Pediatric Orthopaedics Journal Scan

Safety and Efficacy of Instrumented Convex Growth Arrest in Treatment of Congenital Scoliosis.

J Pediatr Orthop. 2013 Sep 15;

Authors: Demirkiran G, Yilmaz G, Kaymaz B, Akel I, Ayvaz M, Acaroglu E, Alanay A, Yazici M

Abstract
BACKGROUND:: Anterior and posterior convex hemiepiphysiodesis is a widely used surgical alternative in the treatment of congenital scoliosis. This procedure has the disadvantage of the need for both anterior and posterior approaches. Furthermore, outcomes may be unpredictable. Posterior convex growth arrest (CGA) with pedicle screws at each segment on the convex side may obviate the need for anterior surgery and provides more predictable outcomes. This study retrospectively evaluates the safety and efficacy of instrumented posterior CGA in congenital scoliosis.
METHODS:: Patients who had posterior CGA with convex pedicle screw instrumentation for congenital scoliosis were evaluated retrospectively. Thirteen patients (6 male, 7 female) were included in the study. Preoperative, early postoperative, and last follow-up standing posteroanterior and lateral x-rays were evaluated. Cobb angles were recorded for the instrumented segment (main curve). Global thoracic kyphosis was measured between T2 and T12 on sagittal plane. These values were compared preoperatively, postoperatively, and at last follow-up. The T1-S1 vertical height and the height between the concave side pedicles of the upper and lower end vertebra of the main curve was also determined and recorded as the concave height.
RESULTS:: The average follow-up was 56.1±10 months (range, 36 to 74 mo) and the average age of the patients at the time of operation was

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Management of Pediatric Type III Supracondylar Humerus Fractures in the United States: Results of a National Survey of Pediatric Orthopaedic Surgeons.

J Pediatr Orthop. 2013 Oct-Nov;33(7):750-4

Authors: Carter CT, Bertrand SL, Cearley DM

Abstract
BACKGROUND: Supracondylar humerus fractures are common injuries in the pediatric population. The most severe, type III injuries, have seen the most debate on treatment regimens. Traditionally, these fractures were treated as surgical emergencies, most often fixed with percutaneous pinning in a cross-pin configuration. The recent literature shows that delayed fixation is comparable to emergent fixation as long as there is no vascular compromise with the injury.
METHODS: A short survey was sent to Pediatric Orthopaedic Society of North America (POSNA) members using an online survey and questionnaire service. The purpose of the survey was to establish an overview of current practices in the United States concerning treatment of type III supracondylar humerus fractures and the influence of the recent literature on the management of these injuries.

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Submuscular Bridge Plating for Length-Unstable, Pediatric Femur Fractures.

J Pediatr Orthop. 2013 Sep 6;

Authors: Samora WP, Guerriero M, Willis L, Klingele KE

Abstract
BACKGROUND:: Submuscular bridge plating has become an acceptable method of treatment for pediatric femur fractures. The purpose of our study was to describe a technique for submuscular bridge plating and review a series of consecutive, length-unstable, pediatric femur fractures treated at a single institution with this technique.
METHODS:: We performed a query of hospital records from January 4, 2006, to May 10, 2011, to identify length-unstable femur fractures treated with submuscular bridge plating by 5 pediatric surgeons. Included were patients treated with submuscular bridge plating for a femur fracture. Excluded were patients with incomplete medical records, inadequate radiographs, or follow-up <6 months duration. Fifty-one patients met diagnostic criteria; 19 patients were excluded due to incomplete medical records and/or radiographs.

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A Classification of Growth Friendly Spine Implants.

J Pediatr Orthop. 2013 Aug 29;

Authors: Skaggs DL, Akbarnia BA, Flynn JM, Myung KS, Sponseller PD, Vitale MG, Approved by the Chest Wall and Spine Deformity Study Group, the Growing Spine Study Group, Pediatric Orthopaedic Society of North America and the Scoliosis Research Society Growing Spine Study Committee

Abstract
BACKGROUND:: Various types of spinal implants have been used with the objective of minimizing spinal deformities while maximizing the spine and thoracic growth in a growing child with a spinal deformity.

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Outcome Measures of Microsurgical Toe Transfers for Reconstruction of Congenital and Traumatic Hand Anomalies.

J Pediatr Orthop. 2013 Aug 29;

Authors: Kaplan JD, Jones NF

Abstract
BACKGROUND:: Outcomes data for children undergoing surgical reconstruction of their congenital hand anomalies has been used infrequently or not at all. Some surgeons even contend that children with total absence of digits or hands function perfectly well. Therefore, the purpose of this study was to evaluate and compare the functional outcomes of children who have undergone microsurgical toe-to-hand transfers for reconstruction of congenital and traumatic hand anomalies with the normal pediatric population.
METHODS:: A total of 10 adolescents and 15 parents of pediatric and adolescent patients who underwent microsurgical toe-to-hand transfers were assessed using the Pediatric Outcomes Data Collection Instrument (PODCI) survey. Surveys were distributed during routine clinic visits or by mail. Indication and diagnosis were analyzed in relation to the functional outcomes obtained from the survey. Scores of the toe transfer patients group were compared with the scores of the normal pediatric population as well as the effect of patient and parent reporting.

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Direct Beam Radiation Exposure to Surgeons During Pinning of Supracondylar Humerus Fractures: Does C-Arm Position and the Attending Surgeon Matter?

J Pediatr Orthop. 2013 Aug 29;

Authors: Eismann EA, Wall EJ, Thomas EC, Little MA

Abstract
BACKGROUND:: Direct beam radiation exposure to the surgeon, especially to their hands, is extremely common during supracondylar humerus fracture pinnings and results in exposure to significantly greater doses of ionizing radiation when compared with scatter radiation. The purpose of this study was to determine how often surgeons are exposed to direct beam radiation during this surgery and whether the C-arm position and the surgeon's experience influence radiation exposure.
METHODS:: In this double blind study, we collected 3842 fluoroscopic still images from 78 closed reduction and percutaneous pinning surgeries for supracondylar humerus fractures performed or supervised by 6 attending surgeons. The percentage of images containing a surgeon's body was calculated as an indicator of direct beam radiation exposure. Total fluoroscopy time, C-arm position (standard or inverted), and whether the primary surgeon was an attending, resident, or both were recorded. Nonparametric statistical analyses were performed.
RESULTS:: Fluoroscopy lasted for a median of 34 seconds, and the surgeon was exposed to direct beam radiation in a median of 13% of fluoroscopy films, with exposure ranging

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Progressive early-onset scoliosis in Conradi disease: a 34-year follow-up of surgical management.

J Pediatr Orthop. 2013 Mar;33(2):e4-9

Authors: Kabirian N, Hunt LA, Ganjavian MS, Akbarnia BA

Abstract
BACKGROUND: Conradi-Hunermann syndrome (CHS) is a rare metabolic syndrome with several orthopaedic problems. Early-onset scoliosis is of great importance because of often rapidly progressive nature and high risk of postoperative complications.
OBJECTIVES: To report the 34-year follow-up and outcome of a patient with CHS treated with combined anterior and posterior fusion without instrumentation.
METHODS: All available clinical and radiographs of a female patient with CHS retrospectively reviewed. Overall health status, sagittal and coronal deformity, pulmonary function test, and outcome questionnaires were evaluated.

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Recurrence of infantile cortical hyperostosis: a case report and review of the literature.

J Pediatr Orthop. 2013 Mar;33(2):e10-7

Authors: Navarre P, Pehlivanov I, Morin B

Abstract
OBJECTIVE: Also named Caffey disease, infantile cortical hyperostosis is a rare disease that usually affects children of a few weeks of age. The clinical picture is that of irritability, soft tissue swelling at various sites (mandible, clavicle, limbs) with local warmth, and pain on palpation. Radiographs demonstrate an important cortical thickening of the affected bony structures. There is generally spontaneous resolution of the inflammatory signs within the first few months or years of life, without future recurrence. We report the case of a recurrence in the adolescent period and conducted a thorough review of the literature to confirm this rare possibility.

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Correlation between the Child Health Questionnaire and the International Knee Documentation Committee score in pediatric and adolescent patients with an anterior cruciate ligament tear.

J Pediatr Orthop. 2013 Mar;33(2):216-20

Authors: Boykin RE, McFeely ED, Shearer D, Frank JS, Harrod CC, Nasreddine AY, Kocher MS

Abstract
BACKGROUND: The modified International Knee Documentation Committee (Pedi-IKDC) Subjective Knee Evaluation Form has recently been shown to be valid, reliable, and responsive in a pediatric and adolescent population. The correlations between the Pedi-IKDC and quality-of-life-related health measures have not been studied in depth to determine how a knee injury affects patients in this age group. The purpose of this study was to examine the association between the Pedi-IKDC score and the Child Health Questionnaire (CHQ) in a group of pediatric patients with an anterior cruciate ligament (ACL) injury.
METHODS: A prospectively collected registry of patients with ACL injuries was searched to indentify all patients who had completed both the Pedi-IKDC and CHQ (CHQ-CF87) questionnaires. These were analyzed to determine significant correlations between domains of the CHQ and the Pedi-IKDC.
RESULTS: A total of 135 patients were included (80 male, 55 female) with a median age of 15.3 years (range, 13.1 to 17.2 y).