Journal of Pediatric Orthopaedics最新文献

{"title":"Peroneal Nerve Dysfunction Following Vascularized Fibular Epiphyseal Transfer (VFET): A Prospective Case Series Study.","authors":"Amr El-Sayed Ali, Ghaydaa Ahmed Shehata, Ahmed Mustafa Elsese, Omar Ahmed Refai","doi":"10.1097/BPO.0000000000003258","DOIUrl":"10.1097/BPO.0000000000003258","url":null,"abstract":"<p><strong>Background: </strong>In skeletally immature individuals, vascularized epiphyseal transfer allows for reconstruction of complex bony defects while preserving longitudinal growth and providing a reliable articular surface for effective joint function. The shape and size of the proximal fibular epiphysis allow for gradual remodeling of the articular surface, facilitating favorable reconstruction and rehabilitation over time. Moreover, the proximal fibula is highly expandable, with less weight-bearing function, contributing to low donor-site morbidity. However, peroneal nerve dysfunction-related foot drop remains a matter of concern. The purpose of this study was to prospectively evaluate the incidence and recovery of peroneal nerve dysfunction following vascularized fibular epiphyseal transfer.</p><p><strong>Methods: </strong>Sixteen patients were recruited from Assiut University Hospitals. Clinical assessment using the Medical Research Council score and electromyography was performed preoperatively and at 3, 6, 12, and 24 weeks postoperatively to assess tibialis anterior function on the donor side. The study was registered as a clinical trial prior to patient enrollment (ClinicalTrials.gov: NCT05884827).</p><p><strong>Results: </strong>Four out of 16 patients developed postoperative foot drop with MRC grade 0 but fully recovered (3 by 12 wk and 1 by 24 wk). Electromyographic abnormalities were observed only in these 4 patients and normalized within 24 weeks (1 by 12 wk and 3 by 24 wk).</p><p><strong>Conclusions: </strong>Peroneal nerve dysfunction-related foot drop following vascularized fibular epiphyseal transfer is usually transient, with clinical and electromyographic recovery occurring in most patients within 6 months.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e880-e884"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377924","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}

{"title":"Lateral Humeral Condyle Fractures in Infants, Toddlers, Preschoolers, and School-Age Children: A Comparative Analysis and the Role of the N-LES-H Index.","authors":"Mohamed Y Hassanein, Mahmoud Y Hassanein","doi":"10.1097/BPO.0000000000003333","DOIUrl":"10.1097/BPO.0000000000003333","url":null,"abstract":"","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e908-e909"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973384","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":"Increased Lateral Waist to Thoracolumbar Height Ratio Correlates With Improved In-brace Correction.","authors":"Matthew J Weintraub, Omar S Taha, Mehdi M Elfilali, Chidebelum O Nnake, Miles J Bomback, Erik D Williams, Joseph G Barile, John Tunney, Ritt R Givens, Michael G Vitale, Benjamin D Roye","doi":"10.1097/BPO.0000000000003252","DOIUrl":"10.1097/BPO.0000000000003252","url":null,"abstract":"<p><strong>Background: </strong>Bracing is the primary non-operative treatment for adolescent idiopathic scoliosis (AIS), with in-brace correction (IBC) being a key predictor of long-term success. Although BMI has been linked to bracing outcomes, it fails to capture important aspects of body habitus, such as fat distribution and torso shape, that influence brace fit and force transmission. This study aims to evaluate a novel radiographic measure, the lateral waist-to-height (WH) ratio, as a more accurate predictor of IBC in AIS patients.</p><p><strong>Methods: </strong>A retrospective review of AIS patients treated with Rigo-style braces between 2014 and 2024 at a single institution was conducted. Thoracolumbar (TL) height and waist width at the iliac crest were measured on AP and lateral radiographs to calculate WH ratios. Linear regression evaluated associations between IBC and BMI, WH ratios, and TL height change. Multivariate regression adjusted for major curve angle and curve apex.</p><p><strong>Results: </strong>The study included 209 females (mean age 11.4±2.1 y, BMI 17.7±2.8). Mean pre-brace major curve angle was 28.2±7.3 degrees, with average IBC of 64.8%±31.6%. Lateral WH ratio correlated positively with IBC ( R =0.21, P =0.014), representing a weak but statistically significant correlation. By contrast, BMI and AP ratio did not demonstrate significant associations with IBC. In multivariate analysis, both major curve angle ( P <0.001) and lateral WH ratio ( P =0.009) were independent predictors of IBC.</p><p><strong>Conclusions: </strong>Lateral WH ratio offers a more holistic representation of body habitus than BMI and is independently associated with in-brace correction. These findings suggest that the lateral WH ratio may provide additional insight into brace fit and initial correction, warranting further study to determine its potential role in predicting long-term bracing outcomes in AIS.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e847-e852"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326575","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 Retrospective Analysis of the Correlation Between Periosteal Entrapment and Growth Disturbances in Salter-Harris II Physeal Fractures of the Distal Tibia in Children.","authors":"Hengheng Zhang, Ming Yang, Xing Tong, Xiaoming Wang, Jinwang Dong, Hanghui Gong, Bing Wang","doi":"10.1097/BPO.0000000000003243","DOIUrl":"10.1097/BPO.0000000000003243","url":null,"abstract":"<p><strong>Background: </strong>Periosteal entrapment (PE) in displaced distal tibial Salter-Harris (S-H) II fractures is considered a risk for growth disturbances, but causality is debated.</p><p><strong>Questions/purposes: </strong>To investigate whether PE is an independent risk factor for growth disturbances in distal tibial S-H II physeal fractures and to compare the clinical efficacy of different treatment methods.</p><p><strong>Patients and methods: </strong>Retrospective analysis of 27 patients (2015 to 2024) with distal tibial S-H II fractures and confirmed PE [magnetic resonance imaging (MRI): n=21; follow-up radiograph: n=6]. Patients received conservative treatment, closed reduction and percutaneous fixation (CR-PF), or open reduction internal fixation (ORIF). Functional outcomes were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire. Correlations (phi coefficient) and risk factors (univariable/multivariable regression) were assessed between PE and growth disturbances.</p><p><strong>Results: </strong>Patients (19 boys and 8 girls; mean age 9.99 y or younger) were followed for a mean of 22.13 months. Overall incidence of growth disturbances was 14.8%, and the difference in the proportion of growth disturbances among the 3 groups was not significant ( P >0.05). No independent risk factors were identified in univariable or multivariable analysis (all P >0.05). All fractures healed, and all groups showed an excellent AOFAS score (100%) at 6 months postinjury and comparable functional recovery (all P >0.05). The only case of premature physeal closure (PPC) occurred in the ORIF group, with the bony bridge appearing at the distal tibial Kump's bump, subsequently leading to an ankle valgus deformity.</p><p><strong>Conclusion: </strong>PE is not independently correlated with growth disturbances following distal tibia SH II fractures, challenging the traditional mainstream view of its causal role in causing growth disturbances. In addition, the therapeutic effects of different treatment methods are comparable. Conservative treatment should be preferred when closed reduction achieves good alignment, and routine periosteal stripping may be unnecessary.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"572-578"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348718","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":"Nonoperative Treatment of Low-grade AC Joint Injuries in Pediatric Athletes.","authors":"Jake M Reed, Eden Epner, Alicia M Hymel, Kevin M Dale, Lance E LeClere","doi":"10.1097/BPO.0000000000003256","DOIUrl":"10.1097/BPO.0000000000003256","url":null,"abstract":"<p><strong>Background: </strong>Pediatric acromioclavicular (AC) joint injuries are rarely reported, and data on return-to-sport rates (RTS) in this population are limited. This study aims to characterize management strategies and return-to-sport outcomes following AC joint injuries in pediatric athletes, addressing a gap in the current literature.</p><p><strong>Methods: </strong>Patients under 18 years of age who sustained an AC joint injury between March 1, 2014, and March 1, 2024, were identified using databases from a large tertiary referral hospital and a large children's hospital. Extracted data included patient demographics, injury patterns, management approaches, and RTS status.</p><p><strong>Results: </strong>A total of 108 patients (110 shoulders) were included (74% male; mean age, 12.77±2.13 ​​​​​y; range 8 to 17 years). Low-grade injuries accounted for 95% of cases, and all injuries were managed nonoperatively. Sling immobilization was used in 40%, physical therapy (PT) in 29%, rest in 17%, and a combination of sling and PT in 15%. The most common mechanisms were football (29, 26%), motor vehicle collisions (11, 10%), and soccer (10, 9%). At least 48% (52) of patients had documented return-to-sport dates, with the median RTS time being 21 days (IQR 14 to 49.45​​​​​ d). Concomitant injury was associated with a longer RTS time (HR 0.33, 95% CI 0.16-0.69, P =0.003).</p><p><strong>Conclusions: </strong>In this cohort of pediatric athletes, AC joint injuries were predominantly low-grade and managed nonoperatively. Of the patients with documented follow-up and RTS, the median RTS time was 3 weeks. These findings reinforce the favorable prognosis of nonoperative treatment for low-grade injuries in this population. Given the rarity of pediatric AC joint injuries and the limited published data, reporting these outcomes is essential to guide evidence-based management in pediatric sports medicine.</p><p><strong>Level of evidence: </strong>IV: retrospective cohort study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"543-548"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326498","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":"How Much Meniscal Translation Is Normal? A Pediatric Physiological Arthroscopic Meniscus Mobility Study.","authors":"Cassidy M Schultz, Dane R G Lind, Amin M Alayleh, Benjamin L Johnson, Marc A Tompkins, Matthew R Schmitz, Yi-Meng Yen, Theodore J Ganley, Kevin G Shea, Henry B Ellis","doi":"10.1097/BPO.0000000000003404","DOIUrl":"10.1097/BPO.0000000000003404","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients with a discoid meniscus often present with peripheral rim instability. Following saucerization, evaluation of peripheral rim instability is routine. However, the normal mobility of pediatric menisci when probed has yet to be studied. The purpose of this study is to establish normal age-based arthroscopic meniscal mobility and meniscal rim width parameters to aid the treating surgeon in identifying an unstable peripheral rim and determining the appropriate amount of saucerization.</p><p><strong>Methods: </strong>Forty fresh-frozen pediatric cadaveric knee specimens under the age of 12 years were arthroscopically evaluated. Surgeons were instructed to probe the anterior horn, body, and posterior horn of both the medial and lateral menisci during the diagnostic arthroscopy. Mobility was described as a percentage of mobile translation, with the tibial plateau as the reference. Measurements of meniscal horn widths were performed using an arthroscopic probe. Menisci were excluded if they had abnormal morphology or if visualization of the compartment was inadequate. Descriptive data and Mann-Whitney U tests were reported.</p><p><strong>Results: </strong>Each horn of the medial meniscus typically translated 0% to 20%, while the lateral meniscus demonstrated greater variability in mobility across the tibial plateau -51.6% of the anterior horn, 48.2% of the menisci at the level of the popliteus, and 29.0% of the posterior horn translated more than 20%. Globally, the medial and lateral meniscus width increased with age, and the lateral meniscus measured larger than the medial meniscus. When specimens were stratified by age group, widths for the medial posterior horn, distance between the meniscal free edge, and distance between roots ( P =0.004; P =0.02; P <0.001) and lateral anterior horn, body, posterior horn, distance between free edge, and distance between the meniscal roots were found to be significantly different ( P =0.04, 0.01, 0.002, 0.01, and 0.04).</p><p><strong>Conclusion: </strong>Lateral meniscal morphology demonstrates more mobility compared with the medial meniscus. Meniscal rim size, when measured arthroscopically, varies between horns and increases with age, which may be useful in determining the extent of saucerization.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e821-e828"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520545","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":"Age is a Risk Factor for Postoperative Stiffness Following Surgical Treatment of Pediatric Discoid Lateral Meniscus: A Report From the SCORE Multicenter Database.","authors":"Henry Baird, Scott McKay, Gregory Knell, Philip Wilson, Jeremy Frank, Alfred Mansour, Kevin Shea, Henry Ellis","doi":"10.1097/BPO.0000000000003264","DOIUrl":"10.1097/BPO.0000000000003264","url":null,"abstract":"<p><strong>Background: </strong>Discoid lateral meniscus is the most common etiology for isolated meniscal pathology in the pediatric population. However, there remains a limited understanding of how complication rates vary among different age groups undergoing surgical management of a symptomatic discoid lateral meniscus. The aims of this study were to compare postoperative complication rates between age groups in pediatric patients undergoing surgical management of a symptomatic discoid lateral meniscus and assess whether patient age group is a risk factor for any complication rate that differed between the 2 age groups.</p><p><strong>Methods: </strong>Consecutive cases of discoid lateral meniscus surgeries from 2018 to 2022 were queried from the SCORE database. Demographic, perioperative, and postoperative complication data were collected and compared between patients <10 and ≥10 years old. A multivariable logistic regression was used to better understand those variables that demonstrated significant differences between age cohorts.</p><p><strong>Results: </strong>Seven hundred sixty-three discoid lateral meniscus surgeries were identified for inclusion in this study, with 160 (20.5%) aged 10 years or younger and 603 (79.5%) 10 years or older. Postoperative stiffness was the most common complication occurring in 5.0% of patients. Overall complication rates were no different between the 2 age groups (11.9% vs. 11.9%, P =1.000). Specific complication rates were also no different between the 2 age groups with the exception that patients 10 years or younger had higher rates of postoperative stiffness than patients 10 years or older (11.3% vs. 3.3%, P <0.001) including both extension loss (6.4% vs. 1.2%, P <0.001) and flexion loss (3.1% vs. 1.7%, P <0.001). In multivariable analysis, age 10 years or younger was identified as a risk factor for postoperative stiffness when controlling for confounding variables. Specifically, patients 10 years or younger had 2.67 (95% CI: 1.12-5.86) and 3.09 (95% CI: 1.11-8.62) times the odds of developing postoperative stiffness and extension loss, respectively, compared with patients 10 years or older.</p><p><strong>Conclusion: </strong>This study shows that age 10 years or younger is a risk factor for developing postoperative stiffness after undergoing surgical treatment of a symptomatic discoid lateral meniscus.</p><p><strong>Level of evidence: </strong>Level III-therapeutic, retrospective comparative study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"535-542"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816429","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":"Outcomes of Arthroscopic Bony Bankart Repair Compared With Soft-Tissue Only Bankart Repair in the Adolescent Population.","authors":"Rajvarun S Grewal, Garrett K Berger, Andrew T Pennock, James D Bomar, Eric W Edmonds","doi":"10.1097/BPO.0000000000003234","DOIUrl":"10.1097/BPO.0000000000003234","url":null,"abstract":"<p><strong>Background: </strong>Outcomes of arthroscopic management of bony Bankart (BB) lesions may result in higher reinjury rates, revision surgeries, and return-to-sport outcomes compared with adolescent patients with no bony Bankart (NBB) lesions.</p><p><strong>Methods: </strong>Adolescent patients undergoing arthroscopic stabilization (2010 to 2023) with a minimum of 2 years follow-up were categorized into BB and NBB cohorts based on MRI and intraoperative findings. Preinjury glenoid diameter was estimated using a best-fit circle technique. Data collected included demographics, injury details, surgical techniques, and surgical outcomes. Patient-reported outcomes were assessed using single assessment numeric evaluation (SANE), pediatric/adolescent shoulder survey (PASS), and quick Disabilities of the Arm Shoulder and Hand (qDASH) scores.</p><p><strong>Results: </strong>Fifty patients were analyzed (25 BB, 25 NBB), with mean age 16.9±0.9 years (BB) and 16.6±1.0 years (NBB) ( P =0.32), and overall mean follow-up 4.2 years. BB was associated with males ( P =0.02) and collision mechanisms of injury ( P =0.02). BB utilized more suture anchors (6.0±1.2 vs. 4.9±1.4) ( P =0.005). Preinjury glenoid diameter was larger in the BB (29.9±2.6 vs. 26.2±2.3 mm) ( P <0.001). Mean sagittal width of the BB fragment measured 5.7±1.5 mm (range: 3 to 10 mm) and represented a mean glenoid bone loss of 18.9%±4.5%. Surgery failure rates (32% BB vs. 32% NBB), revision surgery rates (12% BB vs. 4% NBB), and return to sport rates (88% BB vs. 80% NBB) were not significantly different. SANE scores were higher with BB (91.2±9.9 vs. 85.2±12.8) ( P =0.03), yet no differences were found in PASS and qDASH outcomes.</p><p><strong>Conclusions: </strong>BB was associated with larger glenoid diameters, male sex, and collision injuries, but outcomes did not appear to vary when compared with NBB shoulders, refuting the hypothesis that bony Bankart shoulders would have poorer short-term to mid-term outcomes over time compared with those with only soft-tissue injury. Recurrent instability and revision surgery rates remain high in this youthful population regardless of the presence of a bony Bankart-associated anterior instability.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e829-e835"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194848","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}