Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Pediatrics 104 articles


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.

Does Salter Innominate Osteotomy Predispose the Patient to Acetabular Retroversion in Adulthood?

Daisuke Kobayashi MD, Shinichi Satsuma MD, Maki Kinugasa MD, Ryosuke Kuroda MD, Masahiro Kurosaka MD

Salter innominate osteotomy has been identified as an effective additional surgery for the dysplastic hip. However, because in this procedure, the distal segment of the pelvis is displaced laterally and anteriorly, it may predispose the patient to acetabular retroversion. The degree to which this may be the case, however, remains incompletely characterized.

Incidence and Risk Factors of Allograft Bone Failure After Calcaneal Lengthening

In Hyeok Lee MD, Chin Youb Chung MD, Kyoung Min Lee MD, Soon-Sun Kwon PhD, Sang Young Moon MD, Ki Jin Jung MD, Myung Ki Chung MD, Moon Seok Park MD

Calcaneal lengthening with allograft is frequently used for the treatment of patients with symptomatic planovalgus deformity; however, the behavior of allograft bone after calcaneal lengthening and the risk factors for graft failure are not well documented.

Postural Orthostatic Tachycardia Syndrome (POTS): Association with Ehlers-Danlos Syndrome and Orthopaedic Considerations

Emmanouil Grigoriou MD, Jeffrey R. Boris MD, John P. Dormans MD

Postural orthostatic tachycardia syndrome (POTS) is the most common of several types of dysautonomia, characterized by dysfunction of the autonomic nervous system manifesting with symptoms of orthostatic intolerance with or without associated orthostatic hypotension and excessive autonomic excitation. Given the numerous presenting musculoskeletal symptoms of POTS and its known associations with other clinical entities like Ehlers-Danlos syndrome, POTS constitutes an unusual treatment challenge of which the orthopaedic surgeon and other related healthcare providers should be aware.

Does Fracture Affect the Healing Time or Frequency of Recurrence in a Simple Bone Cyst of the Proximal Femur?

Soo Min Cha MD, Hyun Dae Shin MD, PhD, Kyung Cheon Kim MD, PhD, Jung Woo Park MD

Studies have focused on intramedullary nailing of femoral simple bone cysts but have not clarified the recurrence frequency or management of recurrent cysts. In particular, the affect of pathologic fractures on cyst healing, recurrence, and complications of treatment have not been reported.

Internal Lengthening Device for Congenital Femoral Deficiency and Fibular Hemimelia

Lior Shabtai MD, Stacy C. Specht MPA, Shawn C. Standard MD, John E. Herzenberg MD

Patients with congenital limb shortening can present with joint instability, soft tissue contractures, and significant leg length discrepancy. Classically, lengthening is done with external fixation, which can result in scarring, pin site infection, loss of motion, and pain. We therefore developed an alternative to this approach, a new, controllable, internal lengthening device for patients with congenital limb shortening.

External Fixation for Closed Pediatric Femoral Shaft Fractures: Where Are We Now?

Heather Kong MD, Sanjeev Sabharwal MD, MPH

Recent advances in external fixation technique and pin design have sought to minimize complications such as pin site infection and premature removal of the external fixator. Although newer forms of internal fixation have gained popularity, external fixation may still have a role in managing pediatric femoral shaft fractures.

Safe Zone for Superolateral Entry Pin Into the Distal Humerus in Children: An MRI Analysis

Tamir Bloom MD, Caixia Zhao MD, Alpesh Mehta MD, Uma Thakur MD, John Koerner MD, Sanjeev Sabharwal MD, MPH

The radial nerve is at risk for iatrogenic injury during placement of pins, screws, or wires around the distal humerus. Unlike adults, detailed anatomic information about the relationship of the nerve to the distal humerus is lacking in children.

Is There a Difference in Sagittal Alignment of Blount’s Disease Between Radiographic and Clinical Evaluation?

Seung-Ju Kim MD, PhD, Sanjeev Sabharwal MD, MPH

A procurvatum deformity of the proximal tibia often is seen in patients with Blount’s disease. If left untreated, it can lead to progressive angulation in the sagittal plane and altered contact stresses across the knee.

Results of Clubfoot Management Using the Ponseti Method: Do the Details Matter? A Systematic Review

Dahang Zhao MD, Hai Li MD, PhD, Li Zhao MD, PhD, Jianlin Liu MD, Zhenkai Wu MD, Fangchun Jin MD, PhD

Although the Ponseti method is accepted as the best choice for treatment of clubfoot, the treatment protocol is labor intensive and requires strict attention to details. Deviations in strict use of this method are likely responsible for the variations among centers in reported success rates.