Journal of Pediatric Orthopaedics-Part B最新文献

{"title":"Proximal femoral focal deficiency/congenital femoral deficiency: a proposal for a new classification.","authors":"Gamal A Hosny, Ahmed A Elsheikh","doi":"10.1097/BPB.0000000000001241","DOIUrl":"10.1097/BPB.0000000000001241","url":null,"abstract":"<p><p>Congenital femoral deficiency (CFD) or proximal femoral focal deficiency (PFFD) has been a controversial topic to present, describe, classify, and treat. Since 1939, many classifications have been proposed to describe the disease and plan possible treatment - however, no single widely accepted classification. The currently available classification could not fill the gap between description and surgical planning. Some provided a graphical description of the disease with possible treatment plans, yet there is minimal evidence of its reliability and reproducibility. We propose to develop a new classification with specific criteria. The suggested classification has four types of PFFD/CFD: Type 1 morphological abnormality of the whole femur; Type 2 congenital absence of the femur is subdivided into A - total absence and B - partial absence; Type 3 abnormal proximal femur is subdivided into A - apparent neck pseudoarthrosis and B - coxa vara; and Type 4 short femur (congenital short femur).</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 4","pages":"362-366"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175453","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}

{"title":"Innovations and challenges in pediatric orthopedics: insights from Vietnam.","authors":"Phi Duong Nguyen, Nam Quang Dinh Vo, Nhi Huynh Manh, Man Duc Minh Phan, Hung Ngoc Nguyen","doi":"10.1097/BPB.0000000000001260","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001260","url":null,"abstract":"<p><p>Pediatric orthopedic care in Vietnam has experienced transformative growth over the past three decades, overcoming challenges unique to low-resource settings through innovation, collaboration, and dedication. This review explores Vietnam's progress in managing congenital deformities, trauma care, and rehabilitation, with a focus on decentralized care delivery, cost-effective surgical techniques, and capacity-building initiatives. Highlighting the critical roles played by the Vietnam Pediatric Orthopaedic Association and international collaborations, this analysis underscores the impact of tailored interventions and multidisciplinary approaches. By integrating technology, fostering education, and addressing systemic disparities, Vietnam exemplifies the potential for sustainable advancements in pediatric orthopedic care globally, even amidst resource constraints.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 4","pages":"405-409"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175450","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}

{"title":"Dandy-Walker malformations with other complex congenital deformities associated with scoliosis: a case series.","authors":"Masayoshi Machida, Masafumi Machida, Katsuaki Taira, Naho Nemoto, Noboru Oikawa, Hirofumi Ohashi, Kazuyoshi Nakanishi","doi":"10.1097/BPB.0000000000001213","DOIUrl":"10.1097/BPB.0000000000001213","url":null,"abstract":"<p><p>Dandy-Walker malformations (DWM) is a rare condition with an estimated prevalence of 1 in 30 000 cases. Although DWM often complicates scoliosis, its prevalence and the time of onset are unknown because only a few reports have described the association between scoliosis and DWM. This case series describes spinal deformity associated with DWM. The clinical records and spinal radiographs of 23 consecutive patients with DWM at a single centre were reviewed. DWM was clinically diagnosed if patients met the following three conditions: (1) posterior fossa enlargement, (2) cerebellar hypoplasia and (3) cystic dilation of the fourth ventricle on MRI. Radiological assessment records for the presence, prevalence and time of onset of DWM were studied. Twelve of 23 patients (52%) demonstrated a scoliotic deformity, with 3 (13%) having severe deformities exceeding 60°. The average age at diagnosis was 3.6 ± 2.9 years (range: 0.7-9.7) and at radiographic examination during the final follow-up was 8.7 years (range 1.0-22.0). Only two patients were skeletally mature. The coronal angular deformity at the final follow-up was 34.2 ± 32.3° (range: 10.1-125.1°). One patient with moderate deformity >25° died before bracing. In addition, of three patients with severe deformities, only one had undergone posterior spinal fusion. The prevalence of scoliosis in DWM was 52%, and all patients who developed scoliosis reported early-onset scoliosis under 10 years of age. Early diagnosis and screening of spine deformity are required for patients with DWM to prevent disease progression. Evidence level: 4.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"396-399"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394766","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}

{"title":"The use of intraoperative C-arm flat-detector computed tomography following closed reduction and spica cast application in the treatment of children with developmental dysplasia and hip dislocation.","authors":"Michael Zaidman, Naum Simanovsky, Vladimir Goldman, Eden Weisstub","doi":"10.1097/BPB.0000000000001254","DOIUrl":"10.1097/BPB.0000000000001254","url":null,"abstract":"<p><strong>Level of evidence: </strong>Level IV - case series.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"357-361"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993935","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}

{"title":"Can the increase in the use of perinatal hip sonography really reduce the number of developmental hip dislocations needing closed/open reduction? The experience of a large Italian pediatric hospital.","authors":"Enrico Micciulli, Andrea Magistrelli, Davide Lardo, Fernando De Maio, Ernesto Ippolito","doi":"10.1097/BPB.0000000000001256","DOIUrl":"10.1097/BPB.0000000000001256","url":null,"abstract":"<p><p>Perinatal hip sonography (PHS) is not mandatory in Italy, but during the last years, it has been performed increasingly more even in babies with negative Ortolani maneuver. We aimed to investigate whether the increased use of PHS decreased the number of Graf's type IV hips needing closed/open reduction (COR) at the Bambino Gesù Hospital of Rome, Palidoro (BGHRP). We consulted the BGHRP database from 2012 to 2022 to determine the number of patients with Graf's type IV hips who had COR; the COR patients who had PHS done inside and outside the hospital; the patients who had brace treatment after PHS with a diagnosis of DDH. The hospital's sonographers were ascertained to be experts in Graf's method because they had attended several instructional courses, while the sonographers operating in other centers had not received this training. Sixty-three patients with Graf's type IV hips had COR from 2012 to 2016 while 31, from 2017 to 2022. The difference was significant ( P  = 0.009). The 67 patients with COR who came to BGHRP for follow-up were divided into two groups. Group 1 included 61 patients who had PHS done outside the hospital. In those patients, several DDH had a wrong diagnosis and none had brace treatment. Group 2 included six patients out of the 277 with DDH who had PHS done at BGHRP and who received brace treatment. The difference between the two groups was significant ( P  < 0.001). To decrease the number of dislocated hips needing COR, an increased use of PHS is not sufficient but it is also necessary that sonographers must be experts in Graf's method and aware of DDH treatment.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"351-356"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030493","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}

{"title":"A nationwide survey on the information preferences of parents of children with developmental dysplasia of the hip compared with pediatric orthopedic surgeons' perspectives.","authors":"Wesley W E S Theunissen, Jaap J Tolk, Merel R Van Veen, Christiaan J A Van Bergen, Stijn E W Geraets, Adriaan K Mostert, Arnold T Besselaar, Florens Q M P Van Douveren, Maria C Van der Steen","doi":"10.1097/BPB.0000000000001251","DOIUrl":"10.1097/BPB.0000000000001251","url":null,"abstract":"<p><p>The diagnosis and treatment of developmental dysplasia of the hip (DDH) can be stressful for parents, often worsened by inadequate information. The primary aim of this study is to assess whether the information preferences of parents of children with DDH, identified in a prior single-center study, are generalizable across the Netherlands. A secondary aim is to compare these preferences with the perspectives of pediatric orthopedic surgeons. An online survey was conducted between September and November 2023 among parents of children with DDH and pediatric orthopedic surgeons in the Netherlands. Based on prior qualitative research, the survey included closed- and open-ended questions regarding the content, timing, and format of information delivery. A total of 177 parents and 20 pediatric orthopedic surgeons completed the survey. Median response scores were ≥7 across all questions, suggesting that previously identified parental preferences are applicable nationwide. Both parents and pediatric orthopedic surgeons emphasized the importance of accessible and understandable information to people at all levels of society. Parents strongly preferred reliable DDH-related information before diagnosis and valued resources they could revisit at home, such as websites or printed materials. However, parents showed minimal interest in a smartphone application, a preference that contrasted with pediatric orthopedic surgeons' perspectives. This nationwide study provides a comprehensive overview of the information preferences of parents in DDH care. Comparing these findings with the perspectives of pediatric orthopedic surgeons offers valuable insights for optimizing information delivery. This can help refine information delivery strategies, ultimately enhancing disease understanding, parental satisfaction, and treatment adherence.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"327-336"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Casting, elastic intramedullary nailing or external fixation in pediatric tibial shaft fractures: which is the most appropriate treatment? A multicenter study: comment on study by Marengo et al.","authors":"Siddharth Jain, Sourabh Kumar Sinha, Prateek Behera, John A Santoshi, Sonal Mishra","doi":"10.1097/BPB.0000000000001255","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001255","url":null,"abstract":"","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 4","pages":"410"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175442","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}

{"title":"Dispelling the Dogma: upper-instrumented vertebrae of T5-T6 can achieve similar correction and shoulder balance with less blood loss than T2-T4 in select patients.","authors":"Matthew E LaBarge, William H Waddell, Hani Chanbour, Byron F Stephens, Jeffrey E Martus, Gregory A Mencio, Craig R Louer","doi":"10.1097/BPB.0000000000001245","DOIUrl":"10.1097/BPB.0000000000001245","url":null,"abstract":"<p><p>The choice of upper-instrumented vertebrae (UIV) for posterior spinal fusion (PSF) constructs is influenced by guidelines where UIV is T4 or more cephalad. In a cohort of patients with adolescent idiopathic scoliosis (AIS) with thoracic curves, we sought to (a) compare postoperative shoulder balance for patients with UIV of T5-T6 versus T2-T4 and (b) evaluate curve and operative characteristics that lead to balance with a more caudal UIV. A single-institution AIS registry was queried for patients undergoing PSF from 2000 to 2017. Included were patients undergoing PSF for AIS, with Lenke 1 and 2 curves, and minimum 2-year follow-up. Shoulder balance was defined as: T1 tilt = 0 ± 5°, coracoid height difference (CHD) = 0 ± 1 cm. A total of 161 patients were included, mean follow-up was 47 months. Curves fused to T2-T4 had larger, stiffer preoperative proximal thoracic curves and were more likely to be classified as Lenke 2. Following PSF, there was no difference in final T1 tilt ( P  = 0.062) or final CHD ( P  = 0.176) between groups. Patients with a UIV of T5-T6 had shorter operative times ( P  < 0.001), less operative blood loss ( P  = 0.009), and similar complication rates ( P  = 0.344). In the T5-T6 cohort, 70.3% of patients achieved shoulder balance at the final follow-up. For thoracic AIS undergoing PSF, selecting a UIV of T5 or T6 can result in comparable postoperative shoulder balance in properly selected patients.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"375-382"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574374","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}

{"title":"The impact of hamstring lengthening on stance knee flexion at skeletal maturity in ambulatory cerebral palsy.","authors":"Bidzina Kanashvili, Timothy A Niiler, Chris Church, Nancy Lennon, M Wade Shrader, Jason J Howard, Freeman Miller","doi":"10.1097/BPB.0000000000001174","DOIUrl":"10.1097/BPB.0000000000001174","url":null,"abstract":"<p><p>This study reports the long-term outcomes of hamstring lengthening to treat flexed knee gait in children with ambulatory cerebral palsy (CP) after skeletal maturity. This retrospective longitudinal observational study used instrumented gait analysis (GA) <8 and >15 years old in children with bilateral CP. The primary variable was knee flexion in stance phase. Eighty children (160 limbs) were included; 49% were male, 51% female. Mean age at first GA was 6.0 (SD: 1.2) years and 19.6 (SD: 4.5) years at final GA. Mean follow-up was 13.7 (SD: 4.7) years. Children were classified as Gross Motor Function Classification System I-8, II-46 and III-26. Average Gross Motor Function Measure Dimension D was 72% (SD: 20%). Hamstring lengthenings occurred once in 82, twice in 54 and three times in 10 limbs. From initial to final GA, average knee flexion in stance was unchanged, 27.8° (SD: 14.8°) to final 27.0° (SD: 11.2°; P  = 0.54). Knee flexion at foot contact was 39.6° (SD: 13.0°), improving to final GA of 30.7° (SD: 10.6°; P  < 0.001). Initial gait deviation index was 65.8 (SD: 31.9), improving to final 78.9 (SD: 28.2; P  < 0.001). Older age, males and concomitant plantar flexor lengthening predicted change toward more flexed knee gait. Hamstring lengthening did not lead to back-kneeing gait at maturity while maintaining childhood stance phase knee flexion. A subgroup still developed significant flexed knee gait posture and may have benefited from more aggressive treatment options. This outcome may also be impacted by diverse functional levels, etiologies and treatments of flexed knee gait.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"320-326"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061116","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}

{"title":"Scapular osteomyelitis, a challenging diagnosis: a systematic review in pediatric age.","authors":"Ilaria Liguoro, Sarah Ortis, Francesco Mancuso, Michele Patui, Paola Cogo, Chiara Pilotto","doi":"10.1097/BPB.0000000000001271","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001271","url":null,"abstract":"<p><p>Osteomyelitis of the scapula is a rare site of bone infection. Early diagnosis is difficult because of the rarity of localization, the rapid progression, and the misleading atypical manifestations. We systematically reviewed the current available evidence on osteomyelitis of the scapula to provide a synthesis on the epidemiology, clinical presentation, complications, and management of this infection. PubMed, Scopus, and Google Scholar databases were explored to identify studies, case series, and case reports with no time limits focused on children with scapular osteomyelitis. Thirteen articles were included in the final analysis, for a total of 17 patients (14 children and three newborns). The most frequently reported symptoms in children were pain (100%), limitation of shoulder movements (100%), and fever (79%). Several imaging tests were adopted (X-ray, ultrasound, computed tomography scan, and MRI) with pathological findings in most cases. Blood tests always showed a phlogistic state. The most frequent causative agent was methicillin-sensitive Staphylococcus aureus in children and group B Streptococcus in newborns. The mean total duration of antibiotic treatment was 51.5 days, with intravenous cephalosporins (43%), penicillins (36%), and aminoglycosides (29%) adopted as first-choice antibiotics in most cases. Full recovery was reported in most cases (79% in children). Osteomyelitis should be suspected in cases of osteomuscular symptoms even in the absence of fever or local signs. Inflammatory indices and white blood cell count can be only slightly elevated and normal X-rays cannot exclude the diagnosis, and in case of suspicion, MRI is mandatory.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545860","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}