Journal of Pediatric Orthopaedics-Part B最新文献

Fetal study of soft tissue anomalies and osteocartilage anlagen defects in congenital club foot. 先天性内翻足软组织异常及骨软骨胶原缺损的胎儿研究。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-30 DOI: 10.1097/BPB.0000000000001352

Indu Yadav, Anita Mahajan, Sabita Mishra, Sumit Sural, Preeti Goswami

{"title":"Fetal study of soft tissue anomalies and osteocartilage anlagen defects in congenital club foot.","authors":"Indu Yadav, Anita Mahajan, Sabita Mishra, Sumit Sural, Preeti Goswami","doi":"10.1097/BPB.0000000000001352","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001352","url":null,"abstract":"Congenital talipes equinovarus (CTEV) is a common musculoskeletal entity that affects 1-2 per 1000 of live births worldwide. Most are idiopathic with a typical deformity of midfoot cavus, forefoot adductus, hindfoot varus, and equinus. Controversy exists whether CTEV results primarily from in-utero soft-tissue abnormality or the defect is in the osteocartilage anlagen. This fetus study aimed to elucidate the gross anatomical morphology and morphometry of bones, joints, and soft tissue in CTEV compared with the normal foot. This comparative cross-sectional study done on 12 normal feet and four CTEV (two bilateral and two unilateral) in nine fetuses without spinal defects, aborted between 16-18, 19-20, 22-24, 26-28, and 32-33 weeks, analyzed the morphological and morphometric parameters. In CTEV, the talus was plantarflexed with a short medially deviated neck, and the posterior facet was flat instead of the normal quadrilateral shape, with a less convex tibiotalar articular surface. Calcaneus in CTEV was slightly smaller, displaced into varus, equinus, and internal rotation, and the posterior articular surface was triangular and transversely flat. Angular measurements (α, β, γ, δ) of the talus were increased while the λ angle of the calcaneus was decreased to almost half. All morphometric measurements were statistically significant (P values 0.001 by Mann-Whitney U test). The soft tissues (muscle and tendon) were shorter in length compared to normal. Significant abnormalities were detected in multiple parameters in both osteocartilage anlagen as well as soft tissues in CTEV.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of opioid-free versus traditional opioid-containing postoperative pain management pathways for idiopathic scoliosis. 特发性脊柱侧凸术后无阿片类药物与传统含阿片类药物疼痛管理途径的比较。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-28 DOI: 10.1097/BPB.0000000000001351

Michael Schallmo, Katherine Drexelius, Elizabeth Benson, Ainsley Bloomer, Joseph Burger, Kayla Hietpas, Michael Paloski

{"title":"Comparison of opioid-free versus traditional opioid-containing postoperative pain management pathways for idiopathic scoliosis.","authors":"Michael Schallmo, Katherine Drexelius, Elizabeth Benson, Ainsley Bloomer, Joseph Burger, Kayla Hietpas, Michael Paloski","doi":"10.1097/BPB.0000000000001351","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001351","url":null,"abstract":"While opioid medications are commonly used to manage postoperative pain in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis, their use is associated with negative short and long-term effects. There is a paucity of data evaluating the feasibility and efficacy of opioid-free pain regimens in this population. The purpose of this study was to compare a multimodal opioid-free with a traditional opioid-containing protocol in pediatric patients undergoing instrumented PSF for idiopathic scoliosis. We hypothesized that the opioid-free pain management pathway would result in equivalent length of stay (LOS) and fewer opioids prescribed at discharge compared with an opioid-containing pathway. This was a prospective case-control study comparing opioid-free versus opioid-containing pathways. Eligible participants included patients aged 10-20 years at time of surgery with idiopathic scoliosis who underwent primary instrumented PSF by a single, fellowship-trained pediatric orthopedic surgeon during a 2-year period. Total opioid use was recorded. Statistical analysis included Wilcoxon, Chi-square, and Fisher's exact tests for group comparisons. Patients in the opioid-free group had a greater number of levels fused ( P = 0.036), had a similar inpatient LOS postoperatively ( P = 0.917), and required fewer opioid prescriptions at discharge [10/36 patients (27.8%) vs. 55/56 patients (98.2%), respectively; P < 0.0001]. A comprehensive, multimodal, opioid-free pain management pathway following instrumented PSF for idiopathic scoliosis results in equivalent LOS and fewer opioids prescribed at discharge compared with an opioid-containing pathway. Establishing patient/family expectations beforehand is crucial to the successful engagement and implementation of this opioid-free protocol.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical characteristics at the onset of peri-knee acute osteomyelitis in 56 children. 56例儿童膝周围急性骨髓炎发病时的临床特点。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-28 DOI: 10.1097/BPB.0000000000001350

Haiting Jia, Weidong Mu

{"title":"Clinical characteristics at the onset of peri-knee acute osteomyelitis in 56 children.","authors":"Haiting Jia, Weidong Mu","doi":"10.1097/BPB.0000000000001350","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001350","url":null,"abstract":"This study aimed to summarize the clinical characteristics of acute peri-knee osteomyelitis in children at onset. Fifty-six children (30 boys and 26 girls, aged 19 days to 15 years) diagnosed and treated from July 2017 to 2024 were enrolled, including 32 with distal femoral, 21 with proximal tibial, 2 with proximal fibular, and 1 with patellar involvement. Patients were grouped by epiphyseal involvement (32 epiphysis group and 24 nonepiphysis group), knee septic arthritis (19 arthritis group and 37 nonarthritis group), and methicillin‑resistant Staphylococcus aureus (MRSA) infection (16 MRSA group and 40 non‑MRSA group). Clinical data, including age, gender, onset duration, body temperature, and inflammatory markers, were compared among groups; receiver operating characteristic curve and logistic regression were used to analyze MRSA infection. The epiphysis group showed a higher rate of concurrent septic arthritis than the nonepiphysis group, and the arthritis group had a higher proportion of epiphyseal osteomyelitis. The MRSA group had significantly higher C‑reactive protein (CRP) levels, and CRP exhibited moderate diagnostic value for MRSA infection. Logistic regression identified CRP more than 92.785 mg/L as an independent risk factor for MRSA infection. Our study revealed that in peri-knee acute osteomyelitis, septic arthritis of the knee often occurs when epiphyseal osteomyelitis is present, and epiphyseal osteomyelitis is often present when there is septic arthritis of the knee. CRP levels were higher in MRSA-infected osteomyelitis. CRP above 92.785 mg/L was a high-risk factor for MRSA infection.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How reliable are radiographic measures of the pediatric elbow? Measurement and comparison of four parameters in healthy children's elbow. 小儿肘部的x线测量有多可靠？健康儿童肘部四项参数的测量与比较。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-22 DOI: 10.1097/BPB.0000000000001349

Göker Utku Değer, Ece Davutluoğlu, Nuri Ayoğlu, Mahmut Kürşat Özşahin, Ali Şeker

{"title":"How reliable are radiographic measures of the pediatric elbow? Measurement and comparison of four parameters in healthy children's elbow.","authors":"Göker Utku Değer, Ece Davutluoğlu, Nuri Ayoğlu, Mahmut Kürşat Özşahin, Ali Şeker","doi":"10.1097/BPB.0000000000001349","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001349","url":null,"abstract":"The reproducibility of radiographic parameters used to assess pediatric supracondylar fracture reduction, including Baumann angle, lateral capitellohumeral angle (LCHA), carrying angle, and anterior humeral line (AHL) crossing the capitellum, was evaluated. Two observers undertook a total of 2368 measures on 148 elbow radiographs from 107 patients aged 0-12 years. The observers, who were blinded to their own measurements and each other's measurements, performed the measurements twice with a 1-month interval using an electronic goniometer. The average value and reliability of the measurements were evaluated. Intraobserver and interobserver reliability were determined using intraclass correlation coefficients (ICCs). The mean LCHA of the 148 elbow population was 52.4° (range: 27-74°), the mean Baumann angle was 71.5° (range: 54-90°), and the mean carrying angle was 18° (range: 5-37°). 80% of the AHL was in the middle third of the capitellum. The ICCs for interobserver reliability were moderate to good for Baumann angle 0.71-0.78, for LCHA 0.72-0.72, for carrying angle 0.83-0.85, and for AHL 0.89-0.90. The ICCs for intraobserver reliability were moderate to excellent for Baumann angle 0.93-0.86, for LCHA 0.91-0.81, for carrying angle 0.71-0.92, and for AHL 0.94-0.90. This study demonstrated that Baumann angle, LCHA, carrying angle, and AHL are reliable measuring methods, with normal values reported in the Turkish population.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive assessment of acetabular morphology in developmental dysplasia of the hip: introducing novel parameters for pediatric evaluation. 髋关节发育不良髋臼形态的综合评估：引入儿科评估的新参数。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-17 DOI: 10.1097/BPB.0000000000001347

Arash Maleki, Fereshte Abdolvand, Amir Bisadi, Ali Keipourfard

{"title":"Comprehensive assessment of acetabular morphology in developmental dysplasia of the hip: introducing novel parameters for pediatric evaluation.","authors":"Arash Maleki, Fereshte Abdolvand, Amir Bisadi, Ali Keipourfard","doi":"10.1097/BPB.0000000000001347","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001347","url":null,"abstract":"Developmental dysplasia of the hip (DDH) represents a wide range of abnormalities affecting the acetabulum and femoral head. Traditional diagnostic tools such as anteroposterior pelvic radiographs are limited in evaluating the three-dimensional morphology of the acetabulum, especially in pediatric populations. This study introduces novel measurement parameters that include both angular and dimensional metrics for a comprehensive assessment of acetabular morphology. It also compares these parameters between normal and dysplastic hips in pediatric population. Computed tomography scans of 35 children with unilateral DDH, aged between four and 48 months, were analyzed, comparing dysplastic and normal hips. Parameters measured included anterior and posterior acetabular indexes and lengths, anterior and posterior coverage angles, lengths, and posterior coverage area, dome length and dome coverage. Statistical analyses evaluated differences between groups. Dysplastic hips exhibited higher anterior and posterior acetabular index values and reduced anterior and posterior acetabular lengths, reflecting global elongation and shallowness. Anterior coverage angle was significantly greater, while posterior coverage angle and posterior coverage parameters were reduced, highlighting posterior wall deficiencies. Dome coverage was also significantly decreased. All measurements showed good to excellent interobserver and intraobserver reliability (0.68-0.94 and 0.76-0.92, respectively). Our findings suggest that DDH involves global acetabular deficiencies, including posterior insufficiency, challenging the traditional focus on anterolateral deficiencies. The introduced parameters provide a reproducible method for evaluating pediatric acetabular morphology, offering valuable insights for diagnosis and treatment planning. Future studies should validate these findings and explore MRI for enhanced diagnostic accuracy.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Introduction of the axial malalignment test: a classification system for torsional malalignment in the lower limb. 轴向错位试验简介：下肢扭向错位的分类系统。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-04-07 DOI: 10.1097/BPB.0000000000001346

Sheanna Maine, Mohamed Y Hassanein, Kevin Tetsworth

{"title":"Introduction of the axial malalignment test: a classification system for torsional malalignment in the lower limb.","authors":"Sheanna Maine, Mohamed Y Hassanein, Kevin Tetsworth","doi":"10.1097/BPB.0000000000001346","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001346","url":null,"abstract":"Axial alignment of the lower limbs affects foot progression angle, knee biomechanics, patellofemoral joint instability, and hip impingement, although a standardized method of reference has not yet been described. An understanding of torsional malalignment is critical in many subspecialty areas of orthopaedics including paediatric orthopaedics, deformity correction, sports medicine, hip and knee surgery, as well as trauma. This article aims to provide a reference system to objectively classify axial plane malalignment of the femur and tibia using the 'axial malalignment test' (AMAT). A cohort of patellofemoral dislocators and control subjects underwent bilateral lower limb MRI scans as part of a research protocol. Their femoral and tibial torsion were calculated on axial slices, and femoral torsion for each patient was plotted with respect to their tibial torsion. The resulting scatterplot was divided into a matrix based on normal values constructed from the dataset. Normal, simple, and complex torsional profiles were defined based on whether there was torsion greater than normal in neither, one, or both bones respectively. Measurements of foot progression angle were also compared in selected patients, with extension of the algorithm to include assessment of any soft tissue contribution to finalize descriptive and quantitative values for the AMAT. The AMAT offers a structured approach that incorporates both bony anatomy and soft tissue function to support systematic assessment of torsional deformities. Validation in a larger cohort is needed to confirm these preliminary findings, given the small sample size.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Charleston vs. Providence: are all scoliosis bending braces created equal? 查尔斯顿vs普罗维登斯：所有脊柱侧弯弯曲支架都是平等的吗？

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-03-23 DOI: 10.1097/BPB.0000000000001345

Connor A Nyborg, Laura Morales Leon, Ravi Rajendra, Michael R Cesarek, Claudia Leonardi, R Carter Clement

引用次数: 0

Growth arrest following posterior knee release in children with arthrogryposis multiplex congenita: a previously unreported complication. 儿童多重先天性关节挛缩后膝关节后部松解后生长停止：一种以前未报道的并发症。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-03-23 DOI: 10.1097/BPB.0000000000001344

Lauren C Hyer, Jacob Bailey, Christian Lowson, Katherine R Ward, David E Westberry

{"title":"Growth arrest following posterior knee release in children with arthrogryposis multiplex congenita: a previously unreported complication.","authors":"Lauren C Hyer, Jacob Bailey, Christian Lowson, Katherine R Ward, David E Westberry","doi":"10.1097/BPB.0000000000001344","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001344","url":null,"abstract":"Knee flexion contractures in children with arthrogryposis multiplex congenita (AMC) significantly impair function and ambulation. Posterior knee soft tissue release is a widely used surgical intervention when conservative management fails. However, literature describing complications following this procedure remains limited. This study aims to report distal femoral and proximal tibial physeal arrest as a previously undocumented complication following posterior knee release in children with AMC. Following institutional review board approval, a retrospective case series was performed. Patients with AMC who underwent posterior soft tissue knee release and subsequently developed growth arrest of the distal femur with or without arrest of the proximal tibia were identified from an institutional database. Data collected included demographics, age at index procedure, time to diagnosis of growth arrest, adjunct procedures, clinical deformities, and subsequent interventions. Eight patients (six females and two males) were identified to have either a distal femoral or proximal tibial physeal bar following posterior knee release. Mean age at index surgery was 44 (range: 22-69) months. Growth arrest was identified at a mean of 43 months postoperatively (range: 11-104 months). Progressive deformity was seen in all patients, correlating with the location of the growth arrest. Physeal bar resection was attempted in all cases, with variable or pending outcomes. Distal femoral and proximal tibial growth arrest may occur following posterior knee release in children with AMC. Given the proximity of surgical dissection to the physis, this complication should be recognized as a potential risk. Surgeons should take care to avoid physeal injury, counsel families regarding this potential risk, and closely monitor for growth disturbance during postoperative follow-up.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of gender in patients with developmental dysplasia of the hip treated with closed reduction and spica cast immobilization: does it affect prognosis? 性别在髋关节发育不良患者闭合复位和spica石膏固定中的作用：是否影响预后？

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-03-16 DOI: 10.1097/BPB.0000000000001343

Zhe Kang, Yiqiang Li, Federico Canavese, Jingchun Li, Jianping Wu, Honghong Lin, Hongwen Xu

{"title":"The role of gender in patients with developmental dysplasia of the hip treated with closed reduction and spica cast immobilization: does it affect prognosis?","authors":"Zhe Kang, Yiqiang Li, Federico Canavese, Jingchun Li, Jianping Wu, Honghong Lin, Hongwen Xu","doi":"10.1097/BPB.0000000000001343","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001343","url":null,"abstract":"To investigate the impact of gender on the prognosis of children with developmental dysplasia of the hip (DDH) treated with closed reduction and spica cast immobilization (CR-SCI). A retrospective analysis was conducted on 302 DDH children (347 hips) who underwent CR-SCI at our department from 1 January 2003 to 31 December 2015. Among them, 42 cases (50 hips) were male, and 260 cases (297 hips) were female. The acetabular index, center edge angle (CEA), and avascular necrosis (AVN) of the femoral head were measured and evaluated on anteroposterior pelvic radiographs. The Severin classification was recorded at the final follow-up. Preoperative analysis of acetabular index revealed poorer hip development in females than in males (P = 0.003). However, last follow-up acetabular index, acetabular index improvement, and last follow-up CEA were comparable for both sexes (P > 0.05). There were no statistically significant differences in postoperative re-dislocation rates, reoperation rates, or Severin classification at the final follow-up (P > 0.05). However, significant differences were observed in the incidence of AVN (P = 0.025) and AVN grading (P = 0.046) at the final follow-up. Further univariate analysis showed that gender significantly influenced AVN (P = 0.025). Multivariate analysis revealed that gender (P = 0.005) and adductor tenotomy (P = 0.028) were influencing factors for AVN. Gender is an influencing factor for AVN after CR-SCI for DDH, with male children having a higher probability of developing AVN postoperatively, indicating poorer outcomes despite no significant differences in postoperative imaging and functional outcomes between genders. Intraoperative adductor tenotomy is another risk factor for AVN. Level of Evidence: Level IV-retrospective cohort study.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiographic outcomes of a treatment approach for lower leg deformities in patients with hereditary multiple exostoses. 一种治疗遗传性多发性外骨骼增生患者下肢畸形的方法的影像学结果。

IF 1 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2026-03-02 DOI: 10.1097/BPB.0000000000001342

Kenta Sawamura, Masaki Matsushia, Kenichi Mishima, Shiro Imagama

{"title":"Radiographic outcomes of a treatment approach for lower leg deformities in patients with hereditary multiple exostoses.","authors":"Kenta Sawamura, Masaki Matsushia, Kenichi Mishima, Shiro Imagama","doi":"10.1097/BPB.0000000000001342","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001342","url":null,"abstract":"Hereditary multiple exostoses (HME) represent a rare skeletal disorder characterized by multiple osteochondromas, often leading to angular deformities in the lower limbs as well as leg length discrepancy (LLD), managed with tension band plates (TBP) for deformity correction. However, the utility of both angular deformity and LLD in HME has not been comprehensively evaluated. In this study, we retrospectively reviewed 25 pediatric patients with HME who visited our institution and reached skeletal maturity between 2012 and 2024, assessing a total of 50 limbs. Surgical indications included patients aged greater than 10 years with an open growth plate, predicted LLD of greater than or equal to 20 mm at the skeletal maturity, and a mechanical axis zone (MAZ) greater than or equal to Zone 2. We categorized the outcomes into four groups: excellent [LLD < 10 mm; mechanical axis percentage (%MA) ≤ ±25%], good (LLD < 15 mm; %MA ≤ ±50%), fair (LLD < 20 mm or at least one limb classified as %MA ≤ ±100%), and poor (worse than the previous categories). We used paired t-tests for statistical analyses. Among the 17 surgically treated patients, TBP was performed on 27 limbs and 60 physes. In most cases, multisite and staged surgeries were required. Angular deformities improved significantly, with the mean hip-knee-ankle angle reduced from 7.8 to 2.7° (lower extremity < 0.01), and 92% of limbs achieved MAZ Zone 1. LLD was corrected from 17.6 to 5.6 mm (P < 0.01) at an average correction rate of 0.47 mm/month. The final outcomes were excellent, good, and fair or poor in 12, 11, and 2 patients, respectively. Major complications were not observed. TBP treatment is effective in correcting both angular deformity and LLD in patients with HME, offering a minimally invasive strategy for comprehensive correction of this complex skeletal dysplasia. Careful surgical planning and timing are essential and staged multisite procedures are often required.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0