Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Pediatrics 103 articles

Articles

Does Exercise Influence Pediatric Bone? A Systematic Review

Bonny Specker PhD, Natalie W. Thiex PhD, MPH, Ramu G. Sudhagoni PhD

Periods of growth are thought to be the best time to increase bone mineral content, bone area, and areal bone mineral density (aBMD) through increased loading owing to high rates of bone modeling and remodeling. However, questions remain regarding whether a benefit of exercise is seen at all bone sites, is dependent on pubertal status or sex of the child, or whether other factors such as diet modify the response to exercise.

Lengthening With External Fixation Is Effective in Congenital Femoral Deficiency

Daniel E. Prince MD, MPH, John E. Herzenberg MD, Shawn C. Standard MD, Dror Paley MD

Treatment of congenital femoral deficiency is a complex, multistage protocol and a variety of strategies have been devised to address joint instability, limb length inequality, and deformities. Despite being an important part of the algorithmic approach to the overall treatment of patients with congenital femoral deficiency, a reproducible, safe, and functional treatment for femoral length discrepancy in patients with mild and moderate congenital femoral deficiency has not been reported.

Success of Pavlik Harness Treatment Decreases in Patients ≥ 4 Months and in Ultrasonographically Dislocated Hips in Developmental Dysplasia of the Hip

Hakan Ömeroğlu MD, Nusret Köse MD, Anil Akceylan MD

Treatment of developmental dysplasia of the hip (DDH) using the Pavlik harness has been a widely used method in patients between 0 and 6 months of age for many years. However, the factors influencing the success rate of this treatment modality have still not exactly been determined as a result of the limited number of clinical studies with higher level of evidence.

Surgical Treatment of Hip Instability in Patients With Lower Lumbar Level Myelomeningocele: Is Muscle Transfer Required?

Timur Yildirim MD, Sarper Gursu MD, İlhan Avni Bayhan MD, Hakan Sofu MD, Aysegul Bursali MD

Treatment of hip instability in patients with lower lumbar level myelomeningocele is clinically challenging. Muscle transfer procedures, release of contractures, and intertrochanteric varus-rotation osteotomies have been described to restore weak or absent abductor strength as well as relocation of the hip. However, controlled trials evaluating hip instability in lower lumbar myelomeningocele are limited in the current literature.

Clinical Implications of Psychosocial Factors on Pediatric External Fixation Treatment and Recommendations

Heather M. Richard PsyD, Dylan C. Nguyen MA, John G. Birch MD, FRCS(C), Sandy D. Roland PhD, Mikhail K. Samchukov MD, Alex M. Cherkashin MD

Pediatric limb reconstruction using circular external fixation is a prolonged treatment that interrupts patients’ daily function. Patient personality characteristics and expectations may interfere with planned treatment, making complicated medical procedures more challenging. The aims of this study are to identify factors impacting treatment outcome and recommendations for preoperative evaluation and planning.

Developmental Dislocation of the Hip Successfully Treated by Preoperative Traction and Medial Open Reduction: A 22-year Mean Followup

P. Farsetti MD, R. Caterini MD, V. Potenza MD, E. Ippolito MD

During the last 35 years, the medial approach has been reported more frequently than the anterior approach for open reduction of developmental dislocation of the hip (DDH), however, few studies have followed children treated by medial open reduction to adulthood.

Development of a Mouse Model of Ischemic Osteonecrosis

Nobuhiro Kamiya MD, PhD, Ryosuke Yamaguchi MD, PhD, Olumide Aruwajoye MS, Naga Suresh Adapala PhD, Harry K. W. Kim MD, MS

Availability of a reliable mouse model of ischemic osteonecrosis could accelerate the development of novel therapeutic strategies to stimulate bone healing after ischemic osteonecrosis; however, no mouse model of ischemic osteonecrosis is currently available.

Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

Frank Fitoussi MD, PhD, Brice Ilharreborde MD, PhD

Resection of primary malignant tumors often creates large bony defects. In children, this creates reconstructive challenges, and many options have been described for limb salvage in this setting. Studies have supported the use of an induced-membrane technique after placement of a cement spacer to aid in restoration of bone anatomy.

Modified Dunn Procedure is Superior to In Situ Pinning for Short-term Clinical and Radiographic Improvement in Severe Stable SCFE

Eduardo N. Novais MD, Mary K. Hill BA, Patrick M. Carry BA, Travis C. Heare MD, Ernest L. Sink MD

In situ pinning is the conventional treatment for a stable slipped capital femoral epiphysis (SCFE). However, with a severe stable SCFE the residual deformity may lead to femoroacetabular impingement and articular cartilage damage. A modified Dunn subcapital realignment procedure has been developed to allow for correction at the level of the deformity while preserving the blood supply to the femoral head.

How Do Different Anterior Tibial Tendon Transfer Techniques Influence Forefoot and Hindfoot Motion?

A. R. Knutsen MS, T. Avoian MD, S. N. Sangiorgio PhD, S. L. Borkowski MS, E. Ebramzadeh PhD, L. E. Zionts MD

Idiopathic clubfoot correction is commonly performed using the Ponseti method and is widely reported to provide reliable results. However, a relapsed deformity may occur and often is treated in children older than 2.5 years with repeat casting, followed by an anterior tibial tendon transfer. Several techniques have been described, including a whole tendon transfer using a two-incision technique or a three-incision technique, and a split transfer, but little is known regarding the biomechanical effects of these transfers on forefoot and hindfoot motion.