Journal of the Pediatric Orthopaedic Society of North America最新文献

{"title":"Corrigendum to \"Valgus-Related Elbow Pathology Is Not Associated With Decreased Baumann's Angle: A Case-Control Study\" [J Pediatr Orthop Soc North Am 9 (2024) 100116].","authors":"Nicolas Pascual-Leone, Olivia C Tracey, Ruth H Jones, Nnaoma M Oji, Douglas N Mintz, Peter D Fabricant","doi":"10.1016/j.jposna.2026.100322","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100322","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.jposna.2024.100116.].</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100322"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiopulmonary Consequences of Scoliosis and the Clinical Implications of VO₂max: A Systematic Review.","authors":"Suhani Sharma, Arun Ramnarine, Karim Fouad, Samuel Kirby, Shreya Sankar, Michael O'Connor, George-Paul O'Byrne, Oliver Boughton, Patrick Kiely, Tony Rafferty","doi":"10.1016/j.jposna.2026.100369","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100369","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Multiple parameters, including VO&lt;sub&gt;2&lt;/sub&gt;max, ventilatory efficiency, lung volumes, and exercise tolerance, have been examined, yet their progression with pediatric scoliosis remains unclear. Although pulmonary function tests are widely used, they may underestimate functional impairment, as spirometric measures can remain relatively preserved despite clinically meaningful reductions in exercise capacity. This review aims to define the extent of functional impairment, its association with curve severity, and the potential of VO&lt;sub&gt;2&lt;/sub&gt;max as a marker of surgical recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We systematically searched PubMed, Embase, and Cochrane for eligible studies reporting cardiopulmonary outcomes in pediatric scoliosis. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools and the ROBINS-I risk-of-bias tool. Results were synthesized narratively following the Synthesis Without Meta-analysis guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;From 455 records, 6 studies met the inclusion criteria. Adolescents with idiopathic scoliosis consistently demonstrated reduced aerobic capacity, with mean VO&lt;sub&gt;2&lt;/sub&gt;max values ranging from 27.9 to 33.6 mL kg&lt;sup&gt;-1&lt;/sup&gt;·min&lt;sup&gt;-1&lt;/sup&gt;, approximately 20-25% below reference norms, indicating mild-to-moderate cardiopulmonary impairment. Functional tests such as the 6-min walk and E-fit correlated strongly with VO&lt;sub&gt;2&lt;/sub&gt;max, validating their use as practical surrogates of aerobic performance. Greater curve severity and thoracic deformity were associated with progressive reductions in forced expiratory volume in one second, forced vital capacity, and VO&lt;sub&gt;2&lt;/sub&gt;max, reflecting restrictive ventilatory physiology. Postoperative studies showed stable but not improved VO&lt;sub&gt;2&lt;/sub&gt; or pulmonary function, suggesting that surgery preserves rather than enhances respiratory capacity. Exercise-based rehabilitation improved posture and endurance, though effects on VO&lt;sub&gt;2&lt;/sub&gt;max remain inconclusive.A spectrum of cardiopulmonary parameters deteriorates with scoliosis progression. VO&lt;sub&gt;2&lt;/sub&gt; max may provide the most integrative marker of physiological burden, and prospective longitudinal data are required to establish its role in recovery after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key concept: &lt;/strong&gt;(1)Adolescents with scoliosis exhibit clinically meaningful reductions in cardiopulmonary reserve, which may not be apparent on resting spirometry but become evident during exercise and directly influence perioperative physiological resilience.(2)Radiographic measures of deformity correction do not reliably reflect functional recovery, underscoring the limitations of relying on Cobb angle and pulmonary function tests alone when assessing surgical readiness and postoperative outcomes.(3)Cardiopulmonary exercise testing (CPET) provides an objective, integrative assessment of surgical fitness, allowing differentiation between","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100369"},"PeriodicalIF":0.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cut Short: Evaluation, Management, and Prevention of Pediatric Lawnmower-Related Injuries.","authors":"Hannah Lee, Quinn Kirkpatrick, Hance Wilbert, Joseph Torkieh, Thomas McPartland","doi":"10.1016/j.jposna.2026.100375","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100375","url":null,"abstract":"<p><p>Lawnmower-related injuries in children have serious costs and consequences. Every year, thousands of children sustain injuries to various parts of their bodies, including burns, lacerations, and fractures secondary to lawnmowers which are also the leading cause of amputation in children under 10 years of age. This review emphasizes the importance of thorough trauma assessment, early antibiotic administration, and repeated, careful irrigation and debridement. For limbs that can be preserved, current research supports soft-tissue preservation and stabilizing bones with external fixators. The decision to amputate depends on factors like blood flow, the extent of skeletal and soft-tissue damage, hemodynamic stability, and other considerations. The goal of amputation should be to create a well-padded stump with sufficient length to improve prosthesis fit, leverage, and function. After the initial treatment, long-term sequelae include bone overgrowth, psychological impacts, and financial burdens that affect patients and families for years. Therefore, this review compiles strategies from current research to assist in properly evaluating, managing, and preventing pediatric lawnmower injuries.</p><p><strong>Key concepts: </strong>(1)Lawnmower injuries in children are common, affect all ages and all body parts, and range from burns and lacerations to fractures and amputations.(2)Acute management includes a complete trauma evaluation, antibiotics, irrigation and debridement, and skeletal and soft-tissue stabilization.(3)Amputation principles balance the removal of nonviable, contaminated tissue with the preservation of adequate length for soft-tissue coverage, prosthetic fit, and mechanical function.(4)Both short- and long-term complications include residual pain, infection, osseous overgrowth, reperfusion injury, mental health disorders, and economic costs.(5)Preventive strategies include situational awareness, age limitations, product safety designs, and protective gear, which can save children's limbs and lives.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100375"},"PeriodicalIF":0.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Tibial Tubercle Fractures in Osteogenesis Imperfecta: A Restrospective Case Series.","authors":"Anthony Dure, Emily L Niu, Evan Sheppard, Benjamin D Martin, Laura L Tosi, Syed I Ahmed","doi":"10.1016/j.jposna.2026.100374","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100374","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a rare bone fragility disorder involving type I collagen. Although fragility fractures are common, tibial tubercle apophyseal fracture reporting is limited. This study evaluates our series of tibial tubercle operative fractures in OI patients.</p><p><strong>Methods: </strong>Retrospective review of all operative tibial tubercle fractures from 2010 to 2022, at a level one pediatric trauma and osteogenesis imperfecta referral center identified four patients with concomitant OI. Demographic information, OI type, antecedent and subsequent fracture history, surgical treatment, and OI treatment method were collected. Comparison was made with non-OI operatively treated tibial tubercle patients (n = 183).</p><p><strong>Results: </strong>The mean OI tibial tubercle surgical patient was 11 years (range 9-14). The mean non-OI tibial tubercle surgical patient was 14.5 years (range 8.5-17.0). Two out of four OI patients were female (50%) and 94.5% were male in the non-OI group. Within the OI group, one patient was diagnosed with OI after their tibial tubercle fracture (15 months later). OI types included: type I (n = 3) and type IV (n = 1). Before the tibial tubercle fracture, no patients were on bisphosphonate therapy and three were on vitamin D supplementation. All OI patients underwent open reduction with cannulated screw fixation. In two out of four (50%) OI patients, suture anchors were used. In the non-OI group 13.7% of patients were treated with suture anchors. Three OI patients were treated with a brace, and one patient was casted post-operatively. Immediate weight bearing was allowed in three OI (75%) patients and in 52.5% of non-OI patients. All OI patients returned to baseline activities at 5.4 months (IQR, 4.4, 6.2) and in 4.4 months (IQR, 3.4, 6.4) in the non-OI group.</p><p><strong>Conclusions: </strong>Patients with OI and surgically treated tibial tubercle fractures were younger than those without OI. The OI group made up 2.1% of all tibial tubercle surgical fractures. Suture anchor augments were employed in 50% of the OI cases and in 13.7% in the non-OI group. All OI patients returned to their baseline function, which is comparable to the non-OI group.</p><p><strong>Key concepts: </strong>(1)Traditional surgical fixation methods including suture anchors can be used in OI patients.(2)Post operative immediate weight bearing as tolerated in a locked extended knee brace can be successfully utilized in OI patients.(3)Recovery time to baseline function is comparable between OI patients and non-OI patients after tibial tubercle surgery.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100374"},"PeriodicalIF":0.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited Perspective: Pediatric Hand Injuries Subspecialty Collection.","authors":"Carley B Vuillermin","doi":"10.1016/j.jposna.2026.100366","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100366","url":null,"abstract":"","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100366"},"PeriodicalIF":0.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited Perspective: It is Time to Rename SCFE.","authors":"Laura L Bellaire, Peter Stevens","doi":"10.1016/j.jposna.2026.100371","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100371","url":null,"abstract":"<p><p>While plain radiographs confirm the clinical diagnosis of slipped capital femoral epiphysis (SCFE), advanced imaging offers a deeper understanding of the underlying pathoanatomy-specifically, the role of acquired retroversion in causing gait disturbance, knee pain, and femoroacetabular impingement (FAI). In this manuscript, we synthesize past and recent insights into the pathomechanics of SCFE. Greater recognition of femoral rotation could be achieved by changing the misnomer SCFE to proximal femoral acquired retroversion (PFAR). We hypothesize that rebranding the condition may help enhance understanding among patients and trainees and potentially improve measurement and treatment strategies through imaging and novel surgical approaches that focus on correcting femoral version.</p><p><strong>Key concepts: </strong>(1)The history of diagnosing and treating SCFE relied heavily on two-dimensional imaging and therefore underestimates the role of axial rotation in this condition and its sequelae.(2)The term \"SCFE\" has contributed to ongoing misunderstandings of this diagnosis and may therefore discourage management approaches that focus on correcting retroversion.(3)Revisiting the name of this condition can help improve understanding of its three-dimensional aspects and effects (such as gait disturbance, knee pain, femoroacetabular impingement) among patients, families, and trainees.(4)A new name-proximal femoral acquired retroversion (PFAR)-would align with current fracture terminology conventions, as it describes the displacement of the distal fragment relative to the proximal fragment.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100371"},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plastic Deformation of the Pediatric Forearm: Recognition, Radiographic Measurement, and Management.","authors":"Caitlin Wetzel, Matthew Rohl, Taylor Manes, Allen Kadado","doi":"10.1016/j.jposna.2026.100372","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100372","url":null,"abstract":"<p><p>Pediatric forearm bowing fractures, also known as plastic deformation fractures, are a clinically important but often underdiagnosed injury pattern. These fractures usually occur from longitudinal compressive forces such as falls on an outstretched hand, causing plastic deformation that exceeds the elastic limit of pediatric bone. Patients often present with nonspecific symptoms like pain, swelling, and limited pronation-supination, and these injuries can be subtle on radiographs. Using standardized measurement methods, such as the percentage of radial bowing relative to total bone length, can improve diagnosis; values over approximately 10% of radial length are considered suggestive of pathological bowing. Missing or delaying diagnosis can lead to persistent deformity, limited forearm rotation, malunion, and long-term functional impairments. The purpose of this review is to synthesize and critically evaluate the current literature on pediatric forearm bowing fractures, focusing on their pathophysiology, injury mechanisms, clinical presentation, diagnostic challenges, imaging options, measurement techniques, treatment strategies, and outcomes.</p><p><strong>Key concepts: </strong>(1)Pediatric forearm bowing fractures are subtle plastic deformation injuries that are often underdiagnosed because of minimal radiographic evidence.(2)Unique biomechanical properties of pediatric bone allow deformation without cortical disruption, which can increase the risk of missed diagnoses.(3)Standardized radiographic measurements and awareness of normative bowing values enhance diagnostic accuracy.(4)Early identification and suitable management are essential to prevent long-term deformity and loss of forearm rotation.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100372"},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Pediatric Hand Injuries in the Acute Setting Part 2: Fractures and Dislocations.","authors":"Micah K Sinclair, Daniel Santana, M Claire Manske","doi":"10.1016/j.jposna.2026.100364","DOIUrl":"10.1016/j.jposna.2026.100364","url":null,"abstract":"<p><p>This is the second article in a three-part series on the acute care of pediatric hand injuries. The first article covered what defines a pediatric hand injury, general principles, when to refer a child to a pediatric hand surgeon, and an overview of immobilizing the pediatric hand and upper extremity. For a detailed collection on the technical aspects of pediatric splint and cast application, the reader is referred to the JPOSNA Primer on Cast and Splint Application. https://www.jposna.com/content/jposna_ae_primer_on_cast_and_splint_application. This section will discuss the principles of diagnosis and immediate management for specific fractures and dislocations. Expert opinions were consulted to supplement this review.</p><p><strong>Key concepts: </strong>(1)Phalanx fractures are among the most common upper extremity fractures in children. Treatment varies based on the fracture's location within the phalanx.(2)Radiographs of the finger (including thumb) and clinical functional exam, including evaluation of the involved finger in flexion, are necessary to determine appropriate treatment.(3)Immediate management at time of injury can often be definitive treatment of the presenting injury.(4)Detailed management is described for the most common finger, hand, and carpal fractures.(5)Follow-up with a hand specialist within 1 week of injury will ensure proper treatment of pediatric hand fractures.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100364"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Magnetically Controlled Growing Rods for Early Onset Scoliosis in the Era of Disease-Modifying Therapies: Mid-term Results in a Homogeneous Cohort of Spinal Muscular Atrophy Type 1 Patients.","authors":"Luca Labianca, Cosma Calderaro, Maria Beatrice Manca, Filippo Manni, Edoardo Colantoni, Cristiano Benelli, Nicola Maffulli","doi":"10.1016/j.jposna.2026.100368","DOIUrl":"10.1016/j.jposna.2026.100368","url":null,"abstract":"<p><strong>Background: </strong>The advent of disease-modifying therapies (DMTs) has fundamentally altered the clinical course of spinal muscular atrophy type 1 (SMA-I), resulting in prolonged survival and a higher incidence of early onset scoliosis (EOS). Although growth-friendly surgery is a keystone of management, specific evidence regarding magnetically controlled growing rods (MCGR) in the SMA-I population remains sparse. We evaluate the safety and efficacy of MCGR in a specific, homogeneous cohort of SMA-I patients.</p><p><strong>Methods: </strong>A retrospective investigation was performed on 8 consecutive children with genetically confirmed SMA-I who underwent MCGR implantation for progressive EOS at our institution. To overcome profound osteopenia, we utilized a proximal rib-based \"ring hook\" foundation and distal pelvic/sacroiliac fixation. Outcomes included coronal Cobb angle correction, pelvic alignment, and annualized T1-S1 spinal growth. Distractions were performed at 10-12-week intervals and validated via ultrasonography. Complications and unplanned returns to the operating room (UPRORs) were recorded.</p><p><strong>Results: </strong>Eight patients (mean age 6.9 ± 0.92 years) were followed for a mean of 29.25 ± 4.0 months. The mean Cobb angle improved from 71.9° ± 20.8° to 38.9° ± 15.7° postoperatively (45.9% initial correction; <i>P</i> < .001) and was 44.5° ± 14.1° at the final follow-up. Pelvic obliquity significantly improved from a mean of 25.6° ± 6.3° to 6.6° ± 3.0° (<i>P</i> < .001) and was at the last follow-up (8.7° ± 2.0°; <i>P</i> = .08). Annualized T1-S1 growth was 11.6 ± 3.2 mm/y, with a mean \"distraction efficiency\" of 86.7% compared to the programmed 3 mm target. One mechanical complication (12.5%) occurred (distal iliac screw failure), resulting in a UPROR rate of 6.25 per 100 patient-years. No perioperative respiratory or infectious complications were observed.</p><p><strong>Conclusions: </strong>In this medically fragile SMA-I cohort, MCGR provided effective deformity control and supported longitudinal spinal growth. A multidisciplinary perioperative pathway and rib-based proximal anchoring are essential for optimizing results. While mid-term outcomes are encouraging, further research is needed to evaluate the long-term impact on pulmonary function and construct durability in the post-disease-modifying therapy era.</p><p><strong>Key concepts: </strong>(1)Meaningful deformity correction (45.9% mean Cobb reduction) achieved with preservation of linear spinal growth (11.6 ± 3.2 mm/y).(2)Low perioperative risk, with no infections, no transfusions, and no perioperative respiratory deterioration.(3)A 12.5% mechanical complication rate (one unplanned revision for distal iliac screw failure) over a mean follow-up of 29.25 months.</p><p><strong>Level of evidence: </strong>IV: Case series.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100368"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Obesity on Complication Rates After Treatment of Slipped Capital Femoral Epiphysis: A Retrospective Cohort Database Study.","authors":"Holden Archer, Scott B Rosenfeld, Pablo Castañeda, Jessica A McGraw-Heinrich, Simon P Kelley","doi":"10.1016/j.jposna.2026.100370","DOIUrl":"https://doi.org/10.1016/j.jposna.2026.100370","url":null,"abstract":"<p><strong>Background: </strong>While obesity is a well-established risk factor for slipped capital femoral epiphysis (SCFE), limited data exist regarding its impact on postoperative complication rates. This study aimed to evaluate the association between obesity and complications following SCFE treatment.</p><p><strong>Methods: </strong>We queried a large national database for pediatric patients who underwent treatment for SCFE between June 2005 and June 2025. We divided this cohort into patients with obesity and patients without obesity. We matched the cohorts with a propensity scoring algorithm on a one-to-one basis, resulting in 1,175 patients in each group. We tracked outcomes including infection, pulmonary embolism (PE), chondrolysis, avascular necrosis (AVN), leg length discrepancy (LLD), and hardware complications. We used the relative risk ratio (RR) and 95% confidence intervals (CIs). <i>P</i> values less than 0.05 were considered significant.</p><p><strong>Results: </strong>≤10 (0.85%) patients developed an infection, and none developed a PE; ≤10 (0.85%) patients in each group developed chondrolysis. Thirty-eight (3.23%) patients in the obese group developed AVN after SCFE treatment, and 34 (2.89%) patients in the nonobese group developed AVN (RR = 1.12, CI: 0.71-1.76, <i>P</i> = .632). Seventy-seven (6.55%) patients in the obese group developed LLD compared to 50 (4.26%) patients in the nonobese group (RR = 1.54, CI: 1.09-2.18, <i>P</i> = .014). Sixty-one (5.19%) patients in the obese group had hardware complications, whereas 35 (2.98%) patients in the nonobese group had hardware complications (RR = 1.74, CI: 1.16-2.62, <i>P</i> = .007).</p><p><strong>Conclusions: </strong>Patients with obesity had increased rates of LLD and hardware complications after treatment for SCFE compared to nonobese patients. Our findings highlight the importance of ongoing follow-up and monitoring of SCFE patients to detect the development of any of these outcomes.</p><p><strong>Key concepts: </strong>(1)Rates of infection, pulmonary embolism, and chondrolysis were low (<1%) and did not differ between obese and nonobese cohorts.(2)The rate of avascular necrosis was similar between groups.(3)In contrast, obese patients had significantly higher rates of leg length discrepancy and hardware complications.</p><p><strong>Level of evidence: </strong>III: Retrospective cohort study.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"15 ","pages":"100370"},"PeriodicalIF":0.0,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}