Journal of Pediatric Orthopaedics-Part B最新文献

{"title":"Diagnosis and treatment of lateral to medial diagonal injury of the elbow in children: concomitant lateral condyle and olecranon fractures.","authors":"Yunan Lu, Chentao Xue, Federico Canavese, Yongjie Xia, An Yan, Yuchen Pan, Hetu Yao, Shunyou Chen","doi":"10.1097/BPB.0000000000001263","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001263","url":null,"abstract":"<p><p>Lateral condylar (LC) and olecranon (OC) fractures occurring concurrently on one side are rare phenomena with limited scientific literature. Our study aims to evaluate the radiologic, clinical, and functional consequences of lateral to medial injury of the elbow (LAMEINE) in pediatric patients, simultaneously comparing with lateral to medial diagonal injury of the elbow (MELAINE). Eighteen males and 10 females were diagnosed with LAMEINE. The average age at the time of injury was 3.8 ± 2.3 years (range, 1-9). Out of the 28 fractures, 19 (67.9%) occurred on the left side and nine (32.1%) on the right side. The OC fractures were classified according to the Weiss system, two being type I, 17 type II, and nine type III fractures. Based on the specific case characteristics, the OC fractures were further subdivided into five types corresponding to two types of AO classification: 24 (85.7%) cases of AO 21u-M/2. 1 incomplete fractures [3 type I (10.7%), 16 type II (57.1%), and five type III fractures (17.9%)], and four (14.3%) cases of AO 21u-M/3.1 complete simple fractures [2 type IV (7.1%) and two type V fractures (7.1%)]. All patients underwent surgical intervention. Their clinical and functional outcomes were evaluated using the carrying angle (CA) and elbow performance score (EPS). These results were then compared with those of our MELAINE patients. All patients were followed up for 42.9 ± 23.5 months (range, 15-88). Radiographs indicated that all fractures healed in 5.9 ± 1.4 weeks (range, 4-10). At the last follow-up, the CA and EPS of the injured side were 11.3° ± 2.8° and 97.7 ± 3.7, respectively. All patients had favorable outcomes: 27 patients (96.4%) had excellent EPS, and only one patient (3.6%) had good EPS. The LAMEINE group displayed lower age, displacement, incidence of elbow dislocation, and CA than the MELAINE group (P < 0.05). Although relatively rare, LAMEINE should not be neglected. Surgical treatment aims to stabilize the elbow and avoid varus deformity. With appropriate diagnosis and treatment, good clinical and radiographic outcomes can be achieved for both patterns of 'diagonal lesions' of the pediatric elbow. Level of evidence: III.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095258","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":"Management of postinfective pathological hip dislocation with absent capital femoral epiphysis in young children: a long-term follow-up study.","authors":"Rajesh Kumar Kanojia, Sumit Gupta, Durgesh Sharma, Ajay Kumar","doi":"10.1097/BPB.0000000000001259","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001259","url":null,"abstract":"<p><strong>Level of evidence: </strong>Level IV - therapeutic study.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112620","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":"Factors associated with radiographic correction of the foot after medialising calcaneal osteotomy in children with symptomatic flexible flatfoot.","authors":"Phatcharapa Osateerakun, Pathit Sirichuchnin, Prajak Jiratummarat, Noppachart Limpaphayom","doi":"10.1097/BPB.0000000000001262","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001262","url":null,"abstract":"<p><strong>Level of evidence: </strong>Level IV - prognostic, retrospective case series.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112619","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":"Implants removal in children: results of a survey among Italian orthopaedic surgeons.","authors":"Nunzio Catena, Chiara Arrigoni, Antonio Andreacchio, Renato Toniolo, Fabio Verdoni, Pasquale Guida","doi":"10.1097/BPB.0000000000001187","DOIUrl":"10.1097/BPB.0000000000001187","url":null,"abstract":"<p><p>In the treatment of paediatric limb disorders, the use of metal implants has been increasing over the last decades. Recent studies have addressed the decision of orthopaedic surgeons regarding the removal of implants after the treatment of fracture, and there is a growing consensus within the scientific community supporting the choice of not removing implants in children. This survey aimed to investigate the rationale behind the Italian orthopaedic community's decision regarding metal implant removal in paediatric patients. An electronic questionnaire was sent to all members of the Italian Paediatric Orthopaedic and Traumatology Society, Italian Orthopaedic and Traumatology Society, Italian Club of Osteosynthesis, and South Italy Society of Orthopaedic and Traumatology. The survey comprised 34 questions about hardware removal after the treatment of long bone fractures, epiphyseal growth plate injuries, slipped capital femoral epiphysis (SCFE), and flat foot. Of the 3500 orthopaedic surgeons who received the questionnaire, 5.5% responded. The leading indications for implant removal were the patient's intolerance, pain, ROM limitations, and hardware breakage. Removal of elastic nails for long bone fractures, cannulated screws for growth plate injuries, and SCFE and screws for arthroereisis for flat foot correction were analysed in detail. The consensus among Italian Orthopaedic Surgeons is to remove elastic nails and cannulated screws in cases of pain, intolerance, or breakage and to reduce further risks during patient growth. An increasing number of physicians, however, are endorsing and advocating the growing trend in the literature of not routinely removing the hardware.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"236-239"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248782","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":"Rigid intramedullary nailing of lower limb segments in children and adolescents with metabolic bone disease.","authors":"Charlene K Chin See, Saeed Al-Naser, Nicolas Nicolaou, Stephen N Giles, James A Fernandes","doi":"10.1097/BPB.0000000000001215","DOIUrl":"10.1097/BPB.0000000000001215","url":null,"abstract":"<p><p>Children and adolescents with metabolic bone disease present to the orthopedic surgeon with pain, fractures (which may be impending), and deformity. Different modalities of orthopedic management are available. Scant literature exists on the use of rigid intramedullary nailing in this population. This study sought to evaluate the utilization of this treatment modality in the pediatric cohort, focusing on indications, techniques, and outcomes of the procedures. A retrospective review was performed over an 11-year period at a single tertiary pediatric institution in the UK. Medical records and radiographs were reviewed. Preoperative surgical and medical management, time to bony union, and complications were specifically ascertained. Twenty-seven patients (63 lower limb segments) had rigid intramedullary nailing over the specified period. The majority of patients had an underlying diagnosis of osteogenesis imperfecta or fibrous dysplasia (including McCune Albright Syndrome). Surgical indications included acute fractures, prophylactic stabilization, previous nonunion and malunions, deformity correction, and limb lengthening. All fractures healed and deformity correction was successful. In one patient, delayed union occurred after deformity correction and was successfully treated with dynamization. Fractures healed faster than corrective osteotomies. Complications included implant prominence, cortical penetrance, and screw loosening. Nonunion occurred with limb lengthening in one patient. Rigid intramedullary nailing is a safe and effective method of treatment for lower limb fractures and deformities in children and adolescents. This technique is, therefore, recommended for patients with metabolic bone disease. However, care must be taken in preoperative surgical planning and a multidisciplinary approach should be utilized.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"264-270"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606301","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":"Does postoperative immobilization affect final alignment of pediatric femur fractures treated with flexible intramedullary nailing?","authors":"Adam Michael Miller, Rutledge Carter Clement, Claudia Leonardi","doi":"10.1097/BPB.0000000000001203","DOIUrl":"10.1097/BPB.0000000000001203","url":null,"abstract":"<p><p>Flexible intramedullary nail (FIN) fixation of pediatric femur fractures is a popular method of fixation in children. Typical immobilization options include spica casting, long leg cast, knee immobilizers, or no immobilization and the decision to use each is usually left to surgeon preference. Our primary aim is to evaluate whether different postoperative immobilization status influences outcomes, namely radiographic alignment at the time of healing. A retrospective chart review was conducted of all patients with femur fractures treated with FIN fixation at a pediatric hospital from April 2018 through July 2022. Postoperative immobilization protocols were recorded and separated into two groups, patients who were immobilized (IMM) and patients who were not immobilized (NoIMM). Radiographs were evaluated for fracture alignment immediately following surgery and at the time of healing. Patients demographic, fracture, and postoperative clinical characteristics were compared between the two groups (NoIMM vs. IMM). A total of 41 patients were treated for diaphyseal femur fractures with FINs at our institution during the study period. No significant difference was observed in alignment at healing. Our results suggest that either immobilization or no immobilization after flexible intramedullary nailing of pediatric femoral shaft fractures are viable options when postoperative immobilization status is left to the surgeon's discretion.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"205-208"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127110","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":"Achilles tenotomy during Ponseti's clubfoot treatment: better early than late.","authors":"Siddharth Jain, Prateek Behera, Sourabh Kumar Sinha, John A Santoshi, Sonal Mishra","doi":"10.1097/BPB.0000000000001234","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001234","url":null,"abstract":"","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 3","pages":"305"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722404","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 fate of hemiepiphysiodesis implants left in place after skeletal maturity in patients with idiopathic genu valgum.","authors":"Christopher A Makarewich, Senah E Stephens, Ndidi C Njoku, Emily Zhang, Timothy W Torrez","doi":"10.1097/BPB.0000000000001220","DOIUrl":"10.1097/BPB.0000000000001220","url":null,"abstract":"<p><p>Hemiepiphysiodesis using tension band plate and screws is a frequently used technique for the correction of lower extremity angular deformities. These implants are often left in place if patients have corrected their alignment on reaching skeletal maturity. There is little information regarding the rate of and reasons for subsequent removal of these deep implants. This retrospective case-control study included patients treated with hemiepiphysiodesis with tension band plate and screws at the distal femur and/or proximal tibia for idiopathic genu valgum and reached skeletal maturity with implants retained. Electronic medical records and radiographs were reviewed for patient characteristics and the need for subsequent removal of implants. Those who had implants removed were compared to those with implants not removed using Student's t-test for continuous variables and chi-square for categorical variables. Forty-six patients met inclusion criteria. Twenty-five of 46 patients (54%) underwent subsequent removal of deep implants, and all cases were due to symptoms related to the plate and screws. Factors associated with removal of deep implants included multiple vs. single rounds of hemiepiphysiodesis (76% vs. 43%, P = 0.02) and plates at the distal medial femur alone (P = 0.004). There were no differences between groups regarding sex, age at hemiepiphysiodesis, height, weight, and BMI. In conclusion, after skeletal maturity, there was a 54% rate of removal of symptomatic hemiepiphysiodesis implants. Factors associated with implant removal include repeat hemiepiphysiodesis and isolated distal medial femur plate position. This information can be used to guide patient and provider expectations as patients transition to adulthood.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 3","pages":"282-284"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722409","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":"Clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children.","authors":"Haiting Jia, Tao Liu","doi":"10.1097/BPB.0000000000001235","DOIUrl":"10.1097/BPB.0000000000001235","url":null,"abstract":"<p><p>This study aimed to summarize the clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children. Data of 43 children with acute osteomyelitis of long bones diagnosed and treated from November 2017 to January 2021 were retrospectively analyzed. Medical records, laboratory results, and MRI were reviewed. Surgical drainage of lesions was done to retrieve infective fluid and tissue for examination. There were 12 cases of metaphyseal and epiphysis involvement, including five boys and seven girls, aged from 1 to 12 years old, and the length of hospitalization was 21-45 days. There were six cases of distal femur, five cases of proximal tibia, and one case of distal humerus. The pathogenic microorganisms were methicillin-sensitive Staphylococcus aureus (MSSA) in six cases and methicillin-resistant Staphylococcus aureus (MRSA) in six cases. No complications were reported during the follow-up. Thirty-one cases of simple metaphyseal involvement, including 20 boys and 11 girls, aged 19 days to 12 years, and the length of hospitalization was 18-60 days. Twelve cases of distal femur, 11 cases of proximal tibia, three cases of distal humerus, two cases of proximal tibiofibular, two cases of proximal fibula, and one case of proximal ulna. The pathogenic microorganism was MSSA in 26 cases and MRSA in five cases. One patient with knee contracture during follow-up. Epiphyseal osteomyelitis is rare but can occur in older children. The prognosis is good with aggressive surgical treatment.</p>","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"285-287"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015225","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":"Incidence of complications among operative pediatric supracondylar humerus fractures using medial and lateral pins: a safe technique for percutaneous medial pin placement.","authors":"Andreas Rehm, Rebecca J Worley, Hatem Osman, Katerina Hatzantoni, Helen E Chase, Elizabeth Ashby","doi":"10.1097/BPB.0000000000001238","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001238","url":null,"abstract":"","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 3","pages":"306-307"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722405","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}