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

{"title":"Follow-up After Proximal Femur Fracture Fixation-We Need to Do Better.","authors":"Emilio Feijoo, Adele Bloodworth, Gerald McGwin, David Patch, Shawn R Gilbert, Kevin A Williams, Shane Strom, Michael J Conklin","doi":"10.1016/j.jposna.2025.100231","DOIUrl":"10.1016/j.jposna.2025.100231","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up after proximal femur (femoral neck) fracture is required to screen for complications, especially avascular necrosis (AVN). The purpose of this study was to evaluate sociodemographic characteristics as risk factors for lost-to-follow-up (LTFU) status following proximal femur fractures.</p><p><strong>Methods: </strong>This retrospective case series included patients under the age of 18 years treated at a children's hospital for proximal femur fractures. Data were collected from the electronic medical record (EMR). Area deprivation index (ADI) was determined using patient addresses. Patients were designated as LTFU if they followed up for less than 2 years from the initial operation without being discharged by their surgeon as determined by the last clinic note. The most recent imaging was evaluated for AVN.</p><p><strong>Results: </strong>Forty-two patients (26 male) were included. Twenty-four were in the appropriate follow-up (AFU) group while 18 were in the LTFU (42.9%) group. Average follow-up for the AFU and LTFU groups was 822 (235-3054) days and 103 (2-263) days, respectively. There were seven cases of AVN, all in the AFU group. AVN was seen at an average of 230 days from injury. The LTFU group had a significantly higher proportion of Medicaid and uninsured patients. Commercial/private insurance status was associated with a significantly longer follow-up period (940.6 days) compared with Medicaid patients (295.9 days) and uninsured patients (347.7 days). Both state and national ADI were significantly greater in the LTFU group. Upon multivariate analysis adjusting for distance from clinic, both mean state and national ADI remained significantly greater in the LTFU group.</p><p><strong>Conclusions: </strong>This study highlights disparities in follow-up of pediatric proximal femur fractures. Insurance status and ADI were significantly associated with follow-up. Quality improvement initiatives should be implemented to improve follow-up. Further studies should assess which social determinants most impact the follow-up status.</p><p><strong>Key concepts: </strong>(1)Close follow-up after femoral neck fracture fixation is strongly recommended for avascular necrosis surveillance.(2)A variety of interventions can be considered in patients who develop avascular necrosis if the pathology is detected early through regular follow-up.(3)Certain populations may be more vulnerable to lost to follow-up status.(4)Quality improvement initiatives should be implemented to improve compliance with recommended follow-up after femoral neck fracture fixation.(5)Additional studies should be conducted to ascertain which social determinants of health modify a patient's ability to attend follow-up appointments.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777700","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":"The Modified Bohlman Method for Pediatric High-Grade Spondylolisthesis: Greater than 2-year Follow-up Data From a Consecutive Case Series.","authors":"Dominique L Petty, T Peter Li, Jeffrey M Henstenburg, Kenneth J Noonan","doi":"10.1016/j.jposna.2025.100229","DOIUrl":"10.1016/j.jposna.2025.100229","url":null,"abstract":"<p><strong>Background: </strong>The modified Bohlman method (mBm), which incorporates an allograft strut, standard bone screws, and posterior lateral fusion, offers a potential alternative for achieving stable arthrodesis in high-grade spondylolisthesis (HGS). This study presents the clinical, radiographic, and patient-reported outcomes in a consecutive case series of pediatric patients treated with the mBm at a single institution.</p><p><strong>Methods: </strong>A retrospective review was performed on seven patients under 18 years of age with HGS (Meyerding grade ≥3) who underwent surgical treatment with the mBm between 2009 and 2022. Radiographic spinopelvic parameters were analyzed preoperatively, postoperatively, and at final follow-up. Radiographic fusion was assessed using Brantigan-Steffee criteria. Clinical outcomes, complications, and patient-reported outcome measures, Oswestry Disability Index, and Scoliosis Research Society-22r (SRS-22r) were collected at a minimum follow-up of 2 years.</p><p><strong>Results: </strong>All 7 patients achieved radiographic fusion at L5-S1 at an average radiographic follow-up of 4.7 years. There was no evidence of implant loosening or the need for revision surgery. Following surgery, improvements were observed in slip angle, lumbosacral angle, and sacral slope. The median ODI score was 3.5% (range 0-10%), and the mean SRS-22r score was 4.4, suggesting excellent long-term functional outcomes. The average implant cost for the mBm was $5,350.</p><p><strong>Conclusion: </strong>The mBm provides reliable fusion, favorable spinopelvic alignment, low disability rates, and a cost-effective solution for managing HGS. These findings support the use of the mBm as a safe and effective treatment option for HGS in appropriately selected patients.</p><p><strong>Key concepts: </strong>(1)The modified Bohlman method (mBm) for high-grade spondylolisthesis employs an allograft strut and 6.5 mm stainless steel bone screws to achieve posterior lateral fusion with reliable rates of solid arthrodesis at a minimum of 2 years follow-up.(2)This technique is associated with reductions in slip angle and improvements in lumbosacral alignment, supporting the creation of a stable \"neo-sacrum.\"(3)At greater than 2 years follow-up, patients treated with the mBm demonstrated functional outcomes comparable to published normative values, as measured by the Oswestry Disability Index and Scoliosis Research Society-22r.</p><p><strong>Level of evidence: </strong>Level IV, retrospective case series.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100229"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777711","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":"Single Flexible Nailing of the Humerus for Recurrent Bone Cysts.","authors":"Nakul S Talathi, Casey C Kuka, Alexandre Arkader","doi":"10.1016/j.jposna.2025.100218","DOIUrl":"10.1016/j.jposna.2025.100218","url":null,"abstract":"<p><p>Unicameral bone cysts (UBCs) in the proximal humerus are prone to pathologic fractures. We have discovered that using a single flexible nail, along with comprehensive curettage and grafting of humeral UBCs, is effective for safeguarding the bone and facilitating an early return to activity. Employing just one nail offers several advantages: technical simplicity in contouring and inserting a single nail, reduced surgical time, and elimination of a medial distal humeral dissection while ensuring stable internal fixation and promoting early motion even in cases of cyst recurrence. Our indications, surgical techniques, and helpful tips are outlined in this article.</p><p><strong>Key concepts: </strong>(1)Curettage and flexible intramedullary nailing with a single nail for treating pediatric humeral unicameral bone cysts is an effective prophylactic fixation strategy.(2)This enables ongoing activity even in the presence of cyst recurrence;-; in essence, \"protect the bone and forget the cyst.\"(3)The judicious use of fluoroscopy, the appropriate starting point, and a suitably bent flexible nail allow for the straightforward passage of the nail into the humerus.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100218"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747021","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":"Understanding Orthopaedic and Health-related Quality of Life Outcomes in Patients With Myelomeningocele Functional Classification 1 Spina Bifida in Relationship to Supportive Standing.","authors":"Peter Shen, Vineeta T Swaroop, Ana Marie Rojas, Josephine Hirsch, David I Chu, Jaclyn L Papadakis, Robin Bowman, Jill E Larson","doi":"10.1016/j.jposna.2025.100205","DOIUrl":"10.1016/j.jposna.2025.100205","url":null,"abstract":"<p><strong>Background: </strong>The Myelomeningocele Functional Classification (MMFC) provides a comprehensive summary of functional mobility in patients with spina bifida (SB). The hallmark of MMFC1 patients is the deficiency of gravity-dependent quadriceps musculature strength which precludes independent ambulation but not supportive standing. Limited data exist on the clinical value of supportive standing in this population. The purpose of this study was to identify orthopaedic outcomes and patient-reported quality of life (QOL) scores in MMFC1 spina bifida patients and investigate their relationship to continued supportive standing.</p><p><strong>Methods: </strong>A retrospective chart review was performed between 2004 and 2023 of all patients with SB treated at a regional tertiary pediatric care center. Patients were excluded if manual muscle testing did not fit the criteria for MMFC1 classification. Demographic, clinical outcomes, and the Patient-Reported Outcomes Measurement Information System (PROMIS) scores were reviewed. Supportive standing history was extracted from chart review and analyzed relative to outcome measures. Statistical analyses were reported with <i>P</i> < .05 reaching significance.</p><p><strong>Results: </strong>In total, 2,228 patients in our SB clinic were screened with 78 (3.5%) meeting the MMFC1 inclusion criteria. Thirty-three patients (42%) had at least one fracture with 25 (32%) of those patients having a femur fracture. Thirty-nine patients (50%) had at least one pressure sore with 23 (29%) of those patients having a sacral/ischial wound. Those who continued to stand at the most recent follow-up showed a statistically significant decrease in the number of skin wounds compared with those who discontinued standing, but no difference in number of fractures. A significant difference in the Neurogenic Bladder scores was noted in standing patients with higher bladder QOL scores.</p><p><strong>Conclusion: </strong>MMFC1 patients with spina bifida are at risk for sustaining fractures and/or sacral/ischial pressure sores, but discontinuing supported standing is associated with an increased pressure wound risk. Additionally, patients who continued to stand had higher bladder QOL scores. Utilizing supportive standing in conjunction with multidisciplinary care may decrease the risk of fractures and pressure sores and improve QOL in MMFC1 patients with spina bifida.</p><p><strong>Key concepts: </strong>(1)Myelomeningocele Functional Classification 1 (MMFC1) patients with spina bifida are at risk of incurring a femur fracture regardless of supportive standing.(2)MMFC1 spina bifida patients who continue to stand have significantly fewer number of pressure sores.(3)Improved neurogenic bladder quality of life scores were correlated with MMFC1 spina bifida patients who continued supportive standing.(4)A multidisciplinary team approach is needed to prevent barriers to care and improve quality of life in MMFC1 spina bifida patient","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100205"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777713","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":"Development of a Consensus-based Agenda to Identify Priorities for Clinical Research in Pediatric Orthopaedic Surgery.","authors":"A Noelle Larson, Ria Paradkar, Matthew Schmitz, Raymond Liu, Neeraj M Patel, Henry Ellis, Todd A Milbrandt, Dan Sucato, Kevin Shea, Jennifer Laine","doi":"10.1016/j.jposna.2025.100217","DOIUrl":"10.1016/j.jposna.2025.100217","url":null,"abstract":"<p><strong>Background: </strong>There is a need for additional high quality studies in children's orthopaedic surgery to answer important clinical research questions. The purpose of this study was to develop a consensus-based research agenda to identify top clinical questions to prioritize in pediatric orthopaedics.</p><p><strong>Methods: </strong>A modified Delphi technique was used, where the membership of the Pediatric Orthopaedic Society of North America (POSNA) was asked to submit clinical research questions and then queried iteratively to gain consensus. A steering committee from the POSNA leadership members was assembled to administer, consolidate, and edit survey responses. Final scores were used to select the top 16 research questions distributed by subspecialty area.</p><p><strong>Results: </strong>Based on the call for clinical research questions, 78 orthopaedic surgeons and scientists submitted 116 research questions. The steering committee removed duplicate questions and harmonized submissions to 65 clinical research questions. In spring 2024, the POSNA membership participated in stage 1 voting and submitted 33 additional questions. Duplicate questions were removed. The final voting round included 108 surgeons who rated 54 questions from low (1) to high priority (5). The top scoring questions from each subspecialty area were selected to comprise the POSNA consensus-based clinical research agenda. The top scoring questions were related to the role of orthopaedic surgical treatment in cerebral palsy and surgical indications for residual hip dysplasia.</p><p><strong>Conclusions: </strong>This consensus-based research agenda may guide surgeons, researchers, study group consortia, and funding organizations to improve the clinical evidence in children's orthopaedic surgery and promote high-quality prospective studies.</p><p><strong>Key concepts: </strong>(1)Despite the significant burden and cost of pediatric musculoskeletal conditions, pediatric orthopaedic research receives low research funding, underscoring the need for a focused research agenda.(2)This study used a modified Delphi process to engage pediatric orthopaedic surgeons across multiple pediatric orthopaedic subspecialties in the development of a consensus-based research agenda in order to identify high-priority clinical questions.(3)The final agenda reflects critical gaps in pediatric orthopaedic care, including conditions that impact long-term function and quality of life in pediatric orthopaedic patients.(4)The final agenda aims to guide future research, foster multicenter collaboration, and advocate optimized allocation of funding to improve evidence-based pediatric orthopaedic care.</p><p><strong>Level of evidence: </strong>Level IV (consensus-based expert opinion study).</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777698","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":"Lateral Suspension Bending Casting in the Treatment of Early-onset Scoliosis.","authors":"Chinmay S Paranjape, Vidyadhar V Upasani, Peter O Newton, Keisuke Masuda, James D Bomar, Alexandra Johnson, Anthony A Catanzano","doi":"10.1016/j.jposna.2025.100212","DOIUrl":"10.1016/j.jposna.2025.100212","url":null,"abstract":"<p><p>Early-onset scoliosis (EOS) presents significant challenges due to its potential to progress and cause pulmonary complications, necessitating early and effective intervention. Historically, casting techniques have evolved to address these deformities, with elongation-derotation-flexion (EDF) casting being the predominant method. However, EDF casting requires specialized equipment and can be time-consuming. This paper introduces an alternative method for addressing sweeping thoracolumbar curves in EOS: the three-point lateral suspension bending cast. This technique offers several advantages over EDF casting, including ease of application without specialized equipment, reduced procedural time, and the use of waterproof materials. The method involves positioning the patient with the convex apex side of the curve down, using a muslin bias wrap to create a bending fulcrum, and applying a cast that maintains a three-point bending force. This technique is particularly advantageous in settings where access to specialized equipment is limited or in patients with airway considerations. While effective in treating single sweeping curves, challenges remain in applying this method to double curves or thoracic apices above T9. Despite its longstanding use in a high-volume pediatric spine center, this method has not been extensively documented in the literature. The described technique provides a viable, cost-effective alternative for EOS management, with potential implications for broader application in diverse healthcare settings.</p><p><strong>Key concepts: </strong>(1)Lateral suspension bending casting is an alternative method to elongation-derotation-flexion casting for achieving correction in early-onset scoliosis(2)Bending casts may be applied with minimal specialized equipment and without traction to the neck and head, making it an attractive option for patients with tenuous airways or in environments without a Cotrel table.(3)Bending casts may be applied with waterproof material, for improved patient hygiene and caregiver satisfaction.(4)This method of casting is ideal in long, sweeping thoracolumbar curves with an apex below T8.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100212"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777701","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":"Leukemic Arthritis Mimicking Septic Arthritis in a Pediatric Patient.","authors":"Alyssa Barré, Daniel Hayes, Shawn Dripchak, Ryan Muchow","doi":"10.1016/j.jposna.2025.100214","DOIUrl":"10.1016/j.jposna.2025.100214","url":null,"abstract":"<p><strong>Case: </strong>A 7-year-old girl presented with a painful effusion in her right knee, fever, and a negative joint aspirate. One week later, she presented again with an effusion in her left elbow, elevated inflammatory markers, and a joint aspirate that raised concerns for septic arthritis. Irrigation and debridement of the elbow were performed, and the cultures returned negative results. Subsequently, the child experienced ongoing migratory polyarthropathy over several months, which was ultimately identified as leukemia. The initiation of chemotherapy resolved her symptoms. Although the orthopaedic literature is limited, leukemic arthritis should be considered in the differential diagnosis for a pediatric patient with a painful, swollen joint, especially when symptoms migrate without a clear cause.</p><p><strong>Key concepts: </strong>(1)Leukemic arthritis appears as a painful, swollen joint that is clinically similar to septic arthritis, based on both examination and serum and synovial laboratory values.(2)A prompt diagnosis of acute leukemia is essential as leukemic arthritis can be the first presenting symptom.(3)Recognizing and understanding leukemic arthritis is essential for orthopaedic providers to ensure the timely diagnosis of leukemia and prevent unnecessary procedures and surgeries for these children.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100214"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777702","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":"Thoracic and Lumbar Spine Dissection for Pediatric Deformity.","authors":"Ravi R Agrawal, Keith Bridwell, Munish Gupta, Blake K Montgomery","doi":"10.1016/j.jposna.2025.100213","DOIUrl":"10.1016/j.jposna.2025.100213","url":null,"abstract":"<p><p>The posterior approach to the thoracic and lumbar spine remains the most commonly used method for treating idiopathic scoliosis (IS). A detailed understanding of the relevant anatomy reduces iatrogenic complications, such as durotomy and pneumothorax, while an efficient surgical technique minimizes operative time and blood loss. Few video-based resources detailing step-by-step exposure of the posterior elements are available. Such videos would enhance trainee preparation prior to posterior spinal fusion (PSF) for IS. This technique article reviews the authors' preferred surgical approach, focusing on the pearls and pitfalls of errant techniques. The intended audience includes orthopaedic surgery and neurosurgery trainees. Additionally, it provides a sample pre-test to evaluate trainee knowledge preoperatively (see Appendix).</p><p><strong>Key concepts: </strong>(1) Subperiosteal dissection after splitting the apophysis is essential to achieving hemostasis.(2) Errant dissection of the thoracic spine can cause durotomy, pneumothorax, and neurologic injury.(3) Supraspinous ligament violation near the UIV can increase the risk of junctional kyphosis.(4) Preserving the UIV and LIV facet joints is essential to maintain adjacent segment joint health.(5) Safe placement of all spinal instrumentation (hooks, screws, and sublaminar fixation) requires adequate spinal exposure.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100213"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777712","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":"Fake News? Quantifying the Prevalence of Misinformation Related to Scoliosis on the TikTok Social Media Platform.","authors":"Banahene Glover, Anne-Marie Datcu, Macy Meyer, Emily Lachmann, Amy McIntosh, Megan Johnson, Jaysson T Brooks","doi":"10.1016/j.jposna.2025.100207","DOIUrl":"10.1016/j.jposna.2025.100207","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The lack of presence by spine deformity surgeons on TikTok, in addition to the platform's unregulated nature, raises concerns about the potential spread of misinformation regarding pediatric orthopaedic conditions. The purpose of this study is to assess the prevalence of scoliosis misinformation on TikTok with a specific focus on what types of scoliosis content contain the most misinformation and which content creators produce the most videos containing this misinformation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search was conducted on TikTok using the following hashtags: #scoliosis, #scoliosischiropractor, #scoliosisbrace, #scoliosissurgery. A total of 239 videos were reviewed over a 7-day period by three reviewers. Videos were categorized based on tone, content type, and healthcare provider involvement. Three pediatric spine surgeons reviewed flagged videos for misinformation related to scoliosis. Quality assessment was performed using the Global Quality Scale (GQS) and the DISCERN scoring system, with a score of 5 denoting the highest quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;TikTok videos related to scoliosis received on average 2.4 million views. Most TikTok scoliosis videos, 72.8% (n = 174), were created by patients sharing their experiences. When measuring video content quality, videos by physicians scored significantly higher with mean DISCERN and GQS scores of 3.3 ± 0.5 and 3.7 ± 0.4, respectively, compared to chiropractors with mean DISCERN and GQS scores of 2.3 ± 0.6 and 2.5 ± 0.5 (&lt;i&gt;P&lt;/i&gt; &lt; .0001). Forty-four percent (n = 24) of videos offering scoliosis advice were found to contain misinformation. The majority of these misinformation videos were produced by chiropractors (46%, n = 11) compared to physicians (12.5%, n = 3), although this was not statistically significant. Videos containing misinformation related to scoliosis garnered 2.2 ± 5.2 million views versus videos that did not contain misinformation, which received 1.6 ± 5.1 million views (&lt;i&gt;P&lt;/i&gt; = .7).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Chiropractors are the most frequent healthcare providers offering scoliosis advice on TikTok. The quality of information presented by chiropractors was found to be significantly lower than that of physicians. Spine deformity surgeons should be aware of TikTok's market dominance and provide high-quality information to counter the misinformation currently present on the platform related to scoliosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key concepts: &lt;/strong&gt;(1)The limited presence of spine deformity surgeons on TikTok contributes to the spread of scoliosis misinformation.(2)Patient-generated TikTok videos dominate scoliosis content but frequently lack evidence-based guidance.(3)Chiropractors are the most common healthcare providers posting scoliosis advice, although their content often scores lower in reliability.(4)Physician-led videos generally demonstrate higher DISCERN and GQS scores, emphasizing the value of expert-pro","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100207"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777699","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":"Scope of Practice for Pediatric Orthopaedic Medicine at a Tertiary Care Center.","authors":"Joleen Weissert, Rebecca Vieira, Claire White, Lanna Feldman, Megan Hannon","doi":"10.1016/j.jposna.2025.100201","DOIUrl":"10.1016/j.jposna.2025.100201","url":null,"abstract":"<p><strong>Background: </strong>Pediatric orthopaedic medicine (alternatively/formerly known as non-operative pediatric orthopaedics, NOPO) is an emerging specialty within orthopedics with limited published descriptive studies. This is a retrospective descriptive study of all patient encounters managed by three pediatric orthopedic medicine physicians at a single institution over a five-year period (2019-2024).</p><p><strong>Methods: </strong>Data from an internal hospital database were analyzed to determine the volume of patients seen, diagnoses managed, and surgical referral patterns. A total of 31,216 patient encounters were analyzed.</p><p><strong>Results: </strong>The top diagnoses managed by this group include: acute fracture (all body locations) 24.8% (n=15,019), scoliosis 10.9% (n=6,713), abnormal gait and mobility 7.9% (n=4,558), lower limb alignment 6.9% (n=4,176), joint disorders 6.9% (n=4,135), congenital hip deformities 5.9 % (n=3,453), congenital foot deformities 4% (n=2,442), pain, soft tissue 4% (n= 2,326), developmental delay 4 % (n=2,147), and dorsalgia 2% (n=1,173). Of the unique patients in the dataset 96% were managed medically and 4% had surgery related to their initial diagnosis. The top surgical procedures were: knee surgeries (14.8%), upper extremity pinning/reduction (14.6%), spinal fusion (7%), hip open/closed reduction (6.2%), Achilles lengthening (6.2%), Botox/phenol injection (5.9%), and lower extremity epiphysiodesis (3%).</p><p><strong>Conclusions: </strong>Data from this study provide insight into the unique role pediatric orthopedic medicine physicians play in the pediatric orthopedic community and can help guide curriculum development for future trainees.</p><p><strong>Key concepts: </strong>(1)Pediatric orthopaedic medicine is an emerging specialty within orthopaedics with limited published descriptive studies.(2)Pediatric orthopaedic medicine physicians manage a wide range of orthopaedic conditions traditionally managed by surgical colleagues.(3)In an increasingly specialized pediatric orthopaedic workforce, pediatric orthopaedic medicine physicians can serve as a medical home for many nonsurgical orthopaedic conditions.(4)A formal curriculum for pediatric orthopaedic medicine training should be developed with a goal toward ACGME accreditation of fellowships.</p><p><strong>Level of evidence: </strong>Retrospective cohort study.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"12 ","pages":"100201"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777709","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}