Pediatric Orthopaedics Archive

SUMMARY: Capitellar OCD affects young athletes aged 10-24; MRI or CT beats radiographs for diagnosis, stable lesions with intact cartilage get non-operative care, and surgical options are chosen by patient, function, and lesion morphology.

SUMMARY: International Delphi consensus reached agreement on 82% of statements for managing isolated meniscal tears in skeletally immature children, but not on small radial tears, chronic bucket-handle reduction, or surgical timing.

SUMMARY: International Delphi consensus defines core imaging for hip instability: radiographs first, then CT/MRI, with LCEA under 20° diagnostic of dysplasia and 20°-25° concerning for instability; newer dynamic and soft tissue measures lacked consensus.

SUMMARY: In 438 adolescent-onset idiopathic scoliosis surgery patients, older age at surgery was associated with lower postoperative SRS-22r function at 2 and 5 years, but observational data cannot show earlier surgery improves outcomes.

SUMMARY: In 78 children with femoral fractures treated with titanium elastic nails, most complications were minor; mismatched nail diameters and comminution over 25% predicted malunion, and prominent nail ends caused insertion-site pain.

SUMMARY: Scoping review of 16 studies finds AI (deep learning classifiers, finite element models) being applied to clubfoot diagnosis, treatment planning, gait analysis, and relapse detection, with potential to reduce subjective assessment and treatment variability.

SUMMARY: This overview discusses acceptable alignment in adolescent radial shaft fractures, when to operate, and when plating is preferable to flexible nails given limited remodeling and the need to restore radial bow.

SUMMARY: Pediatric Spine Study Group consensus defines an early onset scoliosis "graduate" as a patient who has had any surgical program, reached skeletal maturity, and has no planned future EOS surgery.

SUMMARY: Describes a surgical technique for rigid congenital clasped thumb in arthrogryposis, pairing a radially based index stiletto flap with growth-preserving MCP chondrodesis to open the web, resurface the volar thumb, and stabilize the joint.

SUMMARY: In 88 young children followed about 9 years, latissimus dorsi (with or without teres major) transfer for brachial plexus birth injury durably improved shoulder abduction, external rotation, and flexion, with few revisions.

SUMMARY: In 110 children with lower-limb differences, radiographic mid-thigh girth, a BMI proxy, correlated with worse patient-reported outcomes while standard alignment parameters largely did not, so body habitus belongs in counseling.

SUMMARY: General-purpose AI models estimated Cobb angles within 5 degrees of spine surgeons in about 91-95% of cases but were unreliable for Lenke classification and landmarks, so they should not guide surgical planning.

SUMMARY: This review covers EOS biplanar imaging, which gives standing 2D/3D whole-body images with 50-80% less radiation than conventional X-rays, and is especially useful for scoliosis, sagittal balance, and limb torsion, though 3D reconstruction needs a trained operator.

SUMMARY: Four large language models answering parent questions on pediatric flexible flatfoot were not reliably distinguishable on clinical quality, but all exceeded recommended readability levels and were only moderately reproducible, so clinician oversight remains necessary.

SUMMARY: This paper proposes a simplified two-group classification and surgical strategy for radial polydactyly that accounts for size discrepancy, axis deviation, soft-tissue quality, and nail deformity, combining transverse and longitudinal reconstructive techniques.

SUMMARY: After hematopoietic stem cell gene therapy in 8 children with Hurler syndrome, acetabular index and migration percentage improved over 4 years, with more hips reaching normal ranges, suggesting dysplasia may stabilize and warrants continued radiographic surveillance.

SUMMARY: Over half of adolescent and young adult scoliosis patients preparing for fusion self-reported anxiety (52%) and 27% reported depression, far exceeding clinical diagnoses, and higher baseline distress independently predicted worse short-term self-image and function.

SUMMARY: Ponseti clubfoot care in Indiana carries a substantial uninsured burden for families, with median out-of-pocket costs of about $2,500-2,700 (roughly 3.5-4% of household income) driven largely by long travel distances.

SUMMARY: In a randomized trial of 60 children aged 5 to 10, casting without reduction was noninferior to reduction under anesthesia for mildly displaced distal radius metaphyseal fractures at 6 months, suggesting routine reduction is unnecessary.

SUMMARY: Using systematic review, family interviews, a Delphi survey, and consensus workshop, the CORE-Kids study defined core outcome domains (including pain, return to activities, complications, and time to union) for all future childhood limb fracture trials.

SUMMARY: In this randomized trial of braced AIS patients, supervised Schroth exercises gave a statistically significant but sub-MCID 3\u00b0 Cobb advantage at 24 months, with no meaningful quality-of-life or clinical status benefit over self-directed exercise.

SUMMARY: In 118 adolescents with supracondylar humerus fractures, pinning and permanent fixation had similar union times and nerve outcomes; older age, severe fracture type, and open approach lengthened union, and permanent fixation gave modestly better elbow motion.

SUMMARY: This narrative review finds highly specialized early athlete training carries some risks, but the mechanisms are poorly understood, so evidence-based youth training recommendations still require more research.

SUMMARY: This review prepares orthopaedic surgeons to identify nonaccidental trauma in children, covering risk factors, sentinel exam findings, suspicious fracture patterns, mimicking conditions, mandated reporting duties, and multidisciplinary management.

SUMMARY: Interviews with 24 surgeons explained why the Big BOSS SCFE trial failed to recruit: few eligible patients, unclear criteria, loss of equipoise, logistical burdens, and patient preferences; embedded qualitative work can guide trial planning.

SUMMARY: In 40 children with severe spinal deformity, a structured home-based halo gravity traction protocol gave about 24% scoliosis correction with a 15% complication rate and far lower cost than inpatient traction.

SUMMARY: In a Danish cohort of nonambulant children with cerebral palsy and hip migration of 30-49%, tenotomy was linked to roughly half the risk of severe hip outcomes, especially in GMFCS IV.

SUMMARY: In 375 pediatric supracondylar fractures treated with percutaneous pinning, 19 developed postoperative ulnar nerve palsy; all 17 followed recovered fully, sometimes after 4 months, so observation is usually appropriate.

SUMMARY: Review proposing that Legg-Calvé-Perthes disease arises from interacting genetic (COL2A1, IL6), epigenetic, and environmental factors such as maternal smoking and low birth weight, pointing toward future screening and preventive strategies.

SUMMARY: ESSKA-ESA expert consensus finds that patient age and first-time versus recurrent dislocation should guide history, physical exam, and imaging choices in traumatic anterior shoulder instability, with 12 statements mostly graded B.