Journal of Pediatric Orthopaedics最新文献

{"title":"Epidemiology of Acute Compartment Syndrome After Pediatric Tibial Tubercle and Tibial Shaft Fractures.","authors":"John D Milner, Michael A Bergen, Helen Zhang, Tucker C Callanan, Jonathan Liu, Rigel P Hall, Alan H Daniels, Aristides I Cruz","doi":"10.1097/BPO.0000000000002855","DOIUrl":"10.1097/BPO.0000000000002855","url":null,"abstract":"<p><strong>Background: </strong>While acute compartment syndrome (ACS) is a well-reported complication after pediatric tibial shaft fractures, prior literature has suggested that pediatric patients with tibial tubercle fractures may be at increased risk of ACS due to the proximity of the tibial tubercle to the anterior tibial recurrent artery. However, this theory was largely based on a series of early case reports without substantiation in larger-scale studies.</p><p><strong>Hypothesis/purpose: </strong>The purpose of this study is to conduct a population-level analysis of the incidence and risk factors of acute compartment syndrome following pediatric tibial tubercle and tibial shaft fractures. We hypothesize that the rate of ACS would be lower in patients with tibial tubercle fractures when compared with those with tibial shaft fractures.</p><p><strong>Methods: </strong>A retrospective cohort analysis of the PearlDiver Mariner database was performed by querying all patients diagnosed with tibial tubercle and tibial shaft fractures between January 2010 and October 2022. Matched cohorts (n=25,483) of patients with pediatric tibial tubercle and tibial shaft fractures were captured using International Classification of Diseases, Ninth Revision (ICD-9), Tenth Revision (ICD-10) billing codes, and age as inclusion/exclusion criteria. Rates of subsequent compartment syndrome were calculated by querying for insurance claims with associated CPT codes for fasciotomy and/or ICD-9/ICD-10 billing codes for compartment syndrome. Student t test and χ 2 analyses were used to compare demographics between the tibial tubercle and tibial shaft cohorts.</p><p><strong>Results: </strong>The rate of ACS was significantly lower in the tibial tubercle cohort (0.46%) than in the tibial shaft cohort (0.70%, P <0.001). Male sex and increased age were associated with an increased risk of developing ACS in both cohorts ( P <0.001). In addition, polytrauma was found to be a risk factor for ACS among patients with tibial shaft fractures ( P <0.001).</p><p><strong>Conclusion: </strong>We report a low rate of ACS following both pediatric tibial tubercle fractures and pediatric tibial shaft fractures. Among patients with tibial tubercle fractures, male sex, and increased age were noted to be risk factors for ACS, whereas male sex, older age, and polytrauma were risk factors for ACS among patients with tibial shaft fractures.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"134-138"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice Patterns Vary Widely in the Care of Pediatric and Adolescent Pelvic and Acetabular Fractures: A CORTICES Survey.","authors":"Brennan Roper, S Rose Purtell, Sayan De, Dell McLaughlin, Walter H Truong, Mark L Miller, Ishaan Swarup, Wendy Ramalingam, Julia S Sanders","doi":"10.1097/BPO.0000000000002847","DOIUrl":"10.1097/BPO.0000000000002847","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric pelvic and acetabular fractures are rare but potentially devastating injuries and significant management variation exists across the United States. This study sought to elucidate treatment decision-making trends, involvement of adult trauma fellowship-trained surgeons in pediatric care, and pre- and postoperative transfer patterns.</p><p><strong>Methods: </strong>Pediatric orthopaedic surgeons who serve as trauma liaisons at 20 PTCs were surveyed regarding training, practice volume, and factors contributing to institutional management of pelvic and acetabular injuries. Five clinical scenarios of pelvic ring and acetabular fractures that varied by injury pattern, age, and sex were presented. Descriptive statistics were used to summarize the results.</p><p><strong>Results: </strong>Eighteen institutions responded to the survey (90% response rate, 16 Level, 1 PTC). All surgeons were pediatric fellowship-trained (77.7% in practice >5 y). The four most common factors affecting whether surgeons independently managed both pelvic ring and acetabular fractures were patient age, fracture characteristics, displacement and need for surgery. The majority reported managing <10 acetabular (72.2%) but >10 pelvic ring (77.8%) injuries per year. In the clinical scenarios, patients <10 were more likely to have treatment decisions made by a pediatric orthopaedic surgeon. Older patients were more likely to be transferred to another institution for surgery but were often transferred back to the PTC postoperatively. In all clinical scenarios other than posterior hip dislocation, a trauma fellowship-trained surgeon was more likely to be the operative surgeon, even when the patient was not transferred.</p><p><strong>Conclusions: </strong>There is substantial variation in the management of pediatric and adolescent pelvic and acetabular fractures. Even at tertiary care PTCs, volumes are low, and trauma fellowship-trained surgeons are often involved in decision-making and operative management. Age and injury pattern seem to play a large role in variation, and patient transfers between facilities are common.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e229-e235"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple Pelvic Osteotomy for Hip Dysplasia: The Akbulut-Coskun Technique Using a Modified Stoppa Approach.","authors":"Deniz Akbulut, Mehmet Coşkun, Abdurrahman Aydin, Fatih Arslanoğlu, Ahmet Sevencan, Yalkin Çamurcu","doi":"10.1097/BPO.0000000000002851","DOIUrl":"10.1097/BPO.0000000000002851","url":null,"abstract":"<p><strong>Background: </strong>Many successful osteotomies have been reported for the treatment of acetabular dysplasia. However, triple pelvic osteotomy remains a technically challenging procedure with potential for significant complications. This study examined a series of Tönnis periacetabular osteotomy (TPAO) procedures performed using the modified Stoppa approach to treat acetabular dysplasia in adolescents.</p><p><strong>Objective: </strong>To describe the radiographic outcomes, complications, and early functional results of TPAO using the modified Stoppa approach for acetabular dysplasia in adolescents.</p><p><strong>Methods: </strong>This study included 16 patients (20 hips) who underwent TPAO using the modified Stoppa approach for symptomatic acetabular dysplasia. The characteristics of the patients and the surgical procedure were discussed. The radiologic outcome was evaluated using the lateral center-edge (CE) and Tönnis roof angles. Perioperative data including surgery duration, blood loss, and complications were recorded. Complications were also discussed.</p><p><strong>Results: </strong>The mean age of the patients was 11.5±1.1 (10 to 13) years. The mean preoperative anteroposterior CE angle was 14.7±3 degrees (7 to 19 degrees), and the mean postoperative angle was 35.7±3.1 degrees (30 to 42 degrees; P <0.001). The mean preoperative Sharp's angle was 55.9±5.4 degrees (48 to 65 degrees), and the postoperative mean was 33±5 degrees (24 to 40 degrees; P <0.001). The mean Tönnis angle before and after osteotomy was 23.3±7.1 degrees (17 to 36 degrees) and 7.1±2 degrees (4 to 10 degrees), respectively ( P <0.001). The mean operative time was 42.2±10.3 minutes with a mean blood loss of 167.7±50.3 mL. One patient sustained a bladder injury as a major complication.</p><p><strong>Conclusions: </strong>The use of TPAO with the intrapelvic modified Stoppa approach in the treatment of hip dysplasia provides the benefits of a single incision, access to 2 hips in the same session, positional advantage, and abductor function preservation. Early results are satisfactory and safe.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"144-151"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Orthopaedic Surgeons Manage Pediatric Diaphyseal Clavicle Fractures Differently Than Nonpediatric Orthopaedic Specialists.","authors":"Margaret J Higgins, Robert W Gomez, Morgan Storino, David Jessen, Zachary J Lamb, Neil Jain, Dustin A Greenhill","doi":"10.1097/BPO.0000000000002858","DOIUrl":"10.1097/BPO.0000000000002858","url":null,"abstract":"<p><strong>Background: </strong>Pediatric clavicle fractures are often managed by physicians with and without pediatric subspecialty training. The aim of this study is to identify if variability of practice exists between pediatric orthopaedic surgeons versus nonpediatric orthopaedic specialists during management of pediatric diaphyseal clavicle fractures.</p><p><strong>Methods: </strong>Patients ≤18 years of age with an acute, closed diaphyseal clavicle fracture treated between January 2018 and July 2023 by a large hospital-employed multispecialty orthopaedic practice (in a regional and academic health network) were retrospectively reviewed. The study involved 26 orthopaedic surgeons (including 3 pediatric, 8 sports medicine, and 6 general) and 11 nonoperative sports medicine physicians, all of which accept patients ranging 0 to 18 years of age. Exclusion criteria included open or impending open fractures and insufficient data. Demographic, radiographic, and outpatient treatment parameters were recorded. Age groups were separated into <10 and ≥10 years old to control for age-associated differences.</p><p><strong>Results: </strong>Among 560 pediatric clavicle fractures, 385 met inclusion criteria (43.6% of which were treated by a pediatric orthopaedic surgeon), and 361 were treated nonoperatively. Follow-up averaged 48.8 days until orthopaedic discharge and 16.9 months until the most recent well-child visit (80% had a well-child visit after orthopaedic discharge). No patient <10 years of age had elective surgery, but pediatric orthopaedic surgeons demonstrated lower surgical rates in adolescent patients than nonpediatric specialties (4.3% vs. 14.4%, OR=3.8, P =0.027). Among the 169 nonoperative patients <10 years of age, pediatric orthopaedic surgeons completed fewer outpatient visits (2.1±0.8 vs. 2.4±0.8, P <0.037), shorter follow-up durations (28.5±18.9 vs. 41.8±22.6 d, P <0.001), less radiographic series (2.1±0.8 vs. 2.4±1.0, P <0.047), and less total radiographs (4.3±1.8 vs. 5.0±2.3, P <0.013) than nonpediatric specialists.</p><p><strong>Conclusions: </strong>The surgical rate of acute, closed diaphyseal clavicle fractures is lower among pediatric versus nonpediatric orthopaedic surgeons in adolescents. During nonoperative management of pediatric clavicle fractures, pediatric orthopaedic surgeons treat young patients (but not adolescents) with less outpatient visits and radiographs than nonpediatric orthopaedic physicians.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e224-e228"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Opioid Consumption Impacted by Study Participation? Maintenance of Fewer Opioid Refills With Reduced Prescription Quantity After Posterior Spinal Fusion in Adolescents With Idiopathic Scoliosis.","authors":"Davin Gong, Daniel Z Yang, Michelle S Caird, Matthew Stepanovich, Noelle Whyte, Ying Li","doi":"10.1097/BPO.0000000000002834","DOIUrl":"10.1097/BPO.0000000000002834","url":null,"abstract":"<p><strong>Background: </strong>Opioid overprescribing can lead to nonmedical opioid use. In a previous prospective study (STUDY), we showed that a standardized protocol involving preoperative education and reduced opioid prescription quantity decreased opioid use in idiopathic scoliosis patients following posterior spinal fusion (PSF). A potential limitation was the Hawthorne effect, where participant behavior changes due to observation. At STUDY conclusion, we continued the reduced opioid prescriptions but discontinued the formal preoperative education. This retrospective study (post-STUDY) assessed if opioid refill requests increased outside of a study setting.</p><p><strong>Methods: </strong>Post-STUDY included patients aged 10 to 17 years who underwent PSF for idiopathic scoliosis between January 2022 and December 2023 and were discharged with a prescription of ≤30 oxycodone doses. Patients were excluded if they had previous spine surgery or were discharged with an opioid other than oxycodone. Demographics, perioperative variables, and opioid refill requests were compared with the data from STUDY, in which patients were aware their opioid use would be tracked. Patient-reported outcomes were collected via Scoliosis Research Society-22r (SRS-22r) surveys.</p><p><strong>Results: </strong>The post-STUDY cohort included 67 patients (69% female). The average age at the time of PSF was 13.9 years (range, 11 to 17 y). The mean number of levels fused was slightly higher (10.9 vs. 10.0, P =0.04), and intraoperative estimated blood loss was lower (211 vs. 303 mL, P <0.01) compared with the STUDY cohort. Demographics, preoperative major curve magnitude, surgery duration, and length of hospital stay were similar. The percentage of patients who requested and received opioid refills between the post-STUDY and STUDY cohorts was also similar [6/67 (9%) vs. 3/49 (6%), P =0.30]. SRS-22r showed improvements in self-image, satisfaction, and mean total score from preoperative to postoperative.</p><p><strong>Conclusions: </strong>Reduced opioid prescriptions did not result in increased opioid refill requests in adolescents undergoing PSF for idiopathic scoliosis outside of a study setting. While formal preoperative discussions about postoperative pain control are important, other factors likely influence opioid use. Further research should explore characteristics that predispose patients to require higher amounts of postoperative opioids.</p><p><strong>Level of evidence: </strong>Level III-therapeutic.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e269-e273"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allograft Anterior Cruciate Ligament Reconstruction in Adolescent Patients May Result in Acceptable Graft Failure Rate in Non-pivoting Sports Athletes.","authors":"Jiahui Zheng, Caining Wen, Yuanmin Zhang","doi":"10.1097/BPO.0000000000002548","DOIUrl":"10.1097/BPO.0000000000002548","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e300"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forearm Fractures in Older Children and Adolescents: ORIF is Safer Than IMN With Equivalent Outcomes.","authors":"Stephen Chen, Matthew E LaBarge, Abigail L Henry, Jacquelyn Pennings, Jeffrey E Martus","doi":"10.1097/BPO.0000000000002853","DOIUrl":"10.1097/BPO.0000000000002853","url":null,"abstract":"<p><strong>Background: </strong>Greater understanding of the impact of skeletal maturity on outcomes is needed to guide operative treatment of diaphyseal forearm fractures in children and adolescents. The purpose of this study was to compare the complications and outcomes of pediatric diaphyseal forearm fractures treated with intramedullary nailing (IMN) or open reduction internal fixation (ORIF) and to identify a radiographic marker of skeletal maturity that will aid in selecting between treatment options.</p><p><strong>Methods: </strong>A retrospective review of patients aged 10 to 16 years treated operatively for diaphyseal forearm fractures was performed. Markers of skeletal maturity including the olecranon apophysis score, the presence of the thumb adductor sesamoid, and radial epiphyseal capping. Complications were graded with the modified Clavien-Dindo system. Outcomes were scored based on final postoperative range of motion combined with complication grade.</p><p><strong>Results: </strong>A total of 260 patients were included: 163 treated with IMN, 97 treated with ORIF, mean age 12.7 years, 72% male. Among closed forearm fractures treated with IMN, open reduction was required in 45% (53/118). Patients treated with IMN had a higher complication rate than ORIF (27.0% vs. 9.3%, P <0.05), including when stratified by age. Complication rates were not impacted by greater skeletal maturity as indicated by the presence of thumb sesamoid or radial epiphyseal capping. There was no significant difference in outcomes between the ORIF and IMN groups. More skeletally immature patients, as identified by a lack of either the thumb adductor sesamoid or radial epiphyseal capping, had significantly better outcomes with ORIF than patients with greater maturity.</p><p><strong>Conclusions: </strong>Across all age groups and levels of skeletal maturity, ORIF had a significantly lower rates of complications compared with IMN with equivalent outcomes. More skeletally immature patients had significantly better outcomes with ORIF treatment when compared with older patients. The thumb adductor sesamoid, radial epiphyseal capping, and the olecranon apophysis score did not provide useful information to select between ORIF over IMN in this population.</p><p><strong>Level of evidence: </strong>Level III-retrospective comparative study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e218-e223"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Change of Asymptomatic Atlantoaxial Instability With Down Syndrome From Infant to Adolescent in Japanese Population: Minimum 10 Years Follow-Up.","authors":"Masayoshi Machida, Brett Rocos, Katsuaki Taira, Naho Nemoto, Noboru Oikawa, Hirofumi Ohashi, Shutaro Aiba, Kazuyoshi Nakanishi","doi":"10.1097/BPO.0000000000002865","DOIUrl":"10.1097/BPO.0000000000002865","url":null,"abstract":"<p><strong>Background: </strong>Although 10% to 60% of patients with Down syndrome (DS) develop atlantoaxial instability (AAI), clarifying the course of asymptomatic AAI may prevent unnecessary clinical interactions and investigations. This study investigates the radiographic changes observed in asymptomatic AAI associated with DS in Japanese children as they grow from infancy to adolescence over a minimum of 10 years.</p><p><strong>Methods: </strong>A retrospective analysis of cervical radiographs acquired from asymptomatic patients with DS in both infancy and adolescence was carried out. Radiographic evaluation included measuring the atlantodental interval (ADI) and the space available for the cord (SAC). In neutral lateral cervical radiographs, AAI was defined as ADI >6 mm and SAC <14 mm.</p><p><strong>Results: </strong>Two hundred thirty-nine patients were included. The mean follow-up was 12.8 years. ADI was 2.3 mm at initial evaluation and 2.7 mm at final evaluation ( P <0.01) in a neutral position, 3.1 and 3.3 mm in flexion ( P =0.18), and 1.7 and 2.1 mm in extension ( P <0.01), respectively. SAC was 15.8 mm at initial evaluation and 20.9 mm at final evaluation ( P <0.01) in neutral position, 15.6 and 20.7 mm in flexion ( P <0.01), and 16.8 and 21.0 mm in extension ( P <0.01), respectively. Forty-five patients (18.8%) showed evidence of AAI at the initial evaluation with 4 patients meeting the threshold for AAI at the final evaluation, one of which had os odontoideum. In contrast, of the 194 patients who did not have AAI at the initial evaluation, 3 (1.3%) developed AAI at the final evaluation. One of these with a normal den developed AAI at 13 years.</p><p><strong>Conclusions: </strong>As 1 patient with a normal dens developed AAI at 13 years, we recommend screening for AAI with X-ray in infancy and adolescence regardless of the presence or absence of an os odontoideum.</p><p><strong>Evidence level: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"173-176"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"K-wire Versus Screw Fixation in Displaced Lateral Condyle Fractures of the Humerus in Children: A Multicenter Study of 762 Fractures.","authors":"Andreas Rehm, Rachael Clegg, Pinelopi Linardatou Novak, Ramy Shehata, Elizabeth Ashby","doi":"10.1097/BPO.0000000000002506","DOIUrl":"10.1097/BPO.0000000000002506","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e299-e300"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10179521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Obesity and Lateral Condyle Fracture Healing: A Pilot Study.","authors":"Jake Smithey, Cole Debevec, Aaradhana Jha, William Gillon, Tyler Dillon, Akeelein Forrest, Adam Middleton, Eldrin Bhanat, Priyanka Nehete, Drew P Melancon, Isaac J Spears, K Kellie Leitch","doi":"10.1097/BPO.0000000000002835","DOIUrl":"10.1097/BPO.0000000000002835","url":null,"abstract":"<p><strong>Objective: </strong>Childhood obesity is a growing public health concern in the United States. Obesity has been shown to lead to increased complications with regards to orthopaedic injuries, such as more severe fracture patterns, notably observed in injuries like lateral condyle fractures of the humerus. However, there is currently a gap in the literature regarding the relationship between obesity and the healing potential of these fractures. This study aims to determine whether obesity is associated with increased surgical time, wound/pin site infections, delayed union/nonunion, and time to union in pediatric patients with lateral condyle fractures of the humerus.</p><p><strong>Methods: </strong>A retrospective chart review was conducted at a level 1 trauma center on all patients 18 years or younger who sustained a lateral condyle fracture of the humerus. Patients were stratified into groups based on their body mass index-for-age percentile as defined by the Centers for Disease Control and Prevention; normal weight (<85%), overweight (85 to <95%), and obese (≥95%). Demographic data, Weiss classification, postoperative complications (infection, delayed union or nonunion, malunion, and need for repeat surgery), length of surgery, and time to union were recorded. Comparisons of categorical data were analyzed using χ 2 tests. Analysis of variance was used to compare the means between weight cohorts for continuous data.</p><p><strong>Results: </strong>A total of 123 patients were analyzed. Sixty-six were categorized as normal weight, 20 were overweight, and 37 were obese. There were no significant differences between weight classes for any complications, including infection, delayed/nonunion, malunion, or repeat surgery. There was no correlation with fracture severity as defined by the Weiss classification of lateral condyle fractures in regards to weight cohort ( P = 0.098). There was no significant difference in length of surgery ( P = 0.393) or average time to union ( P = 0.236) between the weight cohorts.</p><p><strong>Conclusion: </strong>In this study, population with higher pediatric obesity rates than the population average, there was no significant correlation between body mass index-for-age and each of the surgical complications reviewed, length of surgery, or time to union, indicating the healing potential of lateral condyle fractures in obese pediatric patients is no more compromised than that of their normal weight peers.</p><p><strong>Level of evidence: </strong>Level III-a retrospective study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e207-e211"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}