Journal of Childrens Orthopaedics最新文献

{"title":"Clinical outcomes of management of primary medial epicondylar fractures: A systematic review with meta-analysis.","authors":"Michał Bonczar, Patryk Ostrowski, Jakub Wilk, Ignacy Jastrzębski, Jerzy Walocha, Mateusz Koziej, Mariusz Bonczar","doi":"10.1177/18632521261461017","DOIUrl":"10.1177/18632521261461017","url":null,"abstract":"<p><strong>Purpose: </strong>This analysis seeks to clarify the clinical efficacy of each treatment modality and inform evidence-based decision-making in the management of this common yet complex injury.</p><p><strong>Methods: </strong>A comprehensive systematic search was performed across major medical databases, including Medline (PubMed), Scopus, Web of Science, Embase, The Cochrane Library, ClinicalTrials.gov, and CINAHL Ultimate, to identify studies addressing the outcomes of treatment for primary medial epicondyle fractures.</p><p><strong>Results: </strong>A total of 65 studies published between 1982 and 2026 were included in the meta-analysis. The pooled incidence of fracture union rate following surgical treatment was 97% (95% confidence interval (CI): 95%-98%). Conservative immobilization resulted in a markedly lower union rate of 46% (95% CI: 20%-74%). The overall complication rate following surgical treatment was 21% (95% CI: 16%-27%), compared to 36% (95% CI: 13%-63%) for conservative immobilization.</p><p><strong>Conclusion: </strong>Among surgical options, screw fixation was associated with high union rate and the lowest complication profile, with statistically distinct pooled estimates supporting its reliability in achieving stable healing and early mobilization. We believe that the pooled estimates from our study will be valuable in guiding clinical decision-making and will help assess the risk of potential outcomes and complications in patients with medial epicondyle fractures.</p><p><strong>Significance of study: </strong>This study provides high-quality pooled evidence comparing surgical and conservative management of medial epicondyle fractures, helping clinicians make more informed, evidence-based decisions by clarifying differences in union rates, functional outcomes, and complication risks.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"18632521261461017"},"PeriodicalIF":1.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal ulnar osteochondroma as a potential risk factor for radial head dislocation: A retrospective analysis.","authors":"Han Xiao, Miao Li, Xiaoqian Tan, Qian Tan, Weihua Ye, Jiangyan Wu, Kun Liu, Haibo Mei, Guanghui Zhu, An Yan","doi":"10.1177/18632521261461011","DOIUrl":"10.1177/18632521261461011","url":null,"abstract":"<p><strong>Background: </strong>Hereditary multiple osteochondromas (HMO) affecting the proximal radius and ulna represent a rare condition with limited documentation in the clinical literature. This study aims to describe a rare presentation of HMO involving the proximal forearm and discusses potential implications for management.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with HMO treated at our center between 2010 and 2021. Radiographic measurements included the presence or absence of osteochondromas in the entire forearm, radial head status, degree of ulnar bow, and ulnar length percentage. Radiographic measurements were compared using a Brown-Forsythe and Welch test with Tamhane's T2 post hoc analysis.</p><p><strong>Results: </strong>A total of 12 patients with 14 forearms were included in the study. At the final follow-up, all patients with proximal ulnar tumors who did not undergo resection developed subluxation or dislocation. In contrast, all patients with proximal tumors limited in the radius remained free of subluxation or dislocation of the radial head throughout the follow-up period. The mean ulna length percentage in the Located group was 1.07 ± 0.05, while 1.09 ± 0.03 in the Subluxation group and 0.98 ± 0.09 in the Dislocated group. The mean ulna bow in Located group was 12° ± 7°, while 9° ± 6° in Subluxation group and 15° ± 8° in Dislocated group. No significant differences were observed.</p><p><strong>Conclusions: </strong>Proximal osteochondromas from the lateral side of the ulna may be a high-risk factor leading to radial head dislocation. Therefore, surgical excision of the proximal ulnar tumor could serve as a potential intervention to reduce the risk of radial head dislocation in affected patients.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"371-378"},"PeriodicalIF":1.8,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided growth: Current concepts and novel techniques for harnessing a child's growth potential.","authors":"Merel C R Roelen, Christiaan J A van Bergen, Mark F Siemensma, Deborah M Eastwood, Ignacio Sanpera, Jaap J Tolk","doi":"10.1177/18632521261456090","DOIUrl":"10.1177/18632521261456090","url":null,"abstract":"<p><p>The principle of guided growth is grounded in the observations of Hueter and Volkmann, who proposed that longitudinal bone growth is stimulated by tension and inhibited by compression. The importance of guided growth lies in its ability to address limb malalignment in a more physiological and less invasive manner compared to traditional osteotomies. By modulating growth at the physis, guided growth allows for gradual correction of deformities, minimizing the disruption to the child's developing musculoskeletal system and harnessing the child's own growth potential. Guided growth has been most frequently applied for coronal plane angular deformities around the knee, but is increasingly used for deformities in other locations throughout the growing skeleton. A wide range of deformities with underlying idiopathic and non-idiopathic etiologies are amendable to guided growth procedures. Understanding the influence of the underlying etiology, type, and severity of deformity, the growth rate of the treated physis, and skeletal age is essential for treatment success. This review explores current concepts and novel applications of guided growth and highlights areas that warrant further investigation. The focus is on the clinical aspects of guided growth to correct angular or rotational deformities in both the upper and lower extremities.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"313-327"},"PeriodicalIF":1.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with open reduction of pediatric type III supracondylar humerus fractures.","authors":"Farid Najd Mazhar, Bushra Zareie, Hooman Shariatzadeh, Ahmad Hasan, Meisam Jafari Kafiabadi, Narges Akhlaghi, Omid Mahmoudi Nasab","doi":"10.1177/18632521261456089","DOIUrl":"10.1177/18632521261456089","url":null,"abstract":"<p><strong>Purpose: </strong>Supracondylar fractures of the humerus are the most common elbow fractures in children. Surgical fixation is necessary in cases with complete displacement (Gartland type III), with closed reduction and pin fixation being preferred. It is sometimes impossible. This study examined radiological and clinical factors that influence the selection of open reduction methods for these fractures.</p><p><strong>Methods: </strong>A retrospective study was designed to investigate children aged 3-13 years with Gartland type III supracondylar humeral fractures (OTA/AO 13-M/3.1 III) treated with closed and open reduction techniques. We enrolled 140 patients in the closed reduction group (mean age 6.27) and 90 in the open reduction group (mean age 6.86). The main outcomes were achieving adequate closed reduction or switching to open reduction. We used univariate analysis and multivariate logistic regression to find independent risk factors and odds ratios for open reduction and internal fixation.</p><p><strong>Results: </strong>Older children were significantly more likely to have flexion-type fractures (<i>P</i> = 0.001). The final univariate analysis showed that older age (odds ratios (95% confidence interval): 1.1 (1, 1.3)), flexion-type fractures (odds ratios (95% confidence interval): 3.2 (1.4, 7.4)), low-level (below isthmus) fractures (odds ratios (95% confidence interval): 2.2 (1.3, 3.9)), and Pucker sign (odds ratios (95% confidence interval): 2 (1, 4)) were factors that significantly increased the chance of open reduction and internal fixation. The influence of older age and low-level fracture was also strongly demonstrated in multivariate analysis.</p><p><strong>Conclusions: </strong>As age increases, the chance of a flexion-type fracture rises, and thus the chance of needing open reduction. Low-level fractures reduce the possibility of achieving a stable closed reduction by creating a smaller, more cartilaginous distal fragment.</p><p><strong>Type of study/level of evidence: </strong><b>Level III</b>.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"387-394"},"PeriodicalIF":1.8,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irreducible extremity fractures in pediatric and adolescent rodeo-related trauma: A retrospective case series.","authors":"Taylor E Arnold, Jack A Nolte, Derek J Krinock, Hannah R Branton, Brien M Rabenhorst, Deidre L Wyrick, Scott J Schoenleber","doi":"10.1177/18632521261453206","DOIUrl":"10.1177/18632521261453206","url":null,"abstract":"<p><strong>Purpose: </strong>Although most pediatric extremity fractures can be managed with closed reduction, even when operative fixation is required, youth rodeo exposes participants to high-energy livestock-related trauma that may produce fracture patterns associated with failed closed reduction. This study described operative management and fracture irreducibility in pediatric and adolescent extremity injuries sustained during organized rodeo participation.</p><p><strong>Methods: </strong>A retrospective case series was performed at a Level I pediatric trauma center. Patients aged ≤18 years who sustained injuries during organized rodeo participation between November 2017 and December 2023 were identified through trauma registry review. Demographics, injury characteristics, operative management, and intraoperative findings were recorded. Fractures were classified as irreducible when documented closed reduction attempts failed, and open reduction was required to obtain satisfactory alignment.</p><p><strong>Results: </strong>Forty-one patients with rodeo-related injuries were identified. Orthopedic injuries occurred in 21 patients (51.2%), including 18 extremity fractures (43.9%). Thirteen of eighteen extremity fractures (72.2%) were managed operatively. Open reduction after unsuccessful closed reduction attempts was required in 5 of 13 operatively treated fractures (38.5%), representing 27.8% of all extremity fractures. Irreducible injuries included femoral shaft fractures, elbow fracture-dislocations, Monteggia injuries, proximal humerus fractures, and both-bone forearm fractures.</p><p><strong>Conclusion: </strong>Pediatric and adolescent rodeo-related extremity fractures were frequently managed operatively, and open reduction was required in a substantial proportion of surgically treated cases. These findings should be interpreted descriptively because no matched comparison cohort was available.</p><p><strong>Significance of study: </strong>This single-center series suggests that failed closed reduction may occur in several pediatric and adolescent rodeo-related extremity fracture patterns.</p><p><strong>Level of evidence: </strong>IV (Therapeutic Case Series).</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"395-401"},"PeriodicalIF":1.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-developing acetabular dysplasia following normal infant hip ultrasound in breech and family-history cohorts: A systematic review.","authors":"Haider Ali Riaz Lakdawala, Yashvi Verma, María Galán-Olleros, Catharine S Bradley, Kishore Mulpuri, Richard Gardner, Luckshman Bavan","doi":"10.1177/18632521261448943","DOIUrl":"10.1177/18632521261448943","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review evaluates the reported incidence of late-developing acetabular dysplasia in infants with breech presentation or a positive family history of developmental dysplasia of the hip following normal early ultrasound.</p><p><strong>Methods: </strong>MEDLINE, Embase, and the Cochrane Library were searched for studies of breech or positive family-history cohorts who underwent early ultrasound and subsequent radiographic follow-up for late-developing acetabular dysplasia. Two reviewers independently screened studies, extracted data, and assessed methodological quality.</p><p><strong>Results: </strong>Ten studies met inclusion criteria. Across these studies, radiographic follow-up after normal infant ultrasound was incomplete and variably reported, with several cohorts demonstrating substantial attrition. Among infants with a positive family history who underwent radiographic assessment (<i>n</i> = 520), no cases of late-developing acetabular dysplasia were reported. In breech cohorts with available follow-up (<i>n</i> = 727), reported late-developing acetabular dysplasia rates ranged from 0% to 29%, with higher estimates generally observed in studies with earlier follow-up or more permissive diagnostic thresholds. Management was predominantly observational, and operative treatment was described in one case only.</p><p><strong>Conclusions: </strong>Persistent acetabular dysplasia after a normal screening ultrasound was not identified in the included family-history cohorts with post-screening imaging. In breech cohorts, reported rates of late-developing acetabular dysplasia vary widely and appear to be influenced by timing of assessment and diagnostic criteria. Methodological heterogeneity and incomplete cohort ascertainment limit interpretation, underscoring the need for prospective studies with standardised definitions and child-level incidence reporting.</p><p><strong>Significance of study: </strong>This review highlights critical gaps in the evidence informing management of developemental dysplaisa of the hip following screening and provides a framework for designing definitive prospective studies to guide surveillance practices.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"411-418"},"PeriodicalIF":1.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality, reliability, and educational value of YouTube™ videos on Pavlik harness treatment for developmental dysplasia of the hip.","authors":"Beytullah Unat, Çağrı Karabulut, Musa Alperen Bilgin, Ramazan Erol, İbrahim Halil Rızvanoğlu, Nevzat Gönder","doi":"10.1177/18632521261438642","DOIUrl":"10.1177/18632521261438642","url":null,"abstract":"<p><strong>Background: </strong>Pavlik harness is a widely accepted first-line treatment for Developmental dysplasia of the hip in infants. Given the increasing use of online video platforms by caregivers seeking medical information, this study aimed to evaluate the content, quality, and reliability of the most-viewed YouTube™ videos related to the Pavlik harness.</p><p><strong>Methods: </strong>A YouTube™ search was conducted using the terms \"Pavlik harness,\" \"Pavlik harness treatment,\" \"Pavlik harness overview,\" \"Pavlik harness how to apply,\" \"Pavlik harness application,\" and \"Pavlik harness tips.\" 48 videos were included for analysis. Data collected included upload source, video length, date of upload, number of views, likes, dislikes, comments, and the interaction index. Video quality and reliability were evaluated using the Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) benchmark criteria, and DISCERN instrument.</p><p><strong>Results: </strong>Of the 48 videos analyzed, 26 (54.2%) were classified as high quality, 10 (20.8%) as intermediate, and 12 (25%) as low quality. Videos uploaded by healthcare professionals and academic institutions had significantly higher GQS, JAMA, and DISCERN scores compared to those uploaded by non-medical sources(<i>p</i> < 0.001). High-quality videos also had a higher number of likes per day and views per day (<i>p</i> = 0.001 and <i>p</i> = 0.001, respectively).</p><p><strong>Conclusion: </strong>Nearly half of the most-viewed YouTube™ videos on this topic were of intermediate or low quality. Pediatric orthopedic specialists and professional societies should be encouraged to contribute high-quality, evidence-based videos to guide caregivers appropriately. Parents should be advised to rely on videos uploaded by reputable academic sources to ensure accurate and safe application of the Pavlik harness.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"419-427"},"PeriodicalIF":1.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of hemiepiphysiodesis on lower limb deformities due to rickets: A systematic review.","authors":"M Deryl Ivansyah, Aryadi Kurniawan, Ari Wibowo","doi":"10.1177/18632521261444934","DOIUrl":"10.1177/18632521261444934","url":null,"abstract":"<p><strong>Purpose: </strong>Rickets is a condition characterized by a defective mineralization on the epiphyseal plate, either in the form of nutritional or congenital hypophosphatemic rickets, which could lead to progressive bone deformity. One of said deformities is angular growth of the knee which can cause permanent disfigurement. Hemiepiphysiodesis is a surgical option to correct the deformity, yet the studies evaluating its results are rare. This review aimed to map the literature pertaining to this topic.</p><p><strong>Methods: </strong>A comprehensive search was performed across five databases: Pubmed, Cochrane, ProQuest, Embase, and Science Direct to identify studies involving children with rickets treated with hemiepiphysiodesis. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool, and the outcome data were compiled.</p><p><strong>Results: </strong>Six studies fulfilled the inclusion and exclusion criteria of this study with highly varied groupings and outcomes. However, the risk of bias of all studies was low to moderate. Hemiepiphysiodesis showed good outcome in function, radiological parameter, and correction rate with lower complication rate compared to osteotomy. The average time required to achieve full deformity correction was within 10.8-22.7 months. However, hemiepiphysiodesis has a risk of overshooting the correction or paradoxically rebounding to the prior condition, therefore, requiring routine follow-up.</p><p><strong>Conclusion: </strong>Hemiepiphysiodesis is beneficial for the correction of angular deformities in the knee due to rickets.</p><p><strong>Significant of studies: </strong>This review provides a crucial evidence base for clinicians by establishing hemiepiphysiodesis as a viable, less invasive alternative to osteotomy.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"328-336"},"PeriodicalIF":1.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's new in pediatric bone sarcomas and benign bone tumors.","authors":"Nicolas von der Weid, Daniel Baumhoer, Andreas H Krieg","doi":"10.1177/18632521261444250","DOIUrl":"10.1177/18632521261444250","url":null,"abstract":"<p><p>Significant progress has been made in the diagnosis and treatment of pediatric bone tumors in recent years. For malignant bone tumors, a better understanding of the molecular pathogenesis has been achieved, providing new directions for targeted approaches and immunotherapy. Advances in imaging techniques, such as whole-body magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography/computed tomography, have improved the accuracy of staging, treatment response evaluation, and recurrence monitoring. In surgical treatment, 3D printing technology, computer navigation, and minimally invasive techniques have shifted the paradigm from resection to functional reconstruction. Technologies, including modular and expandable implants, along with bio-integrated prostheses, support long-term functional recovery in pediatric patients. For benign bone tumors, the use of targeted drugs like denosumab and the refinement of minimally invasive techniques such as cryotherapy and radiofrequency ablation have achieved a better balance between disease control and functional preservation. The ongoing development of multidisciplinary collaboration further optimizes personalized treatment strategies. Looking ahead, continuous progress in precision medicine will steer the diagnosis and treatment of pediatric bone tumors toward minimally invasive, individualized, and innovative approaches.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"359-370"},"PeriodicalIF":1.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical decision-making in rare bone diseases - A survey among members of the European Paediatric Orthopaedic Society (EPOS) and the European Reference Network on Rare Bone Diseases (ERN BOND).","authors":"Thilini H Gamage, Silvia Coutinho, Alberto Leardini, Inês Alves, Nadine Großmann, Ralph Sakkers, Gemma Marcucci, Laura Masi, Maria Luisa Brandi, M Carola Zillikens, Giovanni Trisolino, Lena Lande Wekre, Joachim Horn","doi":"10.1177/18632521261439074","DOIUrl":"10.1177/18632521261439074","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical management of rare bone diseases (RBDs) is challenged by low prevalence, delayed diagnosis, and complex multidisciplinary needs. This survey aimed to map current clinical practices in RBDs, identify unmet needs, and generate foundational data to guide the development of minimum standards for patient assessment.</p><p><strong>Methods: </strong>An anonymous online survey was distributed to members of the European Paediatric Orthopaedic Society (EPOS) and the European Reference Network on Rare Bone Diseases (ERN BOND) in September 2025. Questions addressed diagnostic work-up, interdisciplinary care, transition practices, and future perspectives. Quantitative data were analysed descriptively, and free-text responses thematically.</p><p><strong>Results: </strong>A total of 119 respondents (35 countries), mostly orthopaedic surgeons (74%), completed the survey. Almost all (118/119) provided direct care, and 63% had >10 years' experience treating RBDs. Over 80% routinely used anthropometric, posture, and alignment measures, whereas the use of advanced tools varied. Interdisciplinary care is widely applied at varying frequencies, with a high consideration for shared decision-making and quality of life. Most lacked registry access (>80%) and formal transition protocols (~70%). Respondents prioritised clinical frameworks over technological advances and anticipated increasing future relevance for technological innovations.</p><p><strong>Conclusions: </strong>This survey highlights considerable variability in clinical decision-making for RBDs. The findings underscore the importance and need of standardised interdisciplinary care, registry data, and structured protocols and frameworks.</p><p><strong>Study significance: </strong>This is the first systematic survey of clinical practice and decision-making process in RBD care among EPOS and ERN BOND members. The findings may guide future recommendations and standards, supporting more harmonised care for individuals with RBDs, especially ultra-rare conditions.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"428-439"},"PeriodicalIF":1.8,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}