaedic-clinic
#16
Vivek Natarajan, Patrick Bosch, Ozgur Dede, Vincent Deeney, Stephen Mendelson, Timothy Ward, Maria Brooks, Tanya Kenkre, James Roach
BACKGROUND: The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009799/percutaneous-hamstring-lengthening-surgery-is-as-effective-as-open-lengthening-in-children-with-cerebral-palsy
#17
Alexander Nazareth, Susan Rethlefsen, Ted C Sousa, Nicole M Mueske, Tishya A L Wren, Robert M Kay
BACKGROUND: Surgical lengthening of the hamstrings is often performed to correct crouch gait in children with cerebral palsy (CP). Previous studies have demonstrated the effectiveness of open hamstring lengthening (oHSL) in improving knee extension static and dynamic range of motion; however, literature regarding percutaneous hamstring lengthening (pHSL) is limited. The purpose of this study was to investigate the effect of open versus pHSL for improving crouch gait and knee function in children with CP...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009798/vitamin-d-deficiency-the-missing-etiological-factor-in-the-development-of-juvenile-osteochondrosis-dissecans
#18
Gerrit S Maier, Djordje Lazovic, Uwe Maus, Klaus E Roth, Konstantin Horas, Jörn B Seeger
BACKGROUND: Vitamin D deficiency can result in rickets and hypocalcemia during infant and childhood growth. There is an increasing interest in the role of vitamin D with regards to childhood bone health. Osteochondrosis dissecans (OD) is a common disease affecting different joints. To date, the exact etiology of OD still remains unclear. The aim of this study was to evaluate a possible association of vitamin D deficiency and juvenile OD. METHODS: A retrospective chart review of the years 2010 to 2015 of all orthopaedic patients with an initial diagnosis of juvenile OD admitted to undergo operative treatment of the OD was performed...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#19
Joshua M Pahys, James T Guille
BACKGROUND: Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27984489/intraobserver-and-interobserver-measurement-variability-of-the-rib-vertebral-angle-difference
#20
Robert G Tysklind, Karen Myung, George Gantsoudes, Shyam Kishan, Chad Turner, Stella Lee, Matthew Wanner, Meagan Sabatino, Scott Linger, Randall T Loder
BACKGROUND: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone...
December 14, 2016: Journal of Pediatric Orthopedics
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