Summary: The radiographs and patient charts of 47 children treated with closed reduction percutaneous pin fixation displaced supracondylar humerus fractures were reviewed. Twenty-seven fixed crossed medial lateral pins. Twenty two parallel laterally placed Baumann's angle on the anteroposterior elbow film humero-capitellar independently measured by three authors initial postoperative films taken at time removal. No statistically significant differences regarding maintenance found when...

There is no standardized complication classification system that has been evaluated for use in pediatric or general orthopaedic surgery. Instead, subjective terms such as major and minor are commonly used. The Clavien-Dindo-Sink demonstrated high interrater intrarater reliability hip-preservation surgery increasingly used within other subspecialties. This based on the magnitude of treatment required potential each to result long-term morbidity. purpose current study was modify application...

Orthopedic surgery for patients with cerebral palsy addresses motion impairments, assuming that this will improve motor function. This study evaluates the relationships among clinical impairment measures standardized assessments of function and disability as an initial step in testing assumption. A total 129 ambulatory children adolescents across six institutions participated a prospective evaluation consisted passive spasticity examination lower extremities, three-dimensional gait...

Background The purpose of this study is to compare the efficacy medial and lateral (crossed pin) lateral-entry pin techniques for Gartland Type 3 supracondylar humerus fractures in children. Methods Six pediatric orthopaedists were divided into 2 treatment groups (medial pins or only pins) based on pre-study pinning technique preferences. Patients randomized 1 which attending was call at time patient presentation. One hundred four patients met inclusion criteria. Forty-seven underwent 57...

Background: Tibial tubercle fractures are typically treated surgically with screws. Implant irritation is the most common complication. However, detailed investigation of this problem challenging, since research limited to small, single-center studies. Understanding who at highest risk may improve patient counseling and potentially guide surgical techniques. The purpose study identify factors for implant in patients undergoing fixation tibial fractures. Methods: This retrospective cohort...

Background: Empirical observations of subjects with an equinus gait have suggested that there is coupled motion between the ankle and knee such that, during single-limb stance, moves into as extends. Since gastrocnemius-soleus muscle-tendon unit spans both joints, we hypothesized this may be responsible for coupling lengthening muscle alone would result in greater dorsiflexion well extension effectively uncoupling these joints. The concept promote counter to popular notion crouch if...

From January 1982 to December 1987, 114 hips of 80 patients underwent pinning for treatment slipped capital femoral epiphysis (SCFE). Three groups were differentiated based on the number pins used. The average length follow-up was 2 years 5 months. mean time physeal closure 5.43 months in single pin group, 5.54 two and 6.44 three or more group. These differences not statistically significant. There a significant decrease rate pin-related complications reoperations group as compared with...

The recent emphasis on shared decision-making has increased the role of Internet as a readily accessible medical reference source for patients and families. However, lack professional review creates concern over quality, accuracy, readability information available to Internet.Three search engines (Google, Yahoo, Bing) were evaluated prospectively using 3 difference terms varying sophistication ("congenital hip dislocation," "developmental dysplasia hip," "hip in children"). Sixty-three...

Background Prior reports suggest that osteoarticular infections may be increasing over time. Questions/Purposes We sought to determine if incidence rates, median in-hospital costs, and length of stay (LOS) osteomyelitis, septic arthritis (SA), combined have changed time for pediatric patients, how they compare previously reported rates. Methods The Kids’ Inpatient Database (KID), a US national sample hospital discharge records from 1997, 2000, 2003, 2006, 2009, 2012, was used yearly...

Study Design. In a retrospective study, 25 patients undergoing posterior spine fusion with allograft bone and Cotrel-Dubousset instrumentation were assessed regarding the efficacy of use. Objectives. To determine if use had deleterious effects rates maintenance deformity correction. Summary Background Data. Previous studies using in adult lumbar models have consistently shown poor rates. Studies pediatric population been more favorable but idiopathic cases used cast or brace immobilization...

Corrective surgery for scoliosis is an extensive procedure with well-known problems of postoperative pain control. Additional nausea, vomiting, ileus, and sedation can result in delayed mobilization a prolonged inpatient hospital stay. At our institution, multimodal approach to management has been used successfully address these issues. The use intravenous acetaminophen helpful adjunct armamentarium medication this patient population. We present illustrative case analgesia beginning...

Thirty-seven cerebral palsy patients were followed with measurements of the migration index (MI), infrapelvic obliquity, and suprapelvic obliquity over a mean period 73 months to evaluate development windblown deformity. The asymmetry was apparent before obliquity; however, 65% eventually had both. final pattern most subluxed hip could not be predicted from initial radiographs or scoliosis. Hip subluxation strongly correlated degree femoral adduction weakly magnitude obliquity. scoliosis...

Objective: The purpose of this long-term study was to determine the efficacy allograft bone for spinal fusion adolescent idiopathic scoliosis. Prior studies comparing and autograft have been short term. Methods: This multicenter retrospective carried out on 111 patients with 132 total curves fused Minimum follow-up 5 years (average 72 months). A variety segmental instrumentation used, most being dual-rod, multiple-hook constructs. Results: Average preoperative curve 59° immediate correction...

Background: Hemi-epiphysiodesis is the mainstay of treatment for angular deformities at knee in children with multiple hereditary exostosis (MHE). Upon deformity correction, metaphyseal screw may be removed from hemi-epiphysiodesis plate, sleeper plate technique, anticipated reimplantation should original recur. The aim present study to compare incidence complications technique complete removal an MHE cohort. Methods: Patients under age 18 who underwent proximal tibia and/or distal femur...

Study Design. A retrospective study to determine the efficacy of posterior-only unit rod instrumentation and fusion in a skeletally immature neuromuscular scoliosis population. Objective. To whether approach this population adequately addresses concerns correction pelvic obliquity, maintenance that over time, incidence crankshaft phenomenon. Summary Background Data. Controversy exists regarding need for anterior release improve curve flexibility obtain an arthrodesis those patients at risk...

This case report documents a rare cause of block to reduction in association with an anterior traumatic dislocation the radial head children. The dislocations described were not reducible closed secondary "button holing" through joint capsule. Open was required release capsule and reduce head. After reduction, elbow immobilized flexion forearm mild supination for 3 weeks. Postoperatively, all patients demonstrated full function range function.

Percutaneous epiphysiodesis using transphyseal screws (PETS) has been associated with implant failure, prominence, angular deformities, and delayed growth inhibition.The aim of this study was to assess the complication rate efficacy (defined as actual inhibition divided by expected inhibition) PETS identify factors improved efficacy.Patients who underwent distal femoral and/or proximal tibial between January 2007 June 2014 were identified. Complications, efficacy, final limb-length...

Abstract Intraoperative electrophysiological monitoring of the spinal cord has traditionally been done by recording somatosensory evoked potentials (SEP). There is a risk that SEPs can be unaltered when significant injury to anterior occurred. The purpose this report describe simple technique for intraoperative stimulation which monitors descending pathways in cord. Stimulation occurs through needle electrodes inserted into spinous processes rostral surgical wound, and recordings are made...

Study Design. Prospective cohort. Objective. To determine if distal spinal fusion level is associated with postoperative sport participation after posterior (PSF) for adolescent idiopathic scoliosis (AIS). Summary of Background Data. The concept “saving a level” during PSF AIS refers to minimizing the extent lumbar theoretically allow increased mobility and more predictable return athletic activity, as well risk degenerative disc disease. There are few prospective studies evaluating...

Background: Given the rare nature of tibial tubercle fractures, previous studies are mostly limited to small, single-center series. This results in practice variation. Previous research has shown poor surgeon agreement on utilization advanced imaging, but improved evidence-based indications may help balance clinical utility with resource utilization. The purpose this study is quantify diagnostic practices for fractures a large, multicenter cohort, attention usage and impact imaging. Methods:...