Journal of Childrens Orthopaedics最新文献

{"title":"Barriers to conducting prospective multicentre studies in paediatric orthopaedics in Europe: Insights from the EPOS Discoid Meniscus (DiMe) project.","authors":"Marco Turati, Marco Crippa, Nicolas Nicolaou, Elena Tassistro, Monika Thüsing, Jaakko Sinikumpu, Aurélien Courvoisier, Joao Jose Cabral, Julio Duart, Benjamin Tschopp, Stéphane Tercier, Gyözö Lehoczky, Simon Vandergugten, Andrei-Vasile Maxim, Nev Davies, Lucrezia Montanari, Stefania Galimberti, Marco Bigoni, Franck Accadbled","doi":"10.1177/18632521261424747","DOIUrl":"10.1177/18632521261424747","url":null,"abstract":"<p><strong>Purpose: </strong>Prospective multicentre studies represent a cornerstone of evidence-based advancement. However, within orthopaedics, and particularly in the European context of paediatric orthopaedics, such rigorous investigations are notably scarce. This study aims to explore the organizational, regulatory, and resource-related barriers hindering initiation of these crucial studies, using the setup phase of the '<i>EPOS Discoid Meniscus (DiMe) Project: a Prospective Multicentric Cohort Protocol</i>'.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from 19 centres initially recruited for the European Paediatric Orthopaedic Society DiMe Project (NCT05580315) cohort study. Delays and perceived obstacles encountered during initiation phases: contract negotiation, ethics committee approval, and patient enrolment were assessed. A descriptive analysis was performed to characterize the data. Twelve responding centres (63.2%) were still in the contract negotiation phase, while 36.8% (<i>n</i> = 7) had progressed to the patient enrolment stage.</p><p><strong>Results: </strong>Median duration for contract negotiation was 12 months (Q1-Q3: 7-22), matching ethical approval (Q1-Q3: 3-12). Sixty-three point two percent (<i>n</i> = 12) of responding centres were still in the contract negotiation phase, while 36.8% (<i>n</i> = 7) had progressed to patient enrolment, with 41 patients enrolled across these sites. Formal ethics committee submission was required <i>de novo</i> in 84.2% (<i>n</i> = 16) of responding centres. Major challenges identified included bureaucratic delays, lack of institutional support, absence of dedicated research staff, and prolonged administrative processes.</p><p><strong>Conclusion: </strong>The initiation of European multicentre studies in paediatric orthopaedics is hindered by institutional and regulatory barriers. Streamlining administrative and ethical processes and allocation of resources and personnel are needed to improve efficiency and facilitate successful collaborations.</p><p><strong>Level of evidence: </strong>V - Expert opinion / Cross-sectional survey.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"216-224"},"PeriodicalIF":1.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328193","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":"Virtual reality as a distraction technique in pediatric patients undergoing orthopedic procedures: A systematic review and meta-analysis of randomized controlled trials.","authors":"Abdullah M Alharran, Abdulrahman Emad AlAyyaf, Abdullah Addar, Reggie Hamdy, Yousef Marwan","doi":"10.1177/18632521251414463","DOIUrl":"10.1177/18632521251414463","url":null,"abstract":"<p><strong>Introduction: </strong>Pain and anxiety are common in pediatric orthopedic procedures such as cast or pin removal, often leading to distress and physiological stress responses. Virtual reality (VR) offers immersive distraction and has shown promise in pediatric procedural care; however, evidence in orthopedic procedures remains limited. This meta-analysis aimed to evaluate the effectiveness of VR compared with standard care in reducing pain, anxiety, and heart rate in children undergoing orthopedic procedures.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, and Cochrane Library from inception to 20 October 2025 for randomized controlled trials (RCTs) comparing VR distraction and standard care in pediatric patients undergoing orthopedic procedures. Outcomes of interest included pain, anxiety, and heart rate. Statistical analysis was performed with R 4.3.1. Standardized mean differences (SMD) using the Inverse-Variance method and the random-effects method.</p><p><strong>Results: </strong>A total of four RCTs were included in the final meta-analysis, comprising 624 patients, of whom 315 (50%) were distracted with VR during clinical orthopedic procedures (mean age 9.84 years, mean 40% females). In the pooled analysis, VR distraction significantly reduced anxiety (SMD = -0.55, 95% confidence intervals (CI) [-0.76, -0.34]; <i>p</i> < 0.01; <i>I</i> ² = 0%), pain (SMD = -0.43; 95% CI [-0.68, -0.19]; <i>p</i> < 0.01; I² = 44%), and heart rate (SMD = -0.34; 95% CI [-0.60, -0.07]; <i>p</i> = 0.01; I² = 53%).</p><p><strong>Conclusion: </strong>In this meta-analysis of four RCTs including 624 pediatric patients, VR distraction reduced procedural anxiety and, in pooled analyses, was associated with modest but statistically significant reductions in pain and heart rate compared with standard care during predominantly cast-related orthopedic clinic procedures. The integration of this child-friendly, nonpharmacological approach provides enhanced procedural comfort and effective anxiety management.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"285-293"},"PeriodicalIF":1.8,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328235","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":"The prevalence of clinically significant proximal femoral growth disturbance following open versus closed reduction in dysplastic hips performed after 6 months: A systematic review and meta-analysis of 150 studies.","authors":"Tim Cheok, Aditya Boppana, Jake Christiansen, Alexander Beveridge, William Jordan, Rhys Martin, Zachary Van Hout, Jaideep Rawat","doi":"10.1177/18632521251410437","DOIUrl":"10.1177/18632521251410437","url":null,"abstract":"<p><strong>Background: </strong>Late diagnosis of developmental hip dysplasia (DDH) may warrant either open or closed reduction of the hip. Proximal femoral growth disturbance (PFGD) is a possible complication following these procedures.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Web of Science, The Cochrane Library and OrthoSearch from the date of inception of each database through to the 2 February 2025 was performed. The primary outcome of interest was the prevalence of clinically significant PFGD following open or closed reduction after 6 months of age. This was defined as Kalamchi-MacEwen or Bucholz-Ogden Type 2 or above.</p><p><strong>Results: </strong>The prevalence of clinically significant PFGD in patients undergoing open reduction was 12.47% (95% Confidence interval (CI): 10.39-14.69), whereas the prevalence of clinically significant PFGD in patients undergoing closed reduction was 9.53% (95% CI: 6.91-12.46). Multivariate analysis suggested that mean age at time of reduction was associated with an increase in the prevalence of PFGD in patients undergoing closed reduction (<i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>We described the prevalence of clinically significant PFGD following closed reduction and open reduction. In both open and closed reduction groups, we observed a high relative heterogeneity (<i>I</i> ²), but acceptable absolute heterogeneity (<i>τ</i> ²), and pooled prevalence estimates should be interpreted with caution. Further studies exploring the influence of disease severity and age on treatment method is required to allow reliable comparisons between open and closed reduction.</p><p><strong>Prospero registration no: </strong>CRD420251015622.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"225-240"},"PeriodicalIF":1.8,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312639","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":"Let them move: Early range of motion and rehabilitation after fixation of medial epicondyle fractures in adolescent athletes.","authors":"Brian Le, Taylor Troutman, Andre Perez-Chaumont, Felix H Savoie, Timothy Skalak","doi":"10.1177/18632521261423069","DOIUrl":"10.1177/18632521261423069","url":null,"abstract":"<p><strong>Background: </strong>Medial epicondyle fractures account for 11%-20% of pediatric elbow fractures. While nonoperative treatment is effective, surgery is often recommended for overhead athletes to enhance union rates, valgus stability, and expedited return to sporting activities. Postoperative recovery protocols vary, with traditionally up to 2 weeks of strict immobilization and rehabilitation lasting 6-12 months. This study evaluates the early range of motion (ROM) and accelerated rehabilitation in high-performing youth athletes undergoing surgical fixation.</p><p><strong>Methods: </strong>A retrospective review included patients aged 12-17 who underwent medial epicondyle fracture fixation (2015-2023). Those with concomitant injuries were excluded. Recovery was assessed by unrestricted Return to Sports (RTS).</p><p><strong>Results: </strong>18 patients (mean age 14) were included. Postoperatively, all wore a hinged elbow orthosis locked at 90° flexion. At 1 week, extension was allowed to -30°, with flexion as tolerated. Physical therapy was initiated, focusing on gentle stretching to full ROM out of the brace. Patients remained in a hinged elbow brace for an average of 4.47 weeks before transitioning to a hinged sleeve or discontinuing brace use. After 4-6 weeks, physical therapy increased with emphasis on strengthening and terminal extension. For the 16 baseball players included, progressive return to throw and hit programs began at an average of 8.6 weeks. All patients returned to sports without restriction at an average of 13.4 weeks.</p><p><strong>Conclusion: </strong>Early mobilization and accelerated rehabilitation following medial epicondyle fracture fixation facilitate a faster RTS in high-demand youth athletes.</p><p><strong>Levels of evidence iv: </strong>Case series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"111-117"},"PeriodicalIF":1.8,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272925","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":"Sociodemographic variables are rarely reported in randomized controlled trials investigating posterior spinal fusion for adolescent idiopathic scoliosis: A systematic review.","authors":"Erin L Brown, Kenneth T Nguyen, Bhavesh R Koppala, Daman P Dhunna, Alexander Kuzma, Nikolas Baksh","doi":"10.1177/18632521251411158","DOIUrl":"10.1177/18632521251411158","url":null,"abstract":"<p><strong>Background: </strong>Adolescent idiopathic scoliosis (AIS) develops between the ages of 10 and skeletal maturity and can lead to physical, psychosocial, and medical complications if untreated. Posterior spinal fusion (PSF) is the primary surgical intervention when bracing fails. Although sociodemographic factors affect access to care, surgical candidacy, perioperative risk, and recovery, these variables are rarely reported in randomized controlled trials (RCTs), limiting assessment of equity and generalizability in AIS outcomes.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, and Scopus were searched on 9 April 2024, using \"posterior spinal fusion,\" \"randomized controlled trial,\" and \"adolescent idiopathic scoliosis.\" Inclusion criteria were full-text RCTs on PSF in AIS; exclusions were non-English publications, cadaver studies, and technique articles. Two authors independently screened studies, with disagreements resolved by a third. Extracted variables included demographics and social factors. Analyses used descriptive statistics, chi-squared tests, and Fisher's exact test (<i>p</i> < 0.05).</p><p><strong>Results: </strong>Of 148 studies, 44 met the inclusion criteria. Age (97.7%) and sex (95.5%) were reported more frequently than race (6.8%) or ethnicity (9.1%) (<i>p</i> < 0.001). No studies reported household income, insurance status, housing, employment, or education. Reporting did not differ by journal (Fisher's exact test, <i>p</i> = 0.999) or publication year (chi-squared test, <i>p</i> = 0.185), although reporting increased slightly after 2017.</p><p><strong>Conclusions: </strong>RCTs on PSF for AIS rarely report sociodemographic variables beyond age and sex. This gap limits understanding of whether outcomes are consistent across populations or if disparities exist in treatment response or recovery. Improved sociodemographic reporting is essential for transparency, external validity, and equity in AIS care.</p><p><strong>Level of evidence: </strong>Systematic review of Level II.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"197-204"},"PeriodicalIF":1.8,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272938","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":"Prevalence of posttraumatic stress disorder in paediatric patients following orthopaedic trauma: A systematic review.","authors":"Janne L Punski-Hoogervorst, Lotje A Hoogervorst, Jan W Schoones, Avi Avital, Pieter Bas de Witte","doi":"10.1177/18632521261419773","DOIUrl":"10.1177/18632521261419773","url":null,"abstract":"<p><strong>Purpose: </strong>Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may develop after exposure to severe psychological threats. It is characterized by debilitating symptoms such as re-experiencing and negative changes in mood and cognitions which are associated with comorbidity, functional impairment and increased mortality. Although orthopaedic trauma may be classified as a traumatic experience causing PTSD, the prevalence of PTSD in paediatric patients following orthopaedic trauma is currently unknown.</p><p><strong>Methods: </strong>This systematic review aimed to obtain insight into the prevalence of PTSD in paediatric patients after orthopaedic trauma (with or without surgical intervention). Seven medical literature databases were searched to identify studies reporting on the occurrence of PTSD in paediatric patients following orthopaedic trauma.</p><p><strong>Results: </strong>Ten studies were included for analysis. Overall, the pooled prevalence of PTSD was 15% (95% confidence interval: -5.1%, 34.2%), with significant heterogeneity between studies regarding patient population (e.g. age, gender and type of orthopaedic injury) as well as tools used to diagnose PTSD - all influencing the occurrence of PTSD.</p><p><strong>Conclusions: </strong>As PTSD appears to be a relatively common psychological comorbidity after orthopaedic paediatric trauma, we emphasize that both clinicians and parents should be aware of PTSD symptoms in children to allow early treatment of PTSD.</p><p><strong>Significance of study: </strong>Approximately one in seven children may develop PTSD following orthopaedic trauma, highlighting the importance of systematic screening and monitoring of PTSD symptoms in paediatric patients recovering from orthopaedic injuries.</p><p><strong>Level of evidence: </strong>Level II (systematic review of level-II studies).</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"103-110"},"PeriodicalIF":1.8,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272890","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":"Evolution and outcomes of telescoping intramedullary rods in pediatric bone fragility disorders: A systematic review.","authors":"Peter Joseph Mounsef, Jack Legler, Dev Patel, Reggie Hamdy","doi":"10.1177/18632521261423059","DOIUrl":"10.1177/18632521261423059","url":null,"abstract":"<p><strong>Purpose: </strong>Telescoping intramedullary rods have transformed the management of long bone deformity and fragility fractures in children, yet complications and revision surgery remain common. This systematic review synthesizes outcomes across telescoping systems to evaluate complication and revision rates, telescoping success, and design evolution to guide implant selection and surgical decision-making in pediatric orthopedics.</p><p><strong>Methods: </strong>A search was conducted through July 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting outcomes of telescoping rods in pediatric patients were included. Due to heterogeneity, results were synthesized descriptively and presented as weighted means per operated bone.</p><p><strong>Results: </strong>Thirty-three studies (861 patients; 2054 rods) were included. Weighted mean complication and revision rates were 49.6% and 25.7% for Bailey-Dubow rods, 61.1% and 24.5% for Sheffield rods, 37.1% and 30.5% for Fassier-Duval rods, 14.9% and 9.0% for corkscrew-locking rods, and 46.7% and 6.7% for distal-female rods. Telescoping success was 48% for Bailey-Dubow, 74% for Fassier-Duval, 94% for corkscrew, and 100% for distal-female designs. Variation in follow-up duration and definitions of complications contributed to differences in reported rates.</p><p><strong>Conclusions: </strong>Modern telescoping rods have reduced migration and mechanical failure compared with earlier designs, yet complication and revision rates remain substantial. Newer systems show encouraging early results but require longer follow-up for validation. Differences in bone anatomy and biomechanics strongly influence implant performance, underscoring the need to tailor rod selection to individual bones.</p><p><strong>Significance: </strong>This review consolidates published complication and revision rates across telescoping rod designs, establishing a foundation for comparison as newer implants are introduced and long-term outcome data become available.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"185-196"},"PeriodicalIF":1.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229847","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":"Risk factors for hip redislocation in surgically treated children with cerebral palsy: A multicenter study with follow-up until skeletal maturity.","authors":"Rafik Ramazanov, Ulaş Can Kolaç, Evren Akpinar, Sadettin Ciftci, Guney Yilmaz, Mehmet Salih Soylemez, Murat Celal Sozbilen, Yavuz Saglam, Hakan Senaran, Abdullah Eren, Mehmet Ali Talmac, Ali Seker, Sema Ertan Birsel, Hanife Avci, Muharrem Yazici","doi":"10.1177/18632521251411141","DOIUrl":"10.1177/18632521251411141","url":null,"abstract":"<p><strong>Purpose: </strong>To identify clinical and radiographic risk factors associated with hip redislocation in children with cerebral palsy (CP) who underwent surgical treatment for hip dislocation.</p><p><strong>Methods: </strong>This multicenter retrospective study included children with CP who underwent reconstructive osteotomy for hip dislocation and were followed until triradiate cartilage closure. Demographic, clinical, and radiographic variables were evaluated. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for redislocation. Additionally, a classification and regression tree (CART) model was developed to stratify redislocation risk.</p><p><strong>Results: </strong>Hip redislocation occurred in 25 of 115 hips (21.7%). Redislocation was significantly more frequent in hips treated with femoral osteotomy alone (40%) compared to combined femoral and pelvic osteotomies (16.7%), (<i>p</i> = 0.026). Multivariate analysis identified younger age at surgery (Odds ratio (OR) = 0.981, <i>p</i> = 0.010), higher postoperative Sharp's angle (OR = 1.082, <i>p</i> = 0.034), and lower postoperative Mose hip ratio (MHR) (OR = 0.007, <i>p</i> = 0.033) as independent predictors of redislocation. Radiographic ratios, including medial joint space to cranial joint space (MJS/CJS) and MJS to maximum capital femoral epiphysis diameter (MJS/MCFED), were also significantly higher in redislocated hips. The CART model classified patients into high- and low-risk groups based on surgical age ≤76 months, postoperative Sharp's angle ≥48°, and MHR < 0.69.</p><p><strong>Conclusions: </strong>Younger surgical age, insufficient correction as indicated by a higher postoperative Sharp angle and lower MHR were independently associated with hip redislocation in CP patients undergoing surgery. MJS/CJS and MJS/MCFED ratios were also associated with redislocation, indicating incomplete reduction.</p><p><strong>Significance of study: </strong>This study presents a clinically applicable decision-tree model to predict redislocation risk after CP hip reconstruction using radiographic parameters.</p><p><strong>Level of evidence: </strong>Level III, multicenter retrospective study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"3-12"},"PeriodicalIF":1.6,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953698","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":"Influential articles on pediatric clavicle injuries: A bibliometric analysis.","authors":"Steven M Garcia, Erin Orozco, Abhay Kopardekar, Sachin Allahabadi, Nirav Pandya","doi":"10.1177/18632521251411146","DOIUrl":"10.1177/18632521251411146","url":null,"abstract":"<p><strong>Purpose: </strong>Clavicle injuries are among the most common pediatric injuries. This study aimed to identify the 50 most cited articles on pediatric and adolescent clavicle injuries, characterize their publication trends, and assess the correlation between citation metrics and study quality.</p><p><strong>Methods: </strong>A bibliometric analysis was performed using Web of Science and Scopus databases, identifying the 50 most cited articles on pediatric and adolescent clavicle injuries. Data extracted included citation counts, citation density, study design, level of evidence, and publication characteristics. Methodological quality was assessed using the modified Coleman Methodology Score (mCMS) and Methodological Index for Non-Randomized Studies (MINORS), where applicable. Correlations between citation metrics and quality scores were evaluated using Spearman correlation.</p><p><strong>Results: </strong>Among the 50 most cited articles published between 1984 and 2019, the majority (70%) were published in the last decade and in Journal of Pediatric Orthopaedics (38%). Most studies originated from the United States (74%). The mean citation count was 31.9 ± 19.7, with a citation density of 2.6 ± 1.4 citations/year. Level 4 evidence predominated (73%), with no level 1 studies identified. The average mCMS and MINORS scores were 40.1 and 13.1, respectively. No significant correlation was found between citation rank and methodological quality scores, although citation rank was significantly correlated with citation density (<i>r</i> _s = -0.66, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The most cited studies on pediatric clavicle injuries are predominantly low-level evidence and retrospective in nature. Citation frequency was not associated with methodological quality, suggesting that article influence is often driven by historical context, novelty, or foundational relevance rather than study rigor.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"40-49"},"PeriodicalIF":1.6,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953519","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":"Response to the Letter to Editor regarding: \"High effectiveness of multilevel orthopedic surgery and guided growth in spastic hemiplegia children\".","authors":"Ulvi Mamedov, Tamara Dolganova, Orkhan Gatamov, Patrick Foster, Akhmed Tomov, Dmitry Popkov","doi":"10.1177/18632521251405152","DOIUrl":"10.1177/18632521251405152","url":null,"abstract":"","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"98-99"},"PeriodicalIF":1.6,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727297","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}