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Journal J Pediatr Orthop

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Open Reduction of Medial Epicondyle Fractures in the Pediatric Population: Supine Versus Prone Position.

Soroush Baghdadi, Daniel Weltsch, Alexandre Arkader, Kathleen Harwood, John T R Lawrence,

<h4>Background</h4>Operative treatment of medial epicondyle fractures can be performed in either a supine or prone position. In the supine position, fracture visualization is sometimes difficult due to the posterior position of the medial epicondyle. However, the prone position requires extensive patient repositioning but may improve visualization. The purpose of this ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):273-278]

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Synthetic Cast Material Versus Plaster of Paris for the Treatment of Idiopathic Clubfoot by the Ponseti Protocol: A Comparative Analysis of 136 Feet.

Sergio Monforte, Flavia Alberghina, Matteo Paonessa, Federico Canavese, Antonio Andreacchio,

<h4>Background</h4>Synthetic casting materials have been used as alternatives to plaster of Paris (POP) in the treatment of clubfoot using the Ponseti method. The aim of this study was to evaluate the clinical outcome of children with idiopathic clubfoot managed by the Ponseti method using POP versus semirigid fiberglass (SRF).<h4>Methods</h4>Medical records ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):296-300]

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Long-term Functional Outcomes and Complications in Operative Versus Nonoperative Treatment for Displaced Midshaft Clavicle Fractures in Adolescents: A Retrospective Comparative Study.

Martin O Riiser, Marius Molund,

<h4>Introduction</h4>Traditionally, midshaft clavicular fractures in adolescents are treated nonoperatively. In later years, a trend toward operative treatment can be observed. Documentation of the benefit of surgery in this group is scarce. The purpose of this study is to evaluate the long-term patient reported functional outcomes and complications for patients treated ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):279-283]

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Outcomes of Patellar Tendon Imbrication With Distal Femoral Extension Osteotomy for Treatment of Crouch Gait.

Lauren C Hyer, Ashley M Carpenter, Prabhav Saraswat, Jon R Davids, David E Westberry,

<h4>Background</h4>Crouch gait is a frequent gait abnormality observed in children with cerebral palsy. Distal femoral extension osteotomy (DFEO) with the tightening of the extensor mechanism is a common treatment strategy to address the pathologic knee flexion contracture and patella alta. The goal of this study was to review the results ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):e356-e366]

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Satisfying Clinical and Functional Results in 12 Apert Children Treated With Soft Tissue Distractor.

Mona I Winge, Magne Røkkum,

<h4>Background</h4>The complex syndactyly in Apert syndrome hands is challenging to operate. The synostosis and tightness of skin between third and fourth digits lead to severe coverage problems during ray release. A soft tissue distractor can simplify the release with the aim to keep all 10 fingers.<h4>Methods</h4>A retrospective follow-up of 12 ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):312-318]

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Pediatric Orthopaedic Surgeon Time Utilization in Clinic: A Pilot Study.

Melanie Patterson, Jeremy Silver, Douglas Armstrong, William Hennrikus,

<h4>Background</h4>The purpose of this study is to quantify how pediatric orthopaedic surgeons spend time in clinic.<h4>Methods</h4>Two pediatric orthopaedic surgeons were individually observed and activities were timed during 3 clinic sessions. One medical student observed and recorded the time using a data collection sheet and a watch. The duration of each ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):319-321]

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Carry on With Raja Ravi Varma, Mary Cassatt, and Renoir.

Gleeson Rebello, Benjamin Joseph,

Raja Ravi Varma's painting "There Comes Papa" depicts his daughter carrying her son astride her hip. The positive implication of the posture of the hips of the child while being carried in this manner on acetabular development is discussed. ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):e367-e368]

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Venous Thromboembolism After Pelvic Osteotomy in Adolescent Patients: A Database Study Characterizing Rates and Current Practices.

Sachin Allahabadi, Millis Faust, Ishaan Swarup,

<h4>Background</h4>Current risks and practices in medical prophylaxis of venous thromboembolism (VTE) after major elective lower extremity surgeries such as pelvic osteotomies have not been well-defined in the pediatric population. The purpose of this study was to (1) evaluate population rates of VTE in adolescents undergoing pelvic osteotomies, and (2) characterize ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):306-311]

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Anterior Cruciate Ligament Tear Following Operative Treatment of Pediatric Tibial Eminence Fractures in a Multicenter Cohort.

Ryan O'Donnell, Steven Bokshan, Kelsey Brown, Julien T Aoyama, Theodore J Ganley, Peter D Fabricant, Neeraj M Patel, Henry B Ellis, Daniel W Green, Indranil Kushare, R Jay Lee, Scott McKay, Jason Rhodes, Brant Sachleben, Catherine Sargent, Gregory A Schmale, Yi-Meng Yen, R Justin Mistovich, Aristides I Cruz,

<h4>Background</h4>Postoperative ipsilateral anterior cruciate ligament (ACL) tears after tibial eminence fracture fixation has been previously noted in the literature. This study aims to describe the prevalence of and risk factors for postoperative ACL tears in a cohort of patients operatively treated for tibial eminence fracture.<h4>Methods</h4>A retrospective review of children undergoing ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):284-289]

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Refracture Rate of Both Bone Forearm Fractures: A Retrospective Comparison of Casting Alone Versus Casting and Extended Functional Bracing.

Lisa Soumekh, Tonye Sylvanus, Aaron Karlen, Caitlin Wahl, Aaron J Huser, Walter H Truong,

<h4>Background</h4>One of the most common pediatric fractures is a midshaft both bone forearm fracture. The preferred nonoperative treatment is cast immobilization for 6 to 8 weeks; however, 4% to 8% refracture within 6 months. There are no comparative studies evaluating the efficacy of bracing after cast immobilization. We hypothesized that ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):267-272]

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Later in Career Surgeon Performance Assessment: Why, When, What, and by Whom.

Peter M Waters, David Williams,

<h4>Background</h4>The average age of practicing surgeons is increasing, consistent with the overall population; one third of Americans are over 55 years of age. Aging is clearly associated with varying loss of skills, yet there are no age-based state or federal requirements for professional skill assessment; or age-specific criteria for board ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):322-326]

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Why the Hips Remain Stable When the Spine Strays: A Deeper Analysis of the Relationship Between Hip Displacement and Severe Scoliosis in Patients With Cerebral Palsy.

Matthew J Hadad, Amy L Xu, Barry R Bryant, Nicholas S Andrade, Alexander H Hoon, Paul D Sponseller,

<h4>Background</h4>Many patients with spastic quadriplegic cerebral palsy (CP) and severe scoliosis develop hip displacement, whereas others do not. We investigated demographic characteristics, risk factors for CP, and imaging findings associated with nondisplaced hips in patients with CP and severe scoliosis.<h4>Methods</h4>We retrospectively analyzed records of 229 patients with spastic quadriplegic CP ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):261-266]

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The Ponseti Method for the Treatment of Clubfeet Associated With Amniotic Band Syndrome: A Single Institution 20-Year Experience.

Melissa Esparza, Elaine Tran, Benjamin Stephens Richards, Chan-Hee Jo, Claire Shivers, Chelsea Karacz, Jordan Polk, Anthony I Riccio,

<h4>Background</h4>Amniotic band syndrome (ABS) is a congenital disorder resulting in fibrous bands that can cause limb anomalies, amputations, and deformities. Clubfoot has been reported in up to 50% of patients with ABS. The purpose of this study is to compare treatment characteristics and outcomes of clubfoot patients with ABS to ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):301-305]

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The Effect of Proximal Anchor Choice During Distraction-based Surgeries for Patients With Nonidiopathic Early-onset Scoliosis: A Retrospective Multicenter Study.

Yehia El-Bromboly, Jennifer Hurry, Kedar Padhye, Charles Johnston, Anna McClung, Amer Samdani, Michael Glotzbecker, Hossam Salah, Tricia St Hilaire, Tara Flynn, Ron El-Hawary, ,

<h4>Background</h4>It is unclear whether the type of proximal anchor affects the spine length achieved with distraction-based surgeries in patients with nonidiopathic early-onset scoliosis (EOS). Since distraction may produce kyphosis, spine length should be assessed in the sagittal plane using the sagittal spine length (SSL-curved arc length of the spine in ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(5):290-295]

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Hip Morphology in Early-stage LCPD: Is There an Argument for Anatomic-specific Containment?

Courtney M Selberg, Joshua T Bram, Patrick Carry, Rachel Y Goldstein, Tim Schrader, Jennifer C Laine, Harry K W Kim, Wudbhav N Sankar, ,

<h4>Background</h4>Early containment surgery has become increasingly popular in Legg-Calvé-Perthes Disease (LCPD), especially for older children. These procedures treat the proximal femur, the acetabulum, or both, and most surgeons endorse the same surgical option regardless of an individual patient's anatomy. This "one-surgery-fits-all" approach fails to consider potential variations in baseline anatomy ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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Physeal Fractures of Distal Tibia: A Systematic Review and Meta-analysis.

Jenni Jalkanen, Juha-Jaakko Sinikumpu, Jani Puhakka, Topi Laaksonen, Yrjänä Nietosvaara, Jussi Kosola, Antti Stenroos,

<h4>Background</h4>Fractures involving the distal tibia growth plate are common in children. Injury or treatment that damages the growth plate may result in progressive angular deformity or leg length discrepancy. There is no consensus on treatment and follow-up of these injuries. This study aims to describe which factors increase the risk ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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Spinal Anesthesia is Superior to General Anesthesia for Percutaneous Achilles Tenotomy in Infants.

Michael A Acquaviva, Christine B Caltoum, Robert J Bielski, Randall T Loder, Tanna J Boyer, Anne E Cossu, Peter F Castelluccio,

<h4>Background</h4>Concern about the effects of inhaled, halogenated anesthetics on neurodevelopment of infants has renewed interest in regional anesthesia as an alternative to general anesthesia (GA). Infants undergoing percutaneous Achilles tenotomy (PAT) are well suited for spinal anesthesia (SP).<h4>Methods</h4>Thirty infants (mean age: 2.3 mo) undergoing PAT with SP were compared with 15 ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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A New Low Dose of Tranexamic Acid for Decreasing the Rate of Blood Loss in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

Lloyd M Halpern, William E Bronson, Clark J Kogan,

<h4>Background</h4>Previous studies have demonstrated that the use of tranexamic acid (TXA) reduces blood loss and transfusion requirements in children undergoing scoliosis surgery. Although TXA is safe and effective, significant adverse events have been reported. Using the lowest effective dose of TXA is advisable. We evaluated a new low dosing regimen ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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The Use of Halo Gravity Traction in Severe, Stiff Scoliosis.

Brett Rocos, Luke Reda, David E Lebel, Michael K Dodds, Reinhard Zeller,

<h4>Purpose</h4>The correction of severe, stiff scoliosis in children is challenging. One method used to reduce the risk is preoperative halo gravity traction (HGT). In this study, the authors sought to define the efficiency and safety of HGT and characterize the chronology of the correction seen.<h4>Method</h4>A consecutive group of pediatric patients ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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Combining Lower Extremity Radiographic Markers Begets More Accurate Predictions of Remaining Skeletal Growth.

Kristin E Yu, Griffin A Coghill, David Vernik, Justin M Lapow, Daniel R Cooperman,

<h4>Background</h4>Radiographic markers of skeletal maturity are vital to the prediction and interpretation of skeletal growth patterns. Accurate predictions of skeletal maturity factor into the management of common musculoskeletal disorders. Bone age is conventionally measured using hand and wrist radiographs. The primary study objective was to optimize skeletal maturity estimates based ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, :]

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Timing of Repeat Ultrasound Examination in Treatment of Stable Developmental Dysplasia of the Hip.

Wesley W E S Theunissen, Marieke van der Steen, Florens Q M P van Douveren, Adhiambo M A Witlox, Jaap J Tolk,

<h4>Background</h4>Worldwide a wide variation exists in duration of Pavlik harness treatment for infants up to 6 months with stable developmental dysplasia of the hip (DDH). The purpose of this study was to evaluate whether shortening the time to first routine follow-up ultrasound after initiation of Pavlik harness treatment would reduce ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(4):203-208]

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Upper Limb Lengthening in Achondroplasia Using Unilateral External Fixation.

Antonio Arenas-Miquelez, Lucas Arbeloa-Gutierrez, Martín Amaya, Blanca Vázquez, Julio De Pablos Fernández,

<h4>Purpose</h4>The purpose of this study was to analyze the long-term results of humeral lengthening in achondroplastic patients and make suggestions on the most appropriate surgical technique to improve patient outcomes.<h4>Methods</h4>Fifty-four humeral lengthening procedures performed in 27 achondroplastic patients were reviewed. Elongations were performed by means of callotasis with unilateral external ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(4):e328-e336]

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Factors Influencing Outcomes of the Dysplastic Hip in Nonambulatory Children With Cerebral Palsy.

Kristen L Carroll, Alan K Stotts, Glen O Baird, Alyssa L Thorman, Matthew Talmage, Whitney D Moss, Mark L McMulkin, Bruce A MacWilliams,

<h4>Background</h4>Hip dysplasia in the nonambulatory child with spastic cerebral palsy (CP) is a common condition not always effectively treated with conservative measures even when recognized early. Optimal surgical intervention strategies and timing are not clear from previous studies. Contralateral hips with less severe subluxation in these patients also often undergo ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(4):221-226]

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The Pediatric Open Supracondylar Fracture: Associated Injuries and Surgical Management.

Douglas G Armstrong, Kevin Monahan, Erik B Lehman, William L Hennrikus,

<h4>Background</h4>While supracondylar (SC) fractures are relatively common in children, the incidence of open injuries is believed to be only 1%. Two prior studies on open SC fractures in children reported an increased incidence of vascular injuries. The purposes of our study were to clarify the incidence, associated conditions, and current ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(4):e342-e346]

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Establishing a Virtual Clinic for Developmental Dysplasia of the Hip: A Prospective Study.

Evelyn P Murphy, Christopher Fenelon, Jim F Kennedy, Michael D O'Sullivan, Jacques Noel, Paula M Kelly, David P Moore, Patrick J O'Toole,

<h4>Background</h4>The aim was to describe the introduction and operation of a virtual developmental dysplasia of the hip (DDH) clinic. Our secondary objectives were to provide an overview of DDH referral reasons, treatment outcomes, and adverse events associated with it.<h4>Methods</h4>A prospective observational study involving all patients referred to the virtual DDH ... Read more >>

J Pediatr Orthop (Journal of pediatric orthopedics)
[2021, 41(4):209-215]

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