Journal of Childrens Orthopaedics最新文献

{"title":"Diagnosis and treatment of \"medial to lateral diagonal injury of the elbow\" in children: Concomitant medial epicondylar and radial neck fractures.","authors":"Yunan Lu,&nbsp;Federico Canavese,&nbsp;Yongjie Xia,&nbsp;Ran Lin,&nbsp;Dianhua Huang,&nbsp;Tianlai Chen,&nbsp;Shunyou Chen","doi":"10.1177/18632521231182422","DOIUrl":"https://doi.org/10.1177/18632521231182422","url":null,"abstract":"<p><strong>Purpose: </strong>The simultaneous and ipsilateral occurrence of medial epicondylar and radial neck fractures is rare. This study evaluated the clinical and radiological outcomes of medial to lateral diagonal injury of the elbow (MELAINE).</p><p><strong>Methods: </strong>Six males and 6 females were diagnosed with MELAINE (left: 10, 83.3%; right: 2, 16.7%). Medial epicondylar and radial neck fractures were classified according to Papavasiliou's classification (seven type II, two type III, three type IV) and Judet's classification (three type I, four type II and five type III), respectively. All patients underwent surgery. The carrying angle, range of motion, and Kim et al. Elbow Performance Score were used to evaluate clinical and functional outcomes; related complications were recorded.</p><p><strong>Results: </strong>Mean age at injury and mean follow-up were 11.1 ± 2.5 (range, 6-14) and 40 ± 25.6 months (range, 13-90), respectively. All fractures consolidated in 6.3 ± 1.2 weeks on average (4-9). Outcomes were good (n = 1; 8.3%) to excellent (n = 11; 91.7%). The carrying angle of the injured and uninjured side was 15.5°± 2.6° and 14.7°± 2°, respectively (p = 0.218). The range of motion of elbow flexion-extension and forearm pronation-supination of the injured side was 144.2°± 10.4°, 4.6°± 5.4°, 76.7°± 9.1°, 80.4°± 9.2°, respectively, with no significant differences from the healthy side (p > 0.05). The Elbow Performance Score of the injured and uninjured side was 96.3 ± 5.3 and 98.8 ± 2.3, respectively (p = 0.139). No cases of infection, cubitus valgus, stiffness, or instability were recorded.</p><p><strong>Conclusion: </strong>Although uncommon, MELAINE should not be neglected. Surgery aims to stabilize the elbow and avoid valgus deformity. If diagnosed and treated, clinical and radiological results are excellent in most cases.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"339-347"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/a5/10.1177_18632521231182422.PMC10411373.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667049","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":"Modifiable and non-modifiable risk factors for failure of non-operative treatment of pediatric forearm fractures: Where can we do better?","authors":"Nakul S Talathi,&nbsp;Brendan Shi,&nbsp;Jeremy Policht,&nbsp;Bailey Mooney,&nbsp;Kevin Y Chen,&nbsp;Mauricio Silva,&nbsp;Rachel M Thompson","doi":"10.1177/18632521231182420","DOIUrl":"https://doi.org/10.1177/18632521231182420","url":null,"abstract":"<p><strong>Introduction: </strong>Distal third forearm fractures are common fractures in children. While outcomes are generally excellent, some patients fail initial non-operative management and require intervention. The purpose of this study is to identify independent risk factors associated with failure of closed reduction.</p><p><strong>Methods: </strong>We conducted a retrospective review of distal third forearm fractures in children treated with closed reduction and casting. Patients were divided into two cohorts-those who were successfully closed reduced and those who failed initial non-operative management. Demographic characteristics, cast type, cast index, radiographic fracture, soft tissue characteristics, and quality of reduction were analyzed between groups.</p><p><strong>Results: </strong>A total of 207 children treated for distal third forearm fractures were included for analysis. A total of 190 (91.8%) children maintained their reduction while 17 (8.2%) failed initial non-operative management. Modifiable risk factors associated with loss of reduction on univariate analysis included the use of a long arm cast (p = 0.003), increased post-reduction displacement (p = 0.02), and increased post-reduction angular deformity (p = 0.01). Non-modifiable risk factors included increased body mass index (p = 0.02), increased presenting fracture displacement (p = 0.002), and increased width of the soft tissue envelope at the fracture site (p = 0.0001). The use of long arm casts (13% vs 2%, odds ratio = 6.44) and soft tissue width (60.6 vs 50.4 mm, odds ratio = 1.1) remained significant risk factors for loss of reduction after multivariate analysis.</p><p><strong>Conclusion: </strong>Both larger soft tissue envelope at the site of the fracture and long arm cast immobilization are independently associated with an increased risk of failing initial closed reduction in distal third forearm fractures in the pediatric population.</p><p><strong>Level of evidence: </strong>level III Case Control Study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"332-338"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033150","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":"Residual acetabular dysplasia after Pavlik harness treatment for Graf type II hips.","authors":"Yuchan Li,&nbsp;Zhigang Wang,&nbsp;Mingyuan Miao,&nbsp;Yunlan Xu,&nbsp;Jing Shi","doi":"10.1177/18632521231182423","DOIUrl":"https://doi.org/10.1177/18632521231182423","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the residual acetabular dysplasia in Graf type II hips after Pavlik harness treatment with a radiographic follow-up at 2 years of age.</p><p><strong>Methods: </strong>We retrospectively reviewed the developmental dysplasia of the hip patients who were treated with the Pavlik harness between March 2018 and February 2022. Patients with Graf type II hip dysplasia who had at least one radiographic follow-up after 2 years of age were included. The following information, sex, laterality, affected side, age at harness initiation, treatment duration, α angle, and the morphology of bony roof, was collected and studied. We evaluated the radiographic acetabular index at the last follow-up and defined the value of greater than 2 standard deviations as residual acetabular dysplasia.</p><p><strong>Results: </strong>A total of 33 patients (53 hips) met the criteria. The mean initial α angle was 53.4°; the mean age at Pavlik harness initiation was 10.9 weeks. The mean treatment duration was 10 weeks. The mean α angle at the last ultrasound follow-up was 64.9°. The mean age of the last radiographic follow-up was 2.6 years, and 26 hips had a residual acetabular dysplasia with acetabular indexes greater than 2 standard deviations above the mean. The morphology of the acetabular bony rim (odds ratio = 4.333, P = 0.029) and age of initial treatment <12 weeks (odds ratio = 7.113, P = 0.014) were seen as significant predictors for a higher acetabular index more than 2 years of age.</p><p><strong>Conclusions: </strong>A notable incidence of residual acetabular dysplasia after Pavlik harness treatment in Graf type II hips, wherein the acetabular bony roof with a blunt rim at the end of treatment and initial age after 12 weeks were independent predictors associated with residual acetabular dysplasia.</p><p><strong>Levels of evidence: </strong>Therapeutic studies, IV.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"306-314"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/30/10.1177_18632521231182423.PMC10411375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332196","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":"Slow-motion smartphone video improves interobserver reliability of gait assessment in ambulatory cerebral palsy.","authors":"Dane J Brodke,&nbsp;Katherine Makaroff,&nbsp;Enda G Kelly,&nbsp;Mauricio Silva,&nbsp;Rachel M Thompson","doi":"10.1177/18632521231177273","DOIUrl":"https://doi.org/10.1177/18632521231177273","url":null,"abstract":"<p><strong>Purpose: </strong>Structured visual gait assessment is essential for the evaluation of pediatric patients with neuromuscular conditions. The purpose of this study was to evaluate the benefit of slow-motion video recorded on a standard smartphone to augment visual gait assessment.</p><p><strong>Methods: </strong>Coronal and sagittal plane videos of the gait of five pediatric subjects were recorded on a smartphone, including four subjects with ambulatory cerebral palsy and one subject without gait pathology. Twenty-one video scorers were recruited and randomized to evaluate slow-motion or normal-speed videos utilizing the Edinburgh Visual Gait Score. The slow-motion group (N = 11) evaluated the videos at one-eighth speed, and the normal-speed group (N = 10) evaluated the same videos at normal speed. Interrater reliabilities were determined by calculating intraclass correlation coefficients for each group as a whole, for each Edinburgh Visual Gait Score item, and after stratification by evaluator experience level.</p><p><strong>Results: </strong>The slow-motion group exhibited an intraclass correlation coefficient of 0.65 (95% confidence interval: 0.58-0.73), whereas the normal-speed group exhibited an intraclass correlation coefficient of 0.57 (95% confidence interval: 0.49-0.65). For less-experienced scorers, intraclass correlation coefficients of 0.62 (95% confidence interval: 0.53-0.71) and 0.50 (95% confidence interval: 0.40-0.59) were calculated for slow motion and normal speed, respectively. For more-experienced scorers, intraclass correlation coefficients of 0.69 (95% confidence interval: 0.61-0.76) and 0.67 (95% confidence interval: 0.58-0.75) were calculated for slow motion and normal speed, respectively.</p><p><strong>Conclusions: </strong>Visual gait assessment is enhanced by the use of slow-motion smartphone video, a tool widely available throughout the world with no marginal cost.</p><p><strong>Level of evidence: </strong>level I, randomized study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"376-381"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/af/10.1177_18632521231177273.PMC10411369.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332199","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":"Changes in height, weight, and body mass index after posterior spinal fusion in juvenile and adolescent idiopathic scoliosis.","authors":"Mitchell A Johnson,&nbsp;Peter M Cirrincione,&nbsp;Colson P Zucker,&nbsp;John S Blanco,&nbsp;Roger F Widmann,&nbsp;Jessica H Heyer","doi":"10.1177/18632521231177041","DOIUrl":"https://doi.org/10.1177/18632521231177041","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior spinal fusion for idiopathic scoliosis is known to increase spinal height, but the impacts on weight and resulting body mass index are unknown. This study assesses body mass index, weight, and height percentile changes over time after posterior spinal fusion for idiopathic scoliosis.</p><p><strong>Methods: </strong>Body mass index, weight, and height age- and sex-adjusted percentiles for patients with idiopathic scoliosis undergoing posterior spinal fusion between January 2016 and August 2022 were calculated based on growth charts from the Centers for Disease Control for Disease Control and compared to preoperative values at 2 weeks, 3 months, 6 months, 1 year, and 2 years. The data were analyzed for normality with a Shapiro-Wilk test, and percentiles were compared with the Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>On average, 12.1 ± 2.3 levels were fused in 269 patients 14.4 ± 1.9 years, and percentiles for body mass index, weight, and height preoperatively were 55.5 ± 29.4%, 57.5 ± 28.9%, and 54.6 ± 30.4%, respectively. Body mass index and weight percentiles decreased at 2 weeks (-10.7%, <i>p</i> < 0.001; -4.6%, <i>p</i> < 0.001, respectively) and 3 months (-6.9%, <i>p</i> < 0.001; -3.2%, <i>p</i> < 0.001, respectively) postoperatively. Postoperative weight loss at 2 weeks averaged 2.25 ± 3.09% of body weight (0.98 ± 4.5 kg), normalizing by 3 months. Body mass index percentile normalized at 1 year, but height percentile was increased at 2 weeks (2.42 ± 1.72 cm, <i>p</i> < 0.001) and through 2 years.</p><p><strong>Conclusion: </strong>Despite initial height increase due to deformity correction, acute postoperative weight and body mass index percentile decreases postoperatively normalize by 1-year body mass index percentile. Physicians may benefit from utilizing this information when discussing the postoperative course of posterior spinal fusion with idiopathic scoliosis.</p><p><strong>Level of evidence: </strong>4, Retrospective Case Series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"354-359"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/83/10.1177_18632521231177041.PMC10411370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350551","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":"A retrospective epidemiological cohort study of ankle fractures in children and teenagers.","authors":"Christina Steiger,&nbsp;Giacomo De Marco,&nbsp;Céline Cuérel,&nbsp;Anne Tabard-Fougère,&nbsp;Moez Chargui,&nbsp;Romain Dayer,&nbsp;Dimitri Ceroni","doi":"10.1177/18632521231182424","DOIUrl":"https://doi.org/10.1177/18632521231182424","url":null,"abstract":"<p><strong>Background: </strong>Ankle fracture is one of the most frequent pediatric lower-limb fractures and may result in serious complications.</p><p><strong>Objective: </strong>This study aimed to determine the epidemiology of ankle fractures, defining fracture types, treatments, and complications in a pediatric population below 16 years old.</p><p><strong>Methods: </strong>Medical records of all the ankle fracture patients treated in our hospital during 2004-2020 were retrospectively reviewed. Data regarding age, sex, mechanism of injury, fracture type, treatment modalities, and complications were collected.</p><p><strong>Results: </strong>We examined records involving 328 children with 331 ankle fractures, with a ratio of 1:2 male per female. Mean annual prevalence was 24.3 per 100,000 children. Mean patient age was 11.2 ± 4.2 years, with 75.3% of them aged over 10 years. Sports activities accounted for the largest percentage of fractures (162 cases; 49.4%), followed by falls (67; 20.4%) and road traffic accidents (37; 11.3%). Physeal fractures were the most frequent type of lesion (223 cases). Most ankle fractures (60%) were managed using closed reduction and casting; for the remaining 40% of cases, fracture fixation was performed after closed or open reduction to correct the articular step-off and ensure the anatomical restoration of the physis. The main ankle fracture complication was premature growth arrest (12.1% of all physeal fractures).</p><p><strong>Conclusion: </strong>Pediatric ankle fractures primarily affect children older than 10 years. Most of these fractures were caused by sports injuries or low-energy trauma. The majority of these fractures are physeal, and the distal tibial physis is affected 10 times more frequently than the distal fibular physis.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"348-353"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10411379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033147","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":"Localized tenosynovial giant cell tumor in children.","authors":"Xifeng Du,&nbsp;Anning Xia,&nbsp;Junying Sun,&nbsp;Yinting Ye","doi":"10.1177/18632521231186795","DOIUrl":"10.1177/18632521231186795","url":null,"abstract":"<p><strong>Background: </strong>To investigate the clinical characteristics and surgical efficacy of localized tenosynovial giant cell tumors in children.</p><p><strong>Methods: </strong>The clinical data, surgery, and follow-up results of 17 children with localized tenosynovial giant cell tumors who visited our hospital from 2011 to 2021 were collected for statistical analysis.</p><p><strong>Results: </strong>The median patient age was 7 years and 8 months, and the ratio of males to females was 1.43 (10/7). The predilection of disease was similar in hands and feet, and the common presenting symptom was mass. One patient experienced recurrence after surgery, and one child had postoperative functional limitations.</p><p><strong>Conclusion: </strong>Extremities are common sites of localized tenosynovial giant cell tumors in children. Complete surgical resection helps reduce the recurrence rate.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 5","pages":"420-427"},"PeriodicalIF":1.4,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/6d/10.1177_18632521231186795.PMC10549694.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175405","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":"Isolating factors for the prediction of rebound after guided growth with tension band plating for the valgus deformity of the knee.","authors":"Alexander Eberle,&nbsp;Anika Stephan,&nbsp;Matthias P Tedeus,&nbsp;Hans M Manner,&nbsp;Hannes A Rüdiger,&nbsp;Vincent A Stadelmann","doi":"10.1177/18632521231182432","DOIUrl":"10.1177/18632521231182432","url":null,"abstract":"<p><strong>Purpose: </strong>The conditions leading to growth rebound after hemiepiphysiodesis are still poorly understood. This article analyzes the radiographical outcomes after guided growth with tension band plating, using plates in idiopathic genu valgum patients and attempts to generate a predictive model of growth rebound.</p><p><strong>Methods: </strong>Patients with idiopathic genu valgum deformity who received tension band plating were selected for evaluation. We only analyzed coronal plane deformities. Only patients with a long-standing X-ray before tension band plating surgery, a long-standing X-ray at tension band plating removal, and a long-standing X-ray at the latest follow-up after tension band plating removal were considered for this study. The change of mechanical axis deviation between the tension band plating removal and the last follow-up was evaluated for rebound, and ordinal logistic regression was performed to determine the relevant variables for predictive modeling rebound growth.</p><p><strong>Results: </strong>Overall, 100 patients (189 legs) were analyzed. The mean mechanical axis deviation at tension band plating removal was 8.4 mm in varus direction, and the mean mechanical axis deviation at the last follow-up was -3.4 mm (p ≤ 0.001). However, 111 legs (59%) showed rebound growth, 57 (30%) stayed stable, and 21 (11%) showed a continuous correction. Six significant factors significantly influencing rebound were isolated which are clinically relevant: sex, age, baseline mechanical axis deviation, mechanical lateral distal femoral angle, and mechanical medial proximal tibial angle, and mechanical axis deviation correction rate. Mechanical axis deviation correction rate had the highest odds ratios. The machine learning classification model for predicting rebound growth built from the study data showed a misclassification rate of 39%.</p><p><strong>Conclusion: </strong>There was a high rate of rebound growth in this cohort, especially for patients at a young age at implantation. The highest risk factors for rebound growth were male sex, and high correction rates, such as found during peak growth spurt. The proposed classification model needs more data to improve its predictive power before it can be used in clinics.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 5","pages":"459-468"},"PeriodicalIF":1.4,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/71/10.1177_18632521231182432.PMC10549697.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170983","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":"Spontaneous improvement of olisthetic scoliosis in children following lumbosacral fusion for high-grade spondylolisthesis: A report of four new cases and systematic review of the literature.","authors":"Charles T Mehlman, Alvin H Crawford","doi":"10.1177/18632521231182427","DOIUrl":"10.1177/18632521231182427","url":null,"abstract":"<p><strong>Background: </strong>The study aim was to present four new well-documented cases of spontaneous improvement of olisthetic scoliosis and to analyze well-documented cases from the literature.</p><p><strong>Methods: </strong>Surgical log search and systematic review were conducted. Inclusion criteria were (1) age less than 18 years, (2) symptomatic high-grade (≥50%) spondylolisthesis, (3) scoliosis ≥20^o, (4) primary surgical treatment via lumbosacral fusion, (5) complete x-rays, and (6) minimum 1-year radiographic follow-up or until curve resolution.</p><p><strong>Results: </strong>A total of 13 patients with average age of 13.9 years were included in the study, 4 from the authors' surgical logs and 9 from the literature. Slip percentage of L5-S1 ranged from 51% to 95%. Olisthetic curve magnitude averaged 34.6° (range: 20°-45°) with majority (8/13) demonstrating long thoracic curves with lateral trunk shift. All but one of these were apex right with rightward trunk shift. The remainder of the curves were isolated lumbar curves, with an apex left morphology without trunk shift. Eleven of the 13 patients showed curve improvement following isolated lumbosacral fusion. Three patients experienced a decrease in curve magnitude of 12°-28° and eight patients enjoyed complete resolution (≤10°) of their scoliosis.</p><p><strong>Conclusion: </strong>The current study summarizes 13 well-documented cases of olisthetic scoliosis (4 new cases and 9 from the literature) that associated with symptomatic high-grade spondylolisthesis. All were treated via a primary posterior lumbosacral fusion strategy. Eleven of the 13 curves showed spontaneous improvement (8 complete resolution of scoliosis) following their lumbosacral surgery.</p><p><strong>Level of evidence: </strong>Therapeutic level IV.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"367-375"},"PeriodicalIF":1.3,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/df/66/10.1177_18632521231182427.PMC10411374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332198","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":"Epidemiology of pediatric trauma and fractures during and beyond the COVID-19 pandemic.","authors":"Liam R Butler, Erin Abbott, Paulos Mengsteab, Calista L Dominy, Jashvant Poeran, Abigail K Allen, Sheena C Ranade","doi":"10.1177/18632521231180161","DOIUrl":"10.1177/18632521231180161","url":null,"abstract":"<p><strong>Purpose: </strong>Previous literature has shown decreases in pediatric trauma during the COVID-19 outbreak, but few have analyzed beyond the peak of the pandemic. This study assesses the epidemiology of pediatric trauma cases in a high-volume teaching hospital in New York City before, during, and after the height of the COVID-19 pandemic.</p><p><strong>Methods: </strong>Institutional data on pediatric trauma orthopedic cases from January 1, 2018 to November 30, 2021 were extracted. The following time frames were studied: (1) April 1-June 22 in 2018 and 2019 (pre-pandemic), (2) April 1-June 22, 2020 (peak pandemic), and (3) April 1-June 22, 2021 (post-peak pandemic). Inferential statistics were used to compare patient and trauma characteristics.</p><p><strong>Results: </strong>Compared to the pre-pandemic cohort (n = 6770), the peak pandemic cohort (n = 828) had a greater proportion of fractures (p < 0.01) and had a significantly decreased overall traumas per week rate (p < 0.01) and fractures per week rate (p < 0.01). These decreased trauma (p < 0.01) and fracture rates (p < 0.01) persisted for the post-peak pandemic cohort (n = 2509). Spatial analysis identified zip code clusters throughout New York City with higher rates of emergency department presentation during the peak pandemic compared to pre-pandemic, and these areas aligned with lower-income neighborhoods.</p><p><strong>Conclusion: </strong>During the peak of the pandemic, overall trauma and fracture volumes decreased, the types of prevalent injuries changed, and neighborhoods of different economic resources were variably impacted. These trends have mostly persisted for 12 months post-peak pandemic. This longitudinal analysis helps inform and improve long-term critical care and public health resource allocation for the future.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 4","pages":"322-331"},"PeriodicalIF":1.3,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/c9/10.1177_18632521231180161.PMC10285363.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9976240","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}