Journal of Pediatric Orthopaedics-Part B最新文献_第4页

Does postoperative immobilization affect final alignment of pediatric femur fractures treated with flexible intramedullary nailing? 术后固定是否会影响采用柔性髓内钉治疗的小儿股骨骨折的最终对位？

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2024-08-15 DOI: 10.1097/BPB.0000000000001203

Adam Michael Miller, Rutledge Carter Clement, Claudia Leonardi

{"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":"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.","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}

引用次数: 0

Achilles tenotomy during Ponseti's clubfoot treatment: better early than late. 跟腱切开术治疗Ponseti内翻足：早期优于晚期。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2025-03-25 DOI: 10.1097/BPB.0000000000001234

Siddharth Jain, Prateek Behera, Sourabh Kumar Sinha, John A Santoshi, Sonal Mishra

引用次数: 0

The fate of hemiepiphysiodesis implants left in place after skeletal maturity in patients with idiopathic genu valgum. 特发性膝外翻患者骨骼成熟后半骨骺固定植入物的命运。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2025-03-25 DOI: 10.1097/BPB.0000000000001220

Christopher A Makarewich, Senah E Stephens, Ndidi C Njoku, Emily Zhang, Timothy W Torrez

{"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":"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.","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}

引用次数: 0

Clinical characteristics of acute epiphyseal osteomyelitis and acute metaphyseal osteomyelitis of long bones in children. 儿童长骨急性骨髓炎和急性干骺端骨髓炎的临床特点。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2025-01-21 DOI: 10.1097/BPB.0000000000001235

Haiting Jia, Tao Liu

{"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":"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.","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}

引用次数: 0

Incidence of complications among operative pediatric supracondylar humerus fractures using medial and lateral pins: a safe technique for percutaneous medial pin placement. 手术儿童肱骨髁上骨折使用内侧和外侧钉的并发症发生率：一种安全的经皮内侧钉置入技术。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2025-03-25 DOI: 10.1097/BPB.0000000000001238

Andreas Rehm, Rebecca J Worley, Hatem Osman, Katerina Hatzantoni, Helen E Chase, Elizabeth Ashby

引用次数: 0

Ray resection in pediatric population after trauma injuries. 儿童外伤后的射线切除术。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2024-02-19 DOI: 10.1097/BPB.0000000000001172

João Marques, Marcos Carvalho, Sérgio Martínez Alvarez, Maria Pia Monjardino, Pedro Cardoso, Tah Pu Ling, Cristina Alves

{"title":"Ray resection in pediatric population after trauma injuries.","authors":"João Marques, Marcos Carvalho, Sérgio Martínez Alvarez, Maria Pia Monjardino, Pedro Cardoso, Tah Pu Ling, Cristina Alves","doi":"10.1097/BPB.0000000000001172","DOIUrl":"10.1097/BPB.0000000000001172","url":null,"abstract":"The aim of this study is to assess the functional, emotional, and social adaptation of pediatric patients submitted to a hand ray resection to treat a traumatic hand injury. Retrospective study of pediatric patients undergoing hand ray resection, in the period 2013-2022, performed in two hospital institutions. Inclusion criteria: age less than 18 years, primary/secondary resection due to traumatic etiology and follow-up time of more than 1 year. Data concerning demographic information, lesion location, traumatic mechanism and surgical description were collected. Functional outcomes (QuickDASH Score), social and emotional integration (PEDSQL) and satisfaction were evaluated. Seven patients were included, with male predominance ( n = 4) and the right side was the most affected ( n = 5). Median age at the time of surgery was 10 years (2-15). Primary ray resection, without previous revascularization, was performed in three patients. Secondary ray resection was performed in four patients. Three patients with an unsuccessful revascularization procedure attempt another patient with a sequela with severe deformity. All patients presented a good adaptation to daily living activities, with good pinch and grip function. The median follow-up was 4 years (min:1; max:9). The scores were collected on six out of seven patients. Median QuickDASH score of 14 (min:11; max:22), and PEDSQL[physical] of 95.31 (min:78.13; max:100) and PEDSQL[social] of 93.47 (min:66.3; max:100). Hand ray resection is a rare procedure in pediatric age and usually difficult for patients and parents to accept. However, it is a useful and safe technique that allows for an improvement in overall hand function and psychosocial readaptation in specific and selected cases. Level of evidence: Level of evidence IV - case series.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"240-248"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906781","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

Can we make out the coronal plane corrections of the knee region by studying the screw divergence in tension band plate induced growth modulations? 我们能否通过研究张力带钢板诱导的生长调节中的螺钉散度来确定膝关节区域的冠状面修正？

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2024-12-24 DOI: 10.1097/BPB.0000000000001224

Anil Agarwal, Kishmita Sachdeva, Ankitha Kanchinadka Sripathy, Varun Garg

{"title":"Can we make out the coronal plane corrections of the knee region by studying the screw divergence in tension band plate induced growth modulations?","authors":"Anil Agarwal, Kishmita Sachdeva, Ankitha Kanchinadka Sripathy, Varun Garg","doi":"10.1097/BPB.0000000000001224","DOIUrl":"10.1097/BPB.0000000000001224","url":null,"abstract":"We studied the correlation between changes in the interscrew angle (screw divergence) and the correction achieved with tension band plates applied for valgus deformities of the knee region. Twenty-eight children with 68 operated physes were included in this retrospective review. The interscrew angle and screw trajectory angle were measured in the initial and follow-up radiographs. Additionally, changes in the mechanical lateral distal femoral angle and medial proximal tibial angle were calculated from the follow-up radiographs. The statistical calculations involved correlating the changes in the above-mentioned parameters and the magnitude of correction. The location of the implant was in the distal femur in 49 and the proximal tibia in 19 limbs. A mean correction of 12.1° was achieved at a follow-up of 12.1 months. The correction was calculated as 1.1°/month (SD = 0.6). The correlation of screw divergence ( R = -0.01; P = 0.97) and changes in screw trajectory angle ( R = -0.11; P = 0.36) to the angular correction achieved was statistically insignificant. The changes in the interscrew angle did not correlate with the angular correction following tension band plates.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"271-274"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883368","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

Response to Rehm et al commentary: Less common than expected: late displacement after minimally displaced pediatric lateral condyle fractures of the elbow. 对Rehm等人评论的回应：比预期的更少见：儿童肘关节外侧髁骨折轻度移位后的晚期移位。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2025-03-25 DOI: 10.1097/BPB.0000000000001252

R Justin Mistovich, Robert J Burkhart, David A Kolin, Peter D Fabricant, Raymond W Liu

引用次数: 0

Femoral shaft fractures in preschool children: external fixation and elastic intramedullary nail treatments in clinical practice. 学龄前儿童股骨干骨折：外固定及弹性髓内钉治疗的临床应用。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2024-12-06 DOI: 10.1097/BPB.0000000000001221

Jiale Guo, Wei Feng, Baojian Song, Danjiang Zhu, Yuwei Wen, Qiang Wang

{"title":"Femoral shaft fractures in preschool children: external fixation and elastic intramedullary nail treatments in clinical practice.","authors":"Jiale Guo, Wei Feng, Baojian Song, Danjiang Zhu, Yuwei Wen, Qiang Wang","doi":"10.1097/BPB.0000000000001221","DOIUrl":"10.1097/BPB.0000000000001221","url":null,"abstract":"Surgical intervention in preschoolers with femoral shaft fractures has increased due to the evolving lifestyle. This study aimed to analyze and compare the efficacy of elastic intramedullary nailing and external fixation in treating femoral shaft fractures in children aged 2-5. Ninety-nine pediatric patients were categorized into the external fixator (EF) and the elastic intramedullary nail (ESIN) group based on surgical techniques. Data on follow-up, intraoperative parameters, postoperative complications, fracture features, and demographics were gathered and compared. The mean duration of follow-up was 32 months, ranging from 25 to 48 months. All fractures had healed completely and no instances of nonunion were observed. At the latest follow-up, within the EF group, there were instances of malunion, delayed union, and refracture, each occurring once. One case in every group exhibited a leg length difference above 2 cm. The external fixation group had a shorter operation duration ( P = 0.04), fewer intraoperative fluoroscopy times ( P < 0.01), earlier partial weight-bearing time ( P < 0.01), and full weight-bearing time ( P < 0.01), while a greater complication rate (29.8 vs. 14.3%, P = 0.07) compared with the ESIN group. The incidence of pin tract infection in the EF group was 21.1% (12/57) compared with 2.4% (1/42) in the ESIN group ( P = 0.07). Eighty percent of the patients' families expressed concern about the residual scar after removing the EF. The ESIN group encounters fewer complications and positive aesthetic effects, making it a preferable treatment option in this specific patient population and fracture pattern. Level of evidence: Class III, retrospective comparative study.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"209-217"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803239","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

Treatment of relapse valgus knee deformity in fibular hemimelia with hemiepiphysiodesis. 腓骨偏瘫伴半表皮成形术复发外翻膝畸形的治疗。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-05-01 Epub Date: 2024-11-27 DOI: 10.1097/BPB.0000000000001217

Ana Gabriela Santana Cuoghi, Ana Maria Ferreira Paccola, Roger Frossard Pagotto, Douglas Manuel Carrapeiro Prina, Monica Paschoal Nogueira

{"title":"Treatment of relapse valgus knee deformity in fibular hemimelia with hemiepiphysiodesis.","authors":"Ana Gabriela Santana Cuoghi, Ana Maria Ferreira Paccola, Roger Frossard Pagotto, Douglas Manuel Carrapeiro Prina, Monica Paschoal Nogueira","doi":"10.1097/BPB.0000000000001217","DOIUrl":"10.1097/BPB.0000000000001217","url":null,"abstract":"The objective of this study was to analyze the treatment of recurrent valgus knee in fibular hemimelia patients with hemiepiphysiodesis and define associated variables for deformity relapse. Sixteen consecutive patients with fibular hemimelia treated with hemiepiphysiodesis (57 physis) were compared to 21 physis of idiopathic cases, in terms of magnitude, speed, and time of correction. Correction of valgus deformity was successfully achieved in all cases. In the fibular hemimelia group, children 4 years and younger had a bigger magnitude of correction than older ones (11° versus 6.9°) and greater speed (1° versus 0.6°), with statistical significance ( P = 0.018 and P = 0.009, respectively), while time for correction was similar among these groups (11.6 months versus 12.3 months). Femoral distal physis corrected faster than proximal tibial physis (10.8 months versus 16.8 months), with statistical significance ( P = 0.032). Thirty-three physis (57.9%) were isolated and 24 (42.1%) were tibia and femur. We found no statistical difference between the two groups regarding time for correction, magnitude, or speed ( P = 0.526, P = 0.910, P = 0.803, respectively). Relapse was observed in 49 physis (86%) of the fibular hemimelia patients. These had a mean age of 5.5 years versus 3.9 years for those without a relapse, with statistical significance ( P = 0.204). Relapse occurred after 2 years of the first procedure. Recurrent valgus deformity in fibular hemimelia can be successfully treated with single or multiple hemiepiphysiodesis with tension band plates in skeletally immature patients in an effective and gradual manner. Level of Evidence: Level III, therapeutic study.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"275-281"},"PeriodicalIF":0.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752124","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