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Journal of Pediatric Orthopedics

Senol Bekmez, Ayaz Afandiyev, Ozgur Dede, Eda Karaismailoğlu, Halil G Demirkiran, Muharrem Yazici
BACKGROUND: Magnetically controlled growing rod (MCGR) concept was introduced with the premise of minimizing the repetitive lengthening surgeries, which is default in traditional growing rod (TGR) treatment for early-onset scoliosis (EOS). Despite good radiographic outcomes, previous studies did not compare identical patient groups in terms of etiology and deformity characteristics; therefore, a true comparison of the MCGR and TGR is essential. This study was designed to compare 2 techniques in terms of clinical, radiologic, and health-related quality of life (HRQoL) outcomes...
October 11, 2018: Journal of Pediatric Orthopedics
Elizabeth A Rapp van Roden, Robert Tyler Richardson, Stephanie A Russo, William C Rose, Kristen F Nicholson, Ross S Chafetz, Peter G Gabos, Suken A Shah, Amer F Samdani, James G Richards
BACKGROUND: Nonsurgically treated patients with AIS demonstrate altered scapular kinematics and decreased patient-reported shoulder function compared with typically developing adolescents. It is unknown whether surgical correction of the spine deformity has beneficial or detrimental effects on scapulothoracic joint function, as previous assessments of shoulder function following surgery have only focused on humerothoracic motion. The objective of this study was to perform a comprehensive analysis of scapular kinematics before and after PSF and compare postoperative scapular kinematics in AIS to those of a typically developing cohort...
October 11, 2018: Journal of Pediatric Orthopedics
Melissa Wallace, David B Johnson, William Pierce, Christopher Iobst, Anthony Riccio, R Lane Wimberly
BACKGROUND: We assessed the effect on the torsional stability by different pin diameters and varied pin configurations in a biomechanical supracondylar humerus fracture model. METHODS: After scanning a model of a pediatric humerus, the image was imported into software. Variable pin trajectories were planned. Acrylonitrile butadiene styrene plastic models were 3-dimensionally printed with predetermined pin trajectories. Models were osteotomized and potted with a polyurethane resin...
October 8, 2018: Journal of Pediatric Orthopedics
Jason P Caffrey, Megan E Jeffords, Christine L Farnsworth, James D Bomar, Vidyadhar V Upasani
BACKGROUND: Children with developmental dysplasia of the hip may require a pelvic osteotomy to treat acetabular dysplasia. Three osteotomies are commonly performed in these patients (Pemberton, Dega, and San Diego), though comparative studies of each are limited. The purpose of this study was to compare changes in acetabular morphology (acetabular version, volume, and octant coverage angles) created by these 3 osteotomies using matched patient-specific 3D-printed pelvic models. METHODS: Fourteen patients with developmental dysplasia of the hip and preoperative computed tomography (CT) imaging were retrospectively included...
October 8, 2018: Journal of Pediatric Orthopedics
Walter H Truong, Meghan J Price, Kunal N Agarwal, Joash R Suryavanshi, Sahana Somasegar, Micha Thompson, Peter D Fabricant, Emily R Dodwell
PURPOSE: Clinical changes are best evaluated with standardized, validated outcomes, including both patient-reported outcome measures and surgeon-reported outcome measures (PROMs and SROMs). The purpose of this study was to describe the spectrum of outcome measures used in pediatric orthopaedic publications over the past 10 years and to determine the proportion that are in fact age-appropriate, validated, and appropriately applied in terms of condition and population. METHODS: The Journal of Bone and Joint Surgery, The Bone and Joint Journal, Journal of Pediatric Orthopaedics A and B, and Journal of Children's Orthopaedics were systematically searched for studies including children aged 18 and below, over a 10-year period from January 2005 to December 2014...
October 8, 2018: Journal of Pediatric Orthopedics
Rachel M Thompson, Joanna Foley, Luciano Dias, Vineeta T Swaroop
BACKGROUND: Nearly 50% of individuals with myelomeningocele will develop a dislocated hip by skeletal maturity. The purpose of this study was to determine the influence of hip status on functional outcomes in a cohort of adult patients with myelomeningocele. METHODS: Patients with a diagnosis of myelomeningocele >18 years were prospectively enrolled over a 12-month period. Neurological level of involvement was obtained from chart review and interview. Clinical examination included hip range of motion and leg-length discrepancy...
October 8, 2018: Journal of Pediatric Orthopedics
Emilie Amaro, Tanya K Marvi, Samuel L Posey, Michael A Benvenuti, Thomas J An, Kevin M Dale, Steven A Lovejoy, Jeffrey E Martus, Megan E Johnson, Gregory A Mencio, Stephanie N Moore-Lotridge, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: The rate of venous thromboembolism in children with musculoskeletal infections (MSKIs) is markedly elevated compared with hospitalized children in general. Predictive biomarkers to identify high-risk patients are needed to prevent the significant morbidity and rare mortality associated with thrombotic complications. We hypothesize that overactivation of the acute phase response is associated with the development of pathologic thrombi and we aim to determine whether elevations in C-reactive protein (CRP) are associated with increased rates of thrombosis in pediatric patients with MSKI...
October 8, 2018: Journal of Pediatric Orthopedics
Gregory J Redding, Heidi Hurn, Klane K White, Viviana Bompadre, Julia Emerson, R Zachary Garza, Kendall Anigian, John Waldhausen, Walter Krengel, Ajeya Joshi
BACKGROUND: Obstructive lung disease occurs in 30% of children with early onset scoliosis (EOS); changes in degree of airway obstruction over time have not been reported. METHODS: Longitudinal patterns of incidental, persistent, and progressive airway obstruction were retrospectively analyzed in a cohort of children with EOS with at least 1 forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) value <85% on serial spirometric assessments over a ≥3-year observation period...
October 8, 2018: Journal of Pediatric Orthopedics
Robert C Spang, Frances A Tepolt, Nikolaos K Paschos, Lauren H Redler, Eric A Davis, Mininder S Kocher
OBJECTIVES: A variety of surgical options exist to treat the challenging problem of recurrent patellar instability in children and adolescents. The goal of the current study is to describe a novel combined reconstruction technique of both the medial patellofemoral ligament (MPFL) and the medial quadriceps tendon-femoral ligament (MQTFL) and report patient outcomes of a single-surgeon series. METHODS: All patients studied underwent simultaneous MPFL and MQTFL reconstruction for patellar instability using gracilis allograft...
October 8, 2018: Journal of Pediatric Orthopedics
Melinda S Sharkey, Richard S Feinn, Sean V Cahill, Alexandra Batter, Afamefuna M Nduaguba, Todd Cassese, Cordelia W Carter
BACKGROUND: It has recently been demonstrated that women members of the Pediatric Orthopaedic Society of North America (POSNA) participate at the Annual Meeting at disproportionately lower rates than men members, as defined by accepted abstract(s). We hypothesize that this discrepancy is associated with lower abstract submission rates by women members. METHODS: POSNA membership directories for the years 2012-2015 were used to record the name, sex, membership category, and years of membership for each member...
September 26, 2018: Journal of Pediatric Orthopedics
Derek T Nhan, Jonathan G Schoenecker, A Noelle Larson, Paul D Sponseller
BACKGROUND: The Pediatric Orthopaedic Society of North America (POSNA) funds grants to improve pediatric musculoskeletal care and maximize new knowledge through publications, presentations, and further funding. We assessed the productivity of POSNA grants by number and rate of grant-specific publications, citations, and extramural funding; determined whether project type or completion status was associated with extramural funding; and compared the success of POSNA-funded versus all other podium presentations by publication rate and POSNA awards...
September 26, 2018: Journal of Pediatric Orthopedics
Oussama Abousamra, Paul D Sponseller, Baron S Lonner, Suken A Shah, Michelle C Marks, Patrick J Cahill, Joshua M Pahys, Peter O Newton
BACKGROUND: Intraoperative blood loss during posterior spinal fusion for adolescent idiopathic scoliosis (AIS) has been reportedly associated with multiple factors. This study aims to investigate the effect of thoracic kyphosis on blood loss in AIS spinal fusion. METHODS: Patients with AIS who underwent posterior-only procedures for Lenke I and II type curves were identified. All included patients had intraoperative tranexamic acid. Difference in estimated blood loss per blood volume (EBL/BV) was identified between hypokyphotic curves (-), normal curves (N), and hyperkyphotic curves (+) classified based on Lenke sagittal modifier...
September 26, 2018: Journal of Pediatric Orthopedics
Jayaram K Udupa, Yubing Tong, Anthony Capraro, Joseph M McDonough, Oscar H Mayer, Suzanne Ho, Paul Wileyto, Drew A Torigian, Robert M Campbell
BACKGROUND: Over the past 100 years, many procedures have been developed for correcting restrictive thoracic deformities which cause thoracic insufficiency syndrome. However, none of them have been assessed by a robust metric incorporating thoracic dynamics. In this paper, we investigate the relationship between radiographic spinal curve and lung volumes derived from thoracic dynamic magnetic resonance imaging (dMRI). Our central hypothesis is that different anteroposterior major spinal curve types induce different restrictions on the left and right lungs and their dynamics...
September 20, 2018: Journal of Pediatric Orthopedics
Robert B Lewis, Omar Hariri, Marilyn E Elliott, Chan-Hee Jo, Brandon A Ramo
BACKGROUND: Health care in America continues to place more importance on providing value-based medicine. Medicare reimbursements are increasingly being tied to this and future policy changes are expected to reinforce these trends. Recent literature has shown pediatric femur fractures in preschool-age children have equivalent clinical and radiographic outcomes when treated with spica casting or flexible intramedullary nails (IMN). We compared hospital care statistics including charges for nonoperative versus operative treatment for closed femur fractures in 3- to 6-year-olds...
September 18, 2018: Journal of Pediatric Orthopedics
Doron Keshet, Alexander Katzman, Michael Zaidman, Mark Eidelman
PURPOSE: Correcting lower limb angular deformities in the skeletally immature patient with guided growth is a very common procedure. Using an 8-plate construct to produce reversible hemiepiphysiodesis allows correction of the mechanical axis of the limb. It has become routine strategy to remove only the metaphyseal screw from the 8-plate construct after desired correction is achieved, in order to ease its reinsertion in case of deformity recurrence. In this study, we evaluated the efficacy and safety of this technique...
September 14, 2018: Journal of Pediatric Orthopedics
Alex Aarvold, Emily K Schaeffer, Simon Kelley, Nicholas M P Clarke, Jose A Herrera-Soto, Charles T Price, Kishore Mulpuri
BACKGROUND: Infants with dislocated irreducible (D/I) hips can be substantially harder to treat than infants with dislocated but reducible hips. The purpose of this study was to compare treatment methods and outcomes for infants with D/I hips in order to optimize management of this difficult patient cohort. METHODS: A multicenter prospective hip dysplasia study database was analyzed from 2010 to 2016. Infants aged below 6 months with clinically and radiologically confirmed D/I hips were included in the study...
September 12, 2018: Journal of Pediatric Orthopedics
Joshua M Abzug, Theresa O Wyrick-Glover, Alexandria L Case, Dan A Zlotolow, Scott H Kozin
BACKGROUND: Loss of midline function impairs the child's ability to perform certain activities of daily living such as dressing, buttoning, and perineal care. The purpose of this study was to assess brachial plexus birth palsy (BPBP) patients with loss of midline function with respect to etiology and treatment. METHODS: A retrospective review of all BPBP patients with loss of midline function was performed. The modified Mallet scale was used with internal rotation assessed via hand on spine and hand to belly...
September 11, 2018: Journal of Pediatric Orthopedics
Don T Li, Jonathan J Cui, Havalee T Henry, Daniel R Cooperman
BACKGROUND: Walker and Goldsmith's classic article on fetal hip joint development reported that neck/shaft angle did not change from 12 weeks of gestational age through term while version increased from 0 to 40 degrees. This suggests no change in coronal alignment during development, a conclusion we dispute. By re-examining their data, we found that the true neck/shaft angle (tNSA) decreased by 7.5 degrees as version increased by 40 degrees from 12 weeks of gestational age to term. METHODS: Four investigators measured both femoral version and neck-shaft angle from photographs published by the authors of femurs at multiple stages of maturation from 12 weeks of gestational age to term...
September 11, 2018: Journal of Pediatric Orthopedics
Robert Ravinsky, James Rofaiel, Benjamin G Escott, Zachary Lim, Bheeshma Ravi, Andrew Howard
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is a well-characterized disorder of the hip seen in adolescent patients. It is characterized by deformity secondary to failure through the proximal femoral growth plate, which results in posterior-inferior displacement of the epiphysis on the proximal femoral metaphysis. Long-term sequelae of SCFE may include osteonecrosis, residual deformity, leg length discrepancy, degenerative joint disease, and chronic pain. The long-term consequences of SCFE may be the source of significant morbidity for the patient, and depending of the local incidence of this condition, may represent a significant expenditure of health care resources...
September 7, 2018: Journal of Pediatric Orthopedics
Karan Dua, Nathan N O'Hara, Igor Shusterman, Joshua M Abzug
BACKGROUND: Phalangeal neck fractures are commonly dorsally displaced and angulated. Surgical treatment is often necessary to restore the retrocondylar recess. The purpose of this study was to determine whether radiographic landmarks can serve as a reference tool for assessing phalangeal neck fracture alignment based on age and sex. METHODS: In total, 1061 lateral finger radiographs that were interpreted as "normal" by pediatric radiologists in children aged 1 to 18 years were retrospectively reviewed...
September 7, 2018: Journal of Pediatric Orthopedics
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