Journal of Pediatric Orthopaedics-Part B最新文献_第6页

The use of proximal fragment transverse Kirschner wire as a joystick to correct rotational displacement in Gartland type III pediatric supracondylar humerus fractures: a novel technique. 使用近端碎片横向克氏针作为操纵杆矫正Gartland III型儿童肱骨髁上骨折的旋转移位：一种新技术。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-13 DOI: 10.1097/BPB.0000000000001248

Mukesh O Phalak, Ajinkya K Chaudhari, Tushar S Chaudhari, Anteshwar Birajdar, Sagar Gurnani

{"title":"The use of proximal fragment transverse Kirschner wire as a joystick to correct rotational displacement in Gartland type III pediatric supracondylar humerus fractures: a novel technique.","authors":"Mukesh O Phalak, Ajinkya K Chaudhari, Tushar S Chaudhari, Anteshwar Birajdar, Sagar Gurnani","doi":"10.1097/BPB.0000000000001248","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001248","url":null,"abstract":"Supracondylar humerus fractures comprise of a major part in pediatric trauma cases. They result from a fall on an outstretched hand. The rotational components of Gartland type III fractures if not corrected appropriately can lead to cubitus varus (gun stock deformity). The surgeon's aim while fixing this fracture is to achieve reduction and stable fixation without a residual deformity. The rotational component is difficult to correct owing to factors like severe swelling, obesity, entrapment of soft tissue, and pull of muscles. This study aimed to demonstrate the use of a proximal fragment Kirschner wire as a joystick to correct the rotational displacement in Gartland type III pediatric supracondylar humerus fractures. We proposed a method of using a lateral 3 mm. Kirschner wire as a joystick by inserting 1-1.5 cm proximal to the fracture and correct the rotational malalignment. The children were followed up for 1 year after surgery and evaluated with Flynn criteria. Amongst 18 type III supracondylar fractures, the average flexion was 146.8° in the 24-week follow-up period. The Flynn criteria showed 14 (77.78%) had excellent outcomes, three (16.66%) had good outcomes, and one (5.56%) had fair outcomes. Patients having obesity, severe edema, rotatory displacement, difficult or inadequate reduction by traction, and manipulation alone using a Kirschner wire in the proximal fragment as a joystick to reduce the fracture is a time-saving, cost-effective, simple, and reproducible technique with an excellent cosmetic and functional outcome without significant complications.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606934","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

Ankle range of motion following surgical correction of early relapse in clubfoot. 畸形足早期复发手术矫正后的踝关节活动范围。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-12 DOI: 10.1097/BPB.0000000000001249

David E Westberry, Emily R Shull, Daphne Lew, Prabhav Saraswat, Emily Waters, Lauren C Hyer

{"title":"Ankle range of motion following surgical correction of early relapse in clubfoot.","authors":"David E Westberry, Emily R Shull, Daphne Lew, Prabhav Saraswat, Emily Waters, Lauren C Hyer","doi":"10.1097/BPB.0000000000001249","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001249","url":null,"abstract":"Surgical options for relapsed clubfoot include repeat heel cord lengthening or posterior release for recurrent equinus, and anterior tibialis tendon transfer (ATT) for residual dynamic supination deformity. Some studies have suggested that these procedures be performed in isolation to allow for early range of motion after intra-articular surgery. This study was performed to examine clinical and radiographic outcomes comparing two surgical methods, simultaneous ATT with posterior release (ATT/PR) vs ATT performed in isolation (ATT(i)), for the management of recurrent clubfoot deformity. Patients who underwent ATT(i) and ATT/PR for relapsed clubfoot deformity after initial Ponseti casting, were 2-20 years old at time of surgery, and had postoperative range of motion (ROM) data, pedobarographic data, and radiographic results with minimal follow-up of 1 year were included. A total of 49 patients (69 feet) were reviewed. Mean age at time of surgery was 4.4 (SD 1.73) years. Of the 69 feet, 27 received ATT(i) and 42 received ATT/PR. No difference in the ROM outcome of ankle dorsiflexion was found between ATT(i) vs ATT/PR at a mean of 5.8 years follow-up. In patients undergoing ATT(i), there was a mild increase in lateral loading of the foot compared to those feet having ATT/PR. Follow up radiographic results for both groups were in the normal range, with less residual radiographic equinus in the ATT/PR group. ATT(i) or ATT performed along with intra-articular posterior capsular release offers comparable short-term outcomes. Level of evidence. This study was a retrospective case series, Level IV.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606930","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

Management of severe, neglected, bilateral congenital knee dislocation. 严重、被忽视的双侧先天性膝关节脱位的治疗。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-07 DOI: 10.1097/BPB.0000000000001246

Rajul Gupta, Premal Naik, Shital N Parikh

{"title":"Management of severe, neglected, bilateral congenital knee dislocation.","authors":"Rajul Gupta, Premal Naik, Shital N Parikh","doi":"10.1097/BPB.0000000000001246","DOIUrl":"10.1097/BPB.0000000000001246","url":null,"abstract":"Congenital dislocation of the knee (CDK) is a rare condition, often associated with syndromes and other limb anomalies. It is typically diagnosed and treated in early infancy. Neglected cases of CDK can present with significant deformities and loss of function. Their treatment is challenging and scarcely reported in the literature. The primary purpose of this study is to report on management of neglected CDK presenting in second decade of life. Four patients (eight knees) with severe, neglected, bilateral CDK who presented in their second decade of life were identified. Their preoperative radiographs were evaluated for presence of distal femoral dysplasia and compared to age-matched controls. Their clinical presentation, surgical treatment, and outcomes were analyzed at minimum 2 year follow-up. All four patients were 11-12 years old and had severe, bilateral, neglected CDK. Three patients had a quadrupedal gait. Preoperative radiographs showed significant distal femoral dysplasia when compared to controls. Surgical interventions included bilateral open reduction with quadricepsplasty in two patients and femoral flexion-shortening osteotomy (FSO) in two patients. At the latest follow-up, all patients had bipedal gait and improved quality of life. Postoperative radiographs showed improvement in distal femoral dysplasia in patients who underwent open reduction and quadricepsplasty. Patients with neglected CDK can present with quadrupedal gait. Compared to femoral FSO, open reduction and quadricepsplasty appears to be a better surgical treatment option as the latter can help restore joint articulation. Once the joint is reduced, distal femoral dysplasia can remodel to a certain extent. Level of evidence: Case series - Level 4.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568758","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

Factors influencing recurrence in clubfoot treatment with the Ponseti method in children under 5 years of age: a scoping review. 影响5岁以下儿童用Ponseti法治疗内翻足复发的因素：一项范围综述

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2025-01-07 DOI: 10.1097/BPB.0000000000001231

Esteban Portilla-Rojas, Gabriela Jovel-Trujillo, Lina Ramírez, Camilo Moreno, Juan Carlos Taborda

{"title":"Factors influencing recurrence in clubfoot treatment with the Ponseti method in children under 5 years of age: a scoping review.","authors":"Esteban Portilla-Rojas, Gabriela Jovel-Trujillo, Lina Ramírez, Camilo Moreno, Juan Carlos Taborda","doi":"10.1097/BPB.0000000000001231","DOIUrl":"10.1097/BPB.0000000000001231","url":null,"abstract":"Clubfoot (CF) is one of the most common musculoskeletal congenital abnormalities. Despite having optimal methods for its treatment, factors associated with the recurrence of CF treatment continue to be a topic of interest. The aim of this study was to perform a scoping review of the existing literature on factors associated with the recurrence of CF following treatment with the Ponseti method in children under 5 years of age. A scoping literature review was conducted in March 2024 using PubMed and Embase databases, and a structured research strategy. Screening of articles was performed by independent reviewers to ensure the inclusion of all pertinent studies. Considering inclusion and exclusion criteria, a final of 18 articles were included which encompassed factors associated with the recurrence of CF after treatment with the Ponseti method. The Ponseti method has demonstrated a high success rate in achieving CF correction. Various factors come into play regarding favorable outcomes and recurrence cases. The identified factors were initial severity scores for CF, age at the beginning of treatment, correct identification of idiopathic CF and complex CF, neuromuscular imbalance, poor nutritional status, noncompliance for the brace use, and the availability of a specialized attention center that ensured proper Ponseti method application and treatment adherence. Our findings highlight the importance of identifying different factors associated with the recurrence of CF following treatment with the Ponseti method, where timely intervention could minimize the risk of recurrence and achieve favorable outcomes.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"177-184"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958063","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 radiological, clinical, and functional results of Jakob type-2 lateral condyle fractures treated with closed reduction and percutaneous pinning versus open reduction and K-wire fixation. 封闭复位经皮钉钉与开放复位k针固定治疗Jakob 2型外侧髁骨折的放射学、临床和功能结果比较

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2025-01-28 DOI: 10.1097/BPB.0000000000001227

Andreas Rehm, Hatem Osman, Ayla C Newton, Rachael Clegg, Elizabeth Ashby, Helen E Chase

引用次数: 0

Toddler's fracture: an updated guide on evaluation and management. 幼儿骨折：评估和管理的最新指南。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2024-09-27 DOI: 10.1097/BPB.0000000000001210

McKenna C Noe, Dale E Jarka, Micah K Sinclair, Caleb W Grote

引用次数: 0

Early clubfoot recurrence can lead to more frequent and earlier second recurrences. 马蹄内翻足早期复发会导致第二次复发更频繁、更早。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2024-10-22 DOI: 10.1097/BPB.0000000000001214

Claire Schaibley, Beltran Torres-Izquierdo, Pooya Hosseinzadeh

{"title":"Early clubfoot recurrence can lead to more frequent and earlier second recurrences.","authors":"Claire Schaibley, Beltran Torres-Izquierdo, Pooya Hosseinzadeh","doi":"10.1097/BPB.0000000000001214","DOIUrl":"10.1097/BPB.0000000000001214","url":null,"abstract":"The frequency of multiple clubfoot recurrences following Ponseti casting and the effect on final outcomes have not been well studied. This study aims to evaluate the effect of early recurrence (during the first 2 years) on the timing and rate of subsequent recurrences. A retrospective review was conducted of children treated with Ponseti casting at a single institution from 2002 to 2023 with minimum follow-up until age 5. Patients who required comprehensive soft tissue surgery to obtain initial correction were excluded. Patient-Reported Outcomes Measurement Information System data were collected when available. A total of 86 patients were included; 69.8% (60) had idiopathic clubfoot. Average follow-up was 5.8 years. Early recurrence (recurrence before age 2) occurred in 26.7% (23). The rate of late recurrence (recurrence after age 2) was higher in the early recurrence group, 73.9% (17) vs. 39.7% (25), P = 0.005. Survival analysis revealed that patients with early recurrence experience late recurrence at a younger age of 3.9 vs. 6.7 years, P ≤ 0.001. The early recurrence group experienced more frequent recurrences, with a median of 3 [interquartile range (IQR): 1-5] total recurrences vs. 0 (IQR: 0-1), P ≤ 0.001. Patients with early recurrence had lower final mobility scores, 40.83 ± 10.88 vs. 48.00 ± 10.60, P = 0.029. In conclusion, this study suggests that early clubfoot recurrence leads to more frequent subsequent recurrence and earlier second recurrence. Patients with early recurrence had comparatively lower outcome scores, primarily due to multiple recurrences. Care providers could use this knowledge to educate parents about the natural history of recurrent clubfeet and emphasize the importance of brace compliance and routine monitoring.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"171-176"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479388","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

Is percutaneous heel cord tenotomy a necessary component in the Ponseti treatment of idiopathic clubfoot deformity? 经皮足跟脊髓肌腱切断术是治疗特发性内翻足畸形的必要手段吗？

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2025-01-07 DOI: 10.1097/BPB.0000000000001233

Lisa Cao, Sarah Parenti, Chan-Hee Jo, Anthony I Riccio

{"title":"Is percutaneous heel cord tenotomy a necessary component in the Ponseti treatment of idiopathic clubfoot deformity?","authors":"Lisa Cao, Sarah Parenti, Chan-Hee Jo, Anthony I Riccio","doi":"10.1097/BPB.0000000000001233","DOIUrl":"10.1097/BPB.0000000000001233","url":null,"abstract":"This study aimed to compare outcomes of idiopathic clubfeet (IC) treated with a percutaneous heel cord tenotomy (PHCT) at the conclusion of Ponseti casting with those that were not. A retrospective review of patients enrolled in a single institution prospective clubfoot registry over 19 years was performed. Patients under the age of 3 months with untreated IC managed via the Ponseti method that had a minimum of 2 years follow-up were included. Dimeglio score, number of casts to achieve correction, bracing compliance, need for subsequent procedures, and outcomes using the Richards classification were compared between patients who underwent a PHCT as part of their initial treatment and those that did not. A total of 1184 clubfeet in 791 patients met inclusion criteria; and 863 feet (73%) underwent a PHCT in clinic as part of initial Ponseti treatment. A total of 23% (75/321) of feet that did not undergo initial PHCT ultimately required a later PHCT or tendo-Achilles lengthening for recurrent equinus. Multivariate analysis demonstrated that an initial PHCT decreased the likelihood of requiring any additional surgical procedure by 30% (odds ratio: 0.70, P = 0.02). While an initial tenotomy was not predictive of clinical outcomes ( P = 0.09), the rate of fair and poor outcomes is more than double from 13.6 to 30% when an initial tenotomy was not performed in feet with Dimeglio scores of 13 or greater ( P = 0.02). Incorporation of a PHCT at the conclusion of Ponseti casting may reduce the need for subsequent and more invasive surgical interventions in IC patients, especially those with Dimeglio scores of 13 or greater. Level of evidence: therapeutic level III.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"157-161"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958072","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

Analysis of pediatric hand injuries in a tertiary care children's hospital. 某三级儿童医院小儿手部损伤分析。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2025-01-28 DOI: 10.1097/BPB.0000000000001188

Uğur Bezirgan, Göksel Vatansever, Yener Yoğun, Servet Elçin Alpat, Orhun Eray Bozkurt, Ebru Dumlupinar

{"title":"Analysis of pediatric hand injuries in a tertiary care children's hospital.","authors":"Uğur Bezirgan, Göksel Vatansever, Yener Yoğun, Servet Elçin Alpat, Orhun Eray Bozkurt, Ebru Dumlupinar","doi":"10.1097/BPB.0000000000001188","DOIUrl":"10.1097/BPB.0000000000001188","url":null,"abstract":"Pediatric hand traumas are common injuries in childhood. The incidence and type of injury vary with age. In our country, there are only two publications in which only crush is examined in etiology. In this study, we aimed to develop a strategy to prevent hand injuries by examining pediatric hand injuries according to the child's developmental stage and anatomical region. The data of 493 (315 boys, 178 girls) patients under the age of 18 between 2016 and 2020 were analyzed. Patients were categorized according to etiology and age. Males are more dominant in pediatric hand injuries (63.9%). The most common cause of hand injuries under the age of 4 years is scald burns. While distal phalanx fractures (79.7%) are more common under 7 years of age, little finger fractures (44.7%) are more common than other finger fractures over 7 years of age. The reason for the increase in fifth metacarpal (neck) fractures between the ages of 12 and 17 years is fighting and punching. Door/window jamming injuries (60.7%) are more common under the age of 7 years, while there is an increase in sports injuries (94.7%) over the age of 7 years. The findings of this study provided age-specific information about the anatomical site, objects, activities, mechanisms, diagnosis, and treatment associated with hand and finger injuries. While developing a strategy to prevent childhood hand and finger injuries in Turkey, it is necessary to focus on age.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":"34 2","pages":"142-150"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069235","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

Unraveling of cannulated screw threads during fixation of medial epicondyle humerus fractures in adolescents: short communication. 青少年肱骨内上髁骨折内固定过程中空心螺钉的解开：短沟通。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-03-01 Epub Date: 2025-01-28 DOI: 10.1097/BPB.0000000000001216

Rajul Gupta, Marcus Shelby, Roger Cornwall, Charles T Mehlman, Shital N Parikh

引用次数: 0