Journal of Pediatric Orthopaedics最新文献

{"title":"Dwarf Maiden of Acropolis.","authors":"Gleeson Rebello, Hitesh Shah, Benjamin Joseph","doi":"10.1097/BPO.0000000000003431","DOIUrl":"10.1097/BPO.0000000000003431","url":null,"abstract":"<p><p>A marble sculpture in the Acropolis is of a dwarf maiden, the only dwarf among over 70 statues in the Athenian Acropolis. The features of the statue suggest that the dwarf is a disproportionate rhizomelic dwarf.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"600-602"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604404","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":"Sports Participation Among Children and Adolescents Following Treatment With the Ponseti Method for Idiopathic Clubfoot: A Multicenter Survey Study.","authors":"James Weihe, Melissa Bent, Lindsey Kent, Abigail Padilla, Shannon Margherio, Rebecca Carl, Karim Masrouha, Pamela Lang, Blaise Nemeth, Natalie Stork","doi":"10.1097/BPO.0000000000003323","DOIUrl":"10.1097/BPO.0000000000003323","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic clubfoot is a complex congenital foot and ankle anomaly commonly treated with the Ponseti method. While gross motor function and activity level are similar in children with clubfoot treated with this method compared with children without clubfoot, data are lacking on sports participation following this treatment. This study aimed to describe the prevalence of sports participation among children with idiopathic clubfoot treated with the Ponseti method.</p><p><strong>Methods: </strong>This was a multicenter retrospective cross-sectional study. Patients aged 5 to 17 years were included if they had been diagnosed with idiopathic clubfoot and treated with the Ponseti method during infancy. Parents of subjects were asked to complete a 1-time REDCap survey that included basic demographic questions, 2 validated activity scores (PROMIS Physical Activity Short Form and PACE+), and questions relating to sports participation. The comparison group consisted of the siblings of patients with clubfoot.</p><p><strong>Results: </strong>One hundred fifty-one patients with clubfoot and 45 siblings without clubfoot were included from 4 institutions. In the clubfoot group, 72.2% of participants were male compared with 60% in the sibling group ( P =0.12). Median PROMIS-PA t-scores were 53.3 [interquartile range (IQR) 8.6] and 56.3 (IQR 13.2) in the clubfoot and sibling groups, respectively ( P =0.016). The median PACE+ scores were 4 (IQR 3.5) in the clubfoot group and 4.75 (IQR 2.75) ( P =0.261) in the sibling group. Sports participation was reported in 120 (79.5%) patients with clubfoot and 43 siblings (95.6%) ( P =0.006). Soccer, baseball, basketball, football, and swimming were the most commonly played sports in both groups.</p><p><strong>Conclusions: </strong>Children treated for idiopathic clubfoot with the Ponseti method remain active and participate in sports similar to their siblings. Further prospective studies examining sports participation and injury prevalence are needed to better understand long-term clinical and functional outcomes in patients treated with the Ponseti method for idiopathic clubfoot.</p><p><strong>Study design: </strong>Retrospective.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e836-e841"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031753","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":"Considerations and Challenges in Open Reduction With Ligamentum Teres Reconstruction for Paediatric Developmental Dysplasia of the Hip.","authors":"Marina M Antonaraki, Panagiotis Nikolinakos","doi":"10.1097/BPO.0000000000003223","DOIUrl":"10.1097/BPO.0000000000003223","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e907"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468253","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":"In the Treatment of Supracondylar Humerus Fractures, Open or Closed Reduction With Percutaneous Pinning Results in Comparable Pain Levels and Low Morphine Requirements.","authors":"Wen-Hao Chang, Kuan-Ying Wu, Yi-Wen Chen, Chi-Hsiu Wang, Kai-Lan Hsu, Chien-An Shih, Chih-Kai Hong","doi":"10.1097/BPO.0000000000003249","DOIUrl":"10.1097/BPO.0000000000003249","url":null,"abstract":"<p><strong>Background: </strong>Pediatric supracondylar humeral fractures often require surgical fixation through closed reduction and percutaneous pinning (CRPP) or open reduction and percutaneous pinning (ORPP). Concerns about postoperative opioid use in children necessitate evaluation of pain and analgesic requirements between the 2 techniques.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included 207 patients aged 1 to 13 years or younger who underwent CRPP (n=167) or ORPP (n=40) between 2013 and 2025. Postoperative pain was assessed using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale and the Numerical Pain Rating Scale (NPRS) at 9  PM on postoperative day 0 and 9 am on postoperative day 1. Analgesic administration, including opioid use and morphine milligram equivalents (MME), as well as rescue analgesics, was recorded. Demographic data, fracture type according to the Gartland classification, and intraoperative variables were collected. Comparisons between groups were performed using Mann-Whitney U and χ 2 tests, with significance defined as P <0.05.</p><p><strong>Results: </strong>Postoperative pain scores were comparable between ORPP and CRPP groups on both day 0 (FLACC scale 2.5±0.8 vs. 2.7±1.2, P =0.613; NPRS 2.7±1.1 vs. 2.7±1.0, P =0.754) and day 1 (FLACC scale 1.6±2.1 vs. 1.8±1.1, P =0.108; NPRS 1.9±1.0 vs. 1.8±0.9, P =0.901). Overall, 16.4% of patients received opioids, with no significant difference in MME or opioid use between groups. The proportion of patients requiring rescue analgesics and the type of analgesics used were also similar.</p><p><strong>Conclusion: </strong>ORPP and CRPP resulted in comparable postoperative pain and opioid requirements, indicating that the additional incision in ORPP does not increase postoperative pain in pediatric supracondylar humeral fractures.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"579-583"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344645","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":"Characteristics of Hip Dysplasia in Adults With Cerebral Palsy.","authors":"Tomoko Sugiyama, Edward A Hurvitz","doi":"10.1097/BPO.0000000000003393","DOIUrl":"10.1097/BPO.0000000000003393","url":null,"abstract":"<p><strong>Background: </strong>With increased life expectancy, cerebral palsy (CP) is no longer solely a pediatric condition. Among adults with CP, orthopaedic conditions and associated pain represent the most prevalent challenges. Hip dysplasia is one of the most common conditions affecting adults with CP; however, the research remains limited, and clear follow-up guidelines are currently lacking. This study aimed to investigate the prevalence and severity of hip dysplasia in adults with CP and identify related factors. Our goal is to create a foundation for developing follow-up methods and clinical screening for specific groups of adults with CP at risk for worsening hip dysplasia.</p><p><strong>Methods: </strong>This retrospective study examined hip radiographs of 331 adults with CP (aged 18 y or older) from (removed for blinding) between 2011 and 2021. Migration percentage (MP) and Melbourne Cerebral Palsy Hip Classification System (MCHCS) were used to assess hip displacement. Patient factors, including age, sex, Gross Motor Function Classification System (GMFCS) level, pain condition and treatment, and spasticity management were analyzed. Linear regression models examined associations between patient factors and MP, while ordered logistic regression assessed relationships between GMFCS and MCHCS.</p><p><strong>Results: </strong>The mean MP across all participants was 23.2% (SD: 15.3), with 24.5% showing hip subluxation (MP>30%). GMFCS level was strongly associated with hip displacement, with GMFCS IV and V showing significantly higher MP values (Parameter Estimate=16.29 and PE=14.20, respectively; both P <0.01). Among GMFCS I/II, MP increased with age (PE=0.10, P =0.046), while no significant age associations were found in other GMFCS groups. MCHCS was also associated with GMFCS level, especially GMFCS IV and V (both P <0.0001). Notably, 21.6% of GMFCS I/II subjects were MCHCS 4 or higher.</p><p><strong>Conclusions: </strong>Hip dysplasia remains prevalent in adults with CP, with GMFCS level being the strongest predictor of displacement severity. Those with GMFCS I/II may experience progressive displacement with aging, while severe displacement in higher GMFCS levels may develop earlier. These findings emphasize the potential importance of understanding the natural history of the hip in CP into adulthood for all GMFCS levels.</p><p><strong>Level of evidence: </strong>Prognostic study level II-retrospective study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e874-e879"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330643","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":"Evaluation of Fracture and Osteotomy Union in the Setting of Osteogenesis Imperfecta: Multicenter Reliability of the Modified Radiographic Union Score for Tibial Fractures (RUST).","authors":"Jeanne M Franzone, Maegen J Wallace, Kenneth J Rogers, Cheryl R Lawing, Maureen J Maciel, Paul W Esposito, Mark S Finkelstein, Mary K Drake, M Steven Farber, Richard W Kruse","doi":"10.1097/BPO.0000000000003263","DOIUrl":"10.1097/BPO.0000000000003263","url":null,"abstract":"<p><strong>Background: </strong>A critical component of patient care for osteogenesis imperfecta patients is understanding the development of union following fracture and osteotomy surgery. Studies evaluating the criteria of bony union in this population have varied. An objective standardized method for fracture healing was developed as the radiographic union score for tibial fractures (RUST), and subsequently revised to the modified RUST (mRUST). The RUST score has been shown to have excellent interobserver and intraobserver reliability in a single-center investigation in an OI population. The purpose of the study was to evaluate the mRUST reliability in a multicenter investigation.</p><p><strong>Methods: </strong>Thirty OI patients with tibial fractures or osteotomy radiographs were identified. Nine observers from 3 institutions measured on 2 separate occasions. Four cortices were scored with the following classification: 1=no callus; 2=callus present; 3=bridging callus; and 4=remodeled, fracture not visible. The modified RUST score ranges from 4 to 16. Interclass and intraclass coefficients (ICC) of 95% CIs were used for interobserver and intraobserver reliabilities.</p><p><strong>Results: </strong>Interobserver reliability ICC representing the interobserver reliability for the first and second scores was the following, respectively, 0.926 (0.864-0.962) and 0.915 (0.845-0.957). Three reviewers' intraobserver reliability for series 1 and series 2 measurements were 0.860 (0.707-0.934), 0.994 (0.986-0.997), and 0.974 (0.946-0.988).</p><p><strong>Conclusions: </strong>Excellent interobserver and intraobserver reliability was demonstrated for the mRUST in the setting of OI bone, indicating the precision of the mRUST for OI tibia healing. Modified RUST application and routine use may help standardize the evaluation of osteotomy and fracture healing in the OI population with further work necessary for it to help make clinical decisions.</p><p><strong>Level of evidence: </strong>Level III-retrospective study of nonconsecutive patients.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"594-599"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468241","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":"Low-Dose Perineural Dexamethasone Enhances Analgesia After Pediatric Hand Surgery Without Elevating Systemic Stress Markers: A Randomized Controlled Trial.","authors":"Tomasz Reysner, Bahadir Ciftci, Szymon Bialka, Wojciech Gola, Piotr Czarecki, Pawel Pietraszek, Grzegorz Kowalski, Przemyslaw Daroszewski, Malgorzata Reysner","doi":"10.1097/BPO.0000000000003287","DOIUrl":"10.1097/BPO.0000000000003287","url":null,"abstract":"<p><strong>Background: </strong>Supraclavicular brachial plexus block is a widely used technique for upper limb surgery in children. Although perineural dexamethasone has demonstrated efficacy in prolonging analgesia in adults, data on its optimal dosing and systemic safety in pediatric patients are limited. This study aimed to evaluate whether low-dose perineural dexamethasone can prolong postoperative analgesia without increasing systemic stress markers in young children undergoing hand or wrist surgery.</p><p><strong>Methods: </strong>In this triple-blinded, randomized controlled trial (ClinicalTrials.gov Identifier: NCT06086392), 90 children aged 3 months to 6 years undergoing elective upper extremity surgery were assigned to receive supraclavicular brachial plexus block with 0.2% ropivacaine combined with either normal saline (control), dexamethasone 0.05 mg/kg, or dexamethasone 0.1 mg/kg. The primary outcome was time from arrival in the postanesthesia care unit to first administration of rescue opioid analgesia. Secondary outcomes included total opioid consumption, postoperative pain intensity using the FLACC scale, blood glucose levels, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and time to motor recovery.</p><p><strong>Results: </strong>Both dexamethasone groups demonstrated significantly prolonged time to first opioid use compared with the control group (mean±SD: 19.4±2.2 h in the 0.1 mg/kg group, 16.0±1.9 h in the 0.05 mg/kg group, and 8.5±1.3 h in controls; P <0.0001). Total opioid consumption was significantly reduced in the dexamethasone groups. Postoperative pain scores were lower in both intervention groups, especially during the first 12 hours. No significant differences were found among groups in blood glucose, inflammatory markers, or incidence of nerve deficits. Motor recovery was delayed in the dexamethasone groups but did not interfere with early mobilization.</p><p><strong>Conclusions: </strong>Low-dose perineural dexamethasone (0.05 to 0.1 mg/kg) safely and effectively prolongs postoperative analgesia and reduces opioid needs in children undergoing upper limb surgery, without causing systemic metabolic or inflammatory disturbances. The 0.05 mg/kg dose may offer a more favorable balance between analgesic efficacy and motor recovery time.</p><p><strong>Level of evidence: </strong>Level I-randomized controlled trial.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"584-593"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623287","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":"Comparison of Changes in Gait Kinematics and Surgical Outcomes After Proximal and Distal Femoral Derotational Osteotomy in Children With Cerebral Palsy.","authors":"Reiko Hara, Susan A Rethlefsen, Alyssa Ponrartana, Tishya A L Wren, Robert M Kay","doi":"10.1097/BPO.0000000000003491","DOIUrl":"https://doi.org/10.1097/BPO.0000000000003491","url":null,"abstract":"<p><strong>Background: </strong>It remains uncertain whether proximal or distal femoral derotational osteotomy is preferable for correcting excessive internal hip rotation and foot progression in children with cerebral palsy (CP). This study compares gait kinematic and surgical outcomes between the 2 types of osteotomies. The relationship between the amount of surgical correction and postoperative gait changes was also explored.</p><p><strong>Methods: </strong>Retrospective data of children who underwent femoral derotational osteotomy with preoperative and postoperative gait analysis were compared between proximal and distal osteotomies for various surgical outcomes. Mean hip rotation and foot progression angles during the stance phase of gait were averaged over several representative strides for each patient, limb, and visit and compared between groups before and after surgery using linear mixed models accounting for repeated measures within each participant and covariates that differed between groups. The correlation between the amount of surgical correction and the change in hip rotation angle during gait was examined.</p><p><strong>Results: </strong>A total of 91 limbs in 52 patients with proximal and 177 limbs in 112 patients with distal osteotomies were analyzed. Both groups improved significantly in hip rotation and foot progression angles during the stance phase of gait postoperatively (P<0.001). The complication rate was higher in the distal group, although the difference was not statistically significant (8% vs. 3%, P=0.13). Additional surgery for isolated hardware removal was performed for 22/91 (24%) limbs with proximal osteotomies (P<0.001). A higher correlation between the amount of surgical correction and the change in hip rotation angle was observed in patients with unilateral femoral osteotomy (r=-0.60, P<0.0001), hemiplegic CP (r=-0.71, P<0.0001), and proximal osteotomy without varus correction (r=-0.63, P<0.0001).</p><p><strong>Conclusions: </strong>Both proximal and distal femoral derotational osteotomies are clinically effective in reducing excessive hip internal rotation and normalizing foot progression during gait in children with CP. Consideration in selecting the site of the procedure should include potential risks and benefits for postoperative complications, morbidity, and the possibility of additional surgery.</p><p><strong>Level of evidence: </strong>Therapeutic studies-investigating the results of treatment, Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111320","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":"A Preliminary Report: Screening Idiopathic Scoliosis (IS) With a Smartphone Application.","authors":"Paul Martrenchar, Agnes Caille, Antonios Dina, Thierry Odent","doi":"10.1097/BPO.0000000000003228","DOIUrl":"10.1097/BPO.0000000000003228","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic scoliosis (IS) is a 3-dimensional spinal deformity that affects ∼3.1% of the population. Current strategies for IS screening and management remain limited resulting in delayed detection and inconsistent follow-up, which can result in missed opportunities for conservative treatment and an increased likelihood of requiring surgical intervention. Early and accessible screening tools may help address these gaps. This study aimed to evaluate the performance of a smartphone-based application that leverages 3D surface topography for IS screening, comparing its accuracy with radiographic assessment in patients with confirmed diagnoses and a cohort of control subjects, which had normal clinical examination excluding spinal pathology.</p><p><strong>Methods: </strong>A multicenter prospective diagnostic study was conducted involving pediatric patients from 2 reference hospitals in France and Canada. The participants included both iodiopathic scoliotic patients and healthy controls, all aged 8 to 18 years. The smartphone applications (SA) was used to capture video scans of the patients, which were then analyzed using AI to estimate the major coronal curve, blinded of the radiographic measurement. The results were compared with standard radiographic measurements to validate the accuracy of the SA.</p><p><strong>Results: </strong>A total of 236 participants were included in the study, comprising 154 (65%) childrens and adolescents diagnosed with idiopathic scoliosis (IS) and 82 (35%) control subjects. When used to screen for scoliosis, defined as a major coronal curve angle >10 degrees, the smartphone application demonstrated a sensitivity of 100% and a specificity of 89%.</p><p><strong>Discussion: </strong>This preliminary report showed that the SA is a promising tool for IS screening. By integrating this technology, the proportion of conservative treatments could increase, reducing the need for surgical interventions, minimizing X-ray exposure and it would decrease the associated socioeconomic costs. Despite the study's limitations, such as selection bias and the lack of reproducibility assessment, the SA shows significant potential for improving IS screening and management. Future studies will focus on using the SA to monitor disease progression.</p><p><strong>Level of evidence: </strong>Level IV-diagnostic study, prospective, and multicentric.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e842-e846"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307124","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":"Internal Extramedullary Lengthening of the Femur With an Intramedullary Lengthening Nail: Outcomes and Technical Considerations From 2 Centers.","authors":"Nickolas J Nahm, Andrew G Georgiadis, Anirejuoritse Bafor, Christopher A Iobst, Mark T Dahl","doi":"10.1097/BPO.0000000000003380","DOIUrl":"10.1097/BPO.0000000000003380","url":null,"abstract":"<p><strong>Background: </strong>Surgical techniques for internal limb lengthening continue to advance. This study evaluates outcomes and technical aspects of extramedullary motorized femoral lengthening in young children.</p><p><strong>Methods: </strong>A retrospective review of extramedullary motorized femoral lengthening at 2 centers was performed. Variables of interest include complications, the magnitude of lengthening, and technical factors, including antegrade versus retrograde techniques.</p><p><strong>Results: </strong>Forty-five extramedullary motorized femoral lengthenings in 40 patients were included with a median follow-up of 27 months (range: 7.7 to 98.4 mo). Antegrade lengthening was performed in 40% of cases (18/45) and retrograde lengthening in 60% of cases (27/45). A median lengthening of 3.8 cm (14% of the femoral segment) was performed. At least one complication occurred in 56% of cases with 12 complications classified as modified Clavien-Dindo III (requiring a reoperation). There were no statistically significant differences in complication rates between antegrade and retrograde techniques.</p><p><strong>Conclusions: </strong>Motorized extramedullary femoral lengthening is a viable treatment option for femoral lengthening in young children. The complication profile is comparable to other femoral lengthening techniques.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e885-e892"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295545","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}