Journal of Childrens Orthopaedics最新文献

{"title":"Factors associated with flexed knee gait in unilateral cerebral palsy.","authors":"K Patrick Do, Jing Feng, Jeremy P Bauer","doi":"10.1177/18632521251325037","DOIUrl":"10.1177/18632521251325037","url":null,"abstract":"<p><strong>Purpose: </strong>A flexed knee gait is a common gait in children with unilateral cerebral palsy. In children without knee contracture, hamstring spasticity is commonly considered a major contributor to a flexed knee gait. We hypothesized that the popliteal angle would not correlate to a flexed knee gait.</p><p><strong>Methods: </strong>This retrospective study included 109 children with unilateral cerebral palsy who had undergone complete 3D gait analysis. Children who had previous surgery or knee flexion contracture were excluded. Children were divided into three groups based on knee position during stance as determined by 3D gait analysis: flexion (FK, 47), hyperextension (HK, 42), and normal (NK, 20).</p><p><strong>Results: </strong>There were no significant correlations between popliteal angle and dynamic peak knee extension in stance or at initial contact. Similarly, peak dorsiflexion during the stance phase did not correlate with dynamic peak knee extension in stance (all <i>p</i> > 0.05). Significant differences were observed in foot position during stance between FK and HK groups, as well as in quick stretch dorsiflexion with the knee extended between HK and NK groups.</p><p><strong>Conclusion: </strong>A flexed knee gait in children with unilateral cerebral palsy does not always correlate with the popliteal angle or dynamic ankle position in gait. These factors may contribute but are insufficient to explain all observed differences. A flexed knee gait likely involves a complex interplay of motor control, strength, spasticity, and lever arm dynamics, indicating that interventions at a single level may not fully improve dynamic knee extension.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"151-157"},"PeriodicalIF":1.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652158","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 musculoskeletal imaging.","authors":"Matan Kraus, Lihi Pertman, Iris Eshed","doi":"10.1177/18632521251325122","DOIUrl":"10.1177/18632521251325122","url":null,"abstract":"<p><p>The field of pediatric musculoskeletal imaging is undergoing significant advancements due to technological innovations and a growing emphasis on safety and patient-centered care. This review explores recent developments in imaging modalities such as advanced magnetic resonance imaging, ultrasound innovations, and artificial intelligence applications. Highlights include radiation dose-reduction techniques in radiography and computed tomography, enhanced diagnostic tools like contrast-enhanced ultrasound and ultra-high-frequency imaging, and the integration of artificial intelligence for pathology detection and workflow optimization. The adoption of advanced methods like whole-body magnetic resonance imaging and computed tomography-like magnetic resonance imaging sequences has improved diagnostic accuracy, minimized radiation exposure, and expanded the capabilities of noninvasive imaging. Emerging technologies, including photon-counting detector computed tomography and deep learning-based reconstructions, are transforming clinical practices by balancing precision and safety. Artificial intelligence applications are reshaping diagnostic approaches, automating complex assessments, and improving efficiency, although challenges such as external validation and limited scope persist. Functional imaging advancements, such as diffusion-weighted imaging and positron emission tomography-magnetic resonance imaging integration, are enhancing disease characterization and treatment planning. This review underscores the clinical impact of these innovations, emphasizing the need for standardized protocols, interdisciplinary collaboration, and continued research to address unmet needs in radiation safety and artificial intelligence integration. It aims to equip healthcare professionals with the knowledge to leverage these advancements for improved outcomes in pediatric musculoskeletal care.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"109-118"},"PeriodicalIF":1.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652160","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":"Robot-assisted percutaneous cannulated screw fixation in the treatment of slipped capital femoral epiphysis.","authors":"Yunfeng Xu, Gang Fu, Chao Feng, Lin Huang, Yuan Ma, Yucheng Zhang, Yuan Zhou, Xiao Luo, Ming Lu, Jie Yang, Yukun Wang, Xuemin Lv, Xieyuan Jiang, Zheng Yang","doi":"10.1177/18632521251319987","DOIUrl":"10.1177/18632521251319987","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate robot-assisted percutaneous cannulated screw fixation for treating slipped capital femoral epiphysis, including acute, chronic, and acute-on-chronic slips. Our study included all stable and unstable slips.</p><p><strong>Methods: </strong>Thirty-one children with unilateral SCFE were treated from October 2019 to October 2021. All 31 patients were followed up for 12-36 months, with an average follow-up time of 24.56 ± 6.73 months. The femoral epiphysis was fixed with a percutaneous cannulated screw assisted by a surgical robot.</p><p><strong>Results: </strong>All 31 femoral head epiphyses underwent successful fixation in one attempt. The average operation time and bleeding were 98.25 ± 15.13 min and 21.65 ± 11.25 ml, respectively. The average distance between the actual and planned entry points was 1.13 ± 0.58 mm and 0.91 ± 0.72 mm in the anteroposterior (AP) and lateral views, respectively. The actual insertion trajectory deviated from the planned position by 3.61 ± 1.34° and 2.33 ± 1.32° in the AP and lateral views, respectively. The average fluoroscopy time was 6.56 ± 3.23 times per screw. The Non-Arthritic Hip Score improved from 28.53 ± 9.17 preoperatively to 67.34 ± 6.21 at the last follow-up (<i>P</i> < 0.05), and the Harris hip score improved from 46.47 ± 15.34 to 89.63 ± 7.52 (<i>P</i> < 0.05). The wounds healed without avascular necrosis or chondrolysis of the femoral head.</p><p><strong>Conclusion: </strong>Robot-assisted percutaneous cannulated screw fixation is effective for treating pediatric SCFE. Screw fixation was accurate and safe, and clinical outcomes were satisfactory.</p><p><strong>Level of evidence: </strong><i>Level</i> 4, Case Series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"158-165"},"PeriodicalIF":1.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434412","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":"Low rate of healing and high incidence of complications in benign pediatric bone tumors treated with synthetic calcium sulfate-calcium phosphate bone graft.","authors":"Ali A Siddiqui, Lindsay M Andras, Annika Y Myers, Bensen B Fan, James Bennett, Kenneth D Illingworth, David L Skaggs, Vernon T Tolo","doi":"10.1177/18632521241310049","DOIUrl":"10.1177/18632521241310049","url":null,"abstract":"<p><strong>Background: </strong>Synthetic calcium sulfate-calcium phosphate bioceramic composite has been developed as a material for bone grafting; however, the literature is limited on outcomes of benign bone tumors treated with bone grafting. This study aims to investigate the outcomes of benign pediatric bone tumors treated with a calcium sulfate-calcium phosphate composite bone graft.</p><p><strong>Methods: </strong>A retrospective review at a tertiary pediatric hospital with benign bone tumors treated with curettage and bone grafting with a calcium sulfate-calcium phosphate synthetic bone graft from 2008-2018 was included. Minimum follow-up was 6 months.</p><p><strong>Results: </strong>Twenty-seven patients met inclusion criteria with a mean age of 10.3 ± 4.5 years and follow-up was 37.2 ± 22.3 months. Diagnoses were unicameral bone cysts (<i>n</i> = 16) and aneurysmal bone cysts (<i>n</i> = 11). Pathologic fracture was present in 48% (13/27) of patients on admission. All patients were treated using synthetic bone grafts and 37% (10/27) with internal fixation. Following index treatment, 96% (26/27) had resolution of pain and returned to full activity at 13.4 ± 10.7 weeks. Complications occurred in 33% (9/27) of patients; one developed chronic hip pain resulting in decreased physical activity, seven had a tumor recurrence without fracture, and one had tumor recurrence with pathologic fracture. Revision surgery was required in 26% (7/27) of cases. Per the modified Neer outcomes rating system, 52% of patients had a healed bone lesion, 4% had a healing lesion with a bone defect, and 44% had a persistent/recurrent cyst.</p><p><strong>Conclusions: </strong>Children with benign bone tumors treated with curettage and bone grafting using a calcium sulfate-calcium phosphate composite had a high incidence of complications and revision surgery.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"166-171"},"PeriodicalIF":1.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082272","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 are patients asking and reading online? An analysis of online patient searches about treatments for developmental dysplasia of the hip.","authors":"Uma Balachandran, Renee Ren, Camila Vicioso, Jiwoo Park, Katrina S Nietsch, Brittany Sacks, Rodnell Busigo Torres, Sheena C Ranade","doi":"10.1177/18632521241310318","DOIUrl":"10.1177/18632521241310318","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to analyze frequently searched questions through Google's \"People Also Ask\" feature related to four common treatments for developmental dysplasia of the hip (DDH): the Pavlik harness, rhino brace, closed reduction surgery and open reduction surgery.</p><p><strong>Methods: </strong>Search terms for each treatment were entered into Google Web Search using a clean-install Google Chrome browser. The top frequently asked questions and associated websites were extracted. Questions were categorized using the Rothwell classification model. Websites were evaluated using the JAMA Benchmark Criteria. Chi-square tests were performed.</p><p><strong>Results: </strong>The initial search yielded 828 questions. Of 479 included questions, the most popular topics were specific activities that patients with DDH can/cannot do (32.8%), technical details about treatments (30.9%) and indications for treatments (18.2%). Websites were commonly academic (59.3%), commercial (40.5%) and governmental (12.3%). There were statistically significant more specific activity questions about Pavlik harnesses than about rhino braces (<i>χ</i> ² = 7.1, <i>p</i> = 0.008), closed reduction (<i>χ</i> ² = 56.5, <i>p</i> < 0.001) and open reduction (<i>χ</i> ² = 14.7, <i>p</i> < 0.001). There were statistically significant more technical details questions about Pavlik harnesses than about closed reduction (<i>χ</i> ² = 4.1, <i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>This study provides insights into common concerns that parents have about their children's DDH treatment, enabling orthopaedic surgeons to provide more effective and targeted consultations. This is particularly important for DDH because affected patients are often diagnosed within the first few months of life, leaving parents overwhelmed by caring for a newborn child and simultaneously coping with this diagnosis.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"92-98"},"PeriodicalIF":1.3,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973450","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":"Health-related quality of life after Dega pelvic osteotomy and varus derotation osteotomy due to spastic hip disease in children with cerebral palsy.","authors":"Maciej Kasprzyk, Aleksander Koch, Marek Jóźwiak","doi":"10.1177/18632521241300880","DOIUrl":"10.1177/18632521241300880","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to present health-related quality of life (HRQL) after combined bone reconstruction in nonambulatory patients with cerebral palsy (CP) after at least a 2-year follow-up and to assess its impact on HRQL using the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire (CPCHILD) as the primary outcome measure.</p><p><strong>Methods: </strong>In this prospective study, we analyzed 31 nonambulatory patients with spastic or mixed CP (GMFCS levels IV-V) who underwent hip reconstructive surgery between 2015 and 2021. The surgical procedures included one-sided varus derotation osteotomy of the femur with Dega transiliac osteotomy and, on the opposite side, varus derotation osteotomy (VDRO) of the femur with shortening and, as needed, Dega pelvic osteotomy.</p><p><strong>Results: </strong>The study demonstrated significant improvement in the hip joint motion range, as assessed by the Thomas test, in hip abduction and rotational movements of the hip, as well as reduction of spasticity. The procedures also resulted in significant radiographic improvement of the femoral head coverage. The assessment of symptoms and problems associated with the hip revealed a positive influence of the surgery on pain, contractures, toileting/perineal hygiene, dressing, seating, transferring, and position changes. The mean improvement at a follow-up visit was significant in all domains of the CPCHILD, except for communication and social interaction.</p><p><strong>Conclusion: </strong>Hip reconstruction with VDRO and Dega pelvic osteotomy can enhance the HRQL of children with CP. These surgical interventions can help to achieve the correct hip position and to reduce pain, which positively affects the patient QL, although proactive treatment results in less invasive procedures.</p><p><strong>Level of evidence: </strong>IV case series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"83-91"},"PeriodicalIF":1.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973449","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":"Diagnosis and management of septic arthritis: A current concepts review.","authors":"Ignacio Sanpera, Marta Salom, Cristina Alves, Deborah Eastwood","doi":"10.1177/18632521241311302","DOIUrl":"10.1177/18632521241311302","url":null,"abstract":"<p><p>Correct diagnosis and treatment of septic arthritis (SA) are essential to achieve satisfactory results and avoid lifelong consequences. Diagnosing septic arthritis is not always easy, which is why new biomarkers have been sought. Another difficulty in diagnosis is the increase in septic arthritis due to Kingella Kingae, which does not show the same signs and symptoms as classic <i>Staphylococcus aureus</i> infections. Increasingly, magnetic resonance imaging plays a more fundamental role in diagnosing septic arthritis, and many studies are focused on this line, especially for the study of associated pathologies. Numerous studies have been published on less invasive treatments for septic arthritis, although the evidence suggests that the results should be taken cautiously. Although most of the published studies focus on the hip and knee, there have also been recent publications on SA in the upper limb, foot, and ankle. Finally, the literature also pays attention to SA in young children due to its different etiology and the greater difficulties in its diagnosis.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"14-19"},"PeriodicalIF":1.3,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933742","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":"Treatment of symptomatic bipartite patella in patients <21 years of age: A systematic review and treatment algorithm.","authors":"Kristen E Hines, David S Liu, Amy E Steele, Daniel Gabriel, Anjali Prabhat, Yi-Meng Yen, Grant Douglas Hogue","doi":"10.1177/18632521241308410","DOIUrl":"10.1177/18632521241308410","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to develop an evidence-based algorithm for the management of symptomatic bipartite patella in the pediatric and adolescent population based on a systemic review of the published literature.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines on PubMed and Embase, selecting for studies discussing the management of symptomatic bipartite patella.</p><p><strong>Results: </strong>Five studies met criteria, involving 315 knees (314 patients, average age 15.8 years). All patients presented with symptomatic bipartite patella and underwent an initial trial of conservative management. Seventy-six percent (239 knees) achieved full resolution of symptoms after conservative management at a median of 1.9 months. The remaining 76 knees (24.12%) had persistent symptoms requiring operative intervention. Surgical techniques included surgical excision, screw fixation, synchondrosis drilling, lateral release, and both arthroscopic and open interventions (92.1%). Most patients (90.79%) who underwent surgical intervention had partial or complete resolution of their symptoms. Seven of 76 knees (9.21%) needed management postoperatively for pain due to trauma, residual symptomatic ossicles, and hardware complications. Of these, four patients required reoperations (average 2 years). The remaining three patients had satisfactory outcomes with an additional course of conservative management and oral analgesics.</p><p><strong>Conclusion: </strong>Management of symptomatic bipartite patella should begin with a trial of conservative management. With refractory symptoms lasting greater than 3 months, surgical intervention may be considered with positive outcomes of partial or complete resolution of symptoms. The proposed algorithm is provided to guide physician management of symptomatic BPP in pediatric or adolescent patients.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"75-82"},"PeriodicalIF":1.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900879","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":"Ankle and foot deformities and malformations in proximal femoral focal deficiency.","authors":"Jiri Chomiak, Monika Frydrychova, Martin Ošťádal, Pavel Dungl","doi":"10.1177/18632521241301942","DOIUrl":"10.1177/18632521241301942","url":null,"abstract":"<p><strong>Purpose: </strong>To describe foot abnormalities in proximal femoral focal deficiency and their correlation to the severity.</p><p><strong>Methods: </strong>Eighty-nine extremities in 87 patients were evaluated between 1996 and 2020 clinically and radiologically. Fibula length, ankle shape, tarsal coalitions, and the number of foot rays were recorded. Extremities with proximal femoral focal deficiency were classified according to Pappas and divided into severe (classes II and V), medium severe (classes III and IV), and mild groups (classes VII, VIII, and IX).</p><p><strong>Results: </strong>The fibula was short in 89% and absent in 11% of cases. An absent fibula occurred mostly in severe class III and only in 4% of mild grades (statistically significant, <i>p</i> = 0.004). The valgus ankle joint prevailed in 82% of cases. Spherical ankle joints (18% of cases) were associated in all cases with a tarsal coalition. Tarsal coalitions occurred in 14.6% and were present in all classes except class IV. Five ray feet were found in 83% of cases, four ray feet were found in 16%, and three ray feet in one extremity. Reduction in the number of foot rays occurred more commonly in association with fibular aplasia (30%).</p><p><strong>Conclusions: </strong>Abnormalities of the fibula and ankle joint represent a constant part of proximal femoral focal deficiency, whereas tarsal coalition and a reduction of foot rays do not. The severity of foot abnormalities does not correlate to the severity of proximal femoral focal deficiency but does with fibular aplasia.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"56-63"},"PeriodicalIF":1.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877982","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 the pediatric spine?","authors":"Brice Ilharreborde, Ilkka Helenius, Daniel Studer, Carol Hasler, Moyo Kruyt, Jorge Mineiro, Dror Ovadia, David Farrington, Sebastien Pesenti, Muharrem Yazici","doi":"10.1177/18632521241309531","DOIUrl":"10.1177/18632521241309531","url":null,"abstract":"<p><strong>Introduction: </strong>The field of pediatric spine surgery has encountered major changes and evolutions lately, with new treatment options available and the development of enabling technologies. This article aims to summarize the most relevant recent literature.</p><p><strong>Materials and methods: </strong>The five most relevant topics were selected and assigned to one or two authors who performed a comprehensive Pubmed database search for articles published in the last 4 years (2021-2024). Only studies with a high level of evidence or clinical relevance were reported.</p><p><strong>Results: </strong>Thirty-nine articles were selected and analyzed, covering the following subjects: treatment options in tweeners, the impact of new medical treatments in pediatric spine practice, the emergence of new surgical techniques, the development of enabling technologies in scoliosis surgery, and recent relevant randomized controlled trials.</p><p><strong>Discussion: </strong>Many new surgical concepts and techniques have been developed lately, but their results need to be further assessed on specific subgroups of patients. Numerous significant medical improvements have been reported in the last 5 years, affecting positively the management of syndromic and neuromuscular patients.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"3-13"},"PeriodicalIF":1.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877983","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}