Peds Ortho

Deep Dive in DDH - Operative Management of Developmental Hip Dislocations

Deep Dive in DDH is a three-part limited series where experts in the field of DDH have been invited to discuss the controversies in the management of hip dysplasia. Episode 1 was published in August and discussed management of DDH in infants under 6 months of age. In Episode 2, we are joined by Eduardo Novais at Nemour Children’s Health in Jacksonville and Salil Upasani of Rady Children’s Hospital and discuss the controversies in the management of developmental hip dislocations in the operating room including the process to decide between closed and open reduction, the use of concomitant osteotomies, adjunctive imaging, and casting protocols.

Hosted by Will Morris (Scottish Rite for Children). Music by A. A. Aalto.

Referenced Publications:

1. Novais EN, Hill MK, Carry PM, Heyn PC. Is Age or Surgical Approach Associated With Osteonecrosis in Patients With Developmental Dysplasia of the Hip? A Meta-analysis. Clin Orthop Relat Res. 2016 May;474(5):1166-77. doi: 10.1007/s11999-015-4590-5. PMID: 26472583; PMCID: PMC4814411.
2. Schmaranzer F, Justo P, Kallini JR, Ferrer MG, Miller P, Bixby SD, Novais EN. Hip Morphology on Post-Reduction MRI Predicts Residual Dysplasia 10 Years After Open or Closed Reduction. J Bone Joint Surg Am. 2024 Jan 17;106(2):110-119. doi: 10.2106/JBJS.23.00333. Epub 2023 Nov 22. PMID: 37992184; PMCID: PMC12205695.
3. Morris WZ, Chilakapati S, Hinds SA, Herring JA, Kim HKW. The Clinical Significance of Infolded Limbus on Postreduction Arthrogram in Developmental Dysplasia of the Hip. J Pediatr Orthop. 2022 Apr 1;42(4):e309-e314. doi: 10.1097/BPO.0000000000002070. PMID: 35132011.
4. Morris WZ, Hinds S, Worrall H, Jo CH, Kim HKW. Secondary Surgery and Residual Dysplasia Following Late Closed or Open Reduction of Developmental Dysplasia of the Hip. J Bone Joint Surg Am. 2021 Feb 3;103(3):235-242. doi: 10.2106/JBJS.20.00562. PMID: 33252590.
5. Gans I, Sankar WN. The medial dye pool revisited: correlation between arthrography and MRI In closed reductions for DDH. J Pediatr Orthop. 2014 Dec;34(8):787-90. doi: 10.1097/BPO.0000000000000187. PMID: 24787303.
6. Novais EN, Hollnagel KF, Bixby SD, Ferrer MG, Williams DN, Kim YJ, Schmaranzer F. Predictive value of post-reduction gadolinium-enhanced magnetic resonance imaging in detecting avascular necrosis after closed and open reduction for developmental dysplasia: A minimum 5-year follow-up study. J Child Orthop. 2025 Jul 6;19(4):329-338. doi: 10.1177/18632521251350524. PMID: 40630930; PMCID: PMC12230044.
7. Paez C, Badrinath R, Holt J, Bomar JD, Mubarak SJ, Upasani VV, Wenger DR. Ligamentum Teres Transfer During Medial Open Reduction in Patients with Developmental Dysplasia of the Hip. Iowa Orthop J. 2021;41(1):47-53. PMID: 34552403; PMCID: PMC8259203.

“Breaking” News on Tethers with Daniel Hoernschemeyer

Dr. Daniel Hoernschemeyer from the University of Missouri joins the show to discuss his recent research on vertebral body tethering as well as the past, present, and future of this new treatment. Your hosts are Josh Holt from the University of Iowa, Stephanie Logterman from Arnold Palmer Hospital for Children, Craig Louer from Vanderbilt, and Tyler McDonald from the University of South Alabama. Produced by Josh Holt and Carter Clement (Manning Family Children’s). Music by A.A. Aalto.

 

References:

 

“Growth modulation increases clinical success in vertebral body Tethering.” Hoernschemeyer et al. Spine Deformity 2025.

 

“Anterior Vertebral Body Tethering: A Single-Center Cohort with 4.3 to 7.4 Years of Follow-up.” Hoernschemeyer et al. JBJS 2024.

 

“Effect of Vertebral Body Tether Tensioning on Vertebral Body Growth Modulation.” Jackson et al. with PSSG. JOR Spine 2025.

 

“Growth modulation response in vertebral body tethering depends primarily on magnitude of concave vertebral body growth.” Louer et al. with PSSG. Spine Deformity 2024.

 

“Multicenter validation of a surgical planning tool for lumbar vertebral body tethering simulating growth modulation over 2 years.” Cobetto et al. Spine Deformity 2025.

IPOS 2025

Drs. Stephanie Logterman from Arnold Palmer Hospital for Children and Tyler McDonald from the University of South Alabama bring you this year's IPOS® 2025 episode. We highlight some of the exciting programming from this year's meeting delve into a few interesting topics in pediatric orthopedics. Special guests include Drs. Rachel Thompson, Michael Vitale, Jennifer Beck, Alex Arkader, Brian Kaufman, Lindley Wall, Jaysson Brooks, Henry Ellis, Wood Sankar, and Derek Kelly. This episode is produced by Tyler McDonald. Music by A.A. Aalto.

AACPDM 2025

This special episode brings you inside the 79th Annual Meeting of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM), held in New Orleans, October 15–18, 2025. Join host Tyler McDonald from the University of South Alabama as he attends his first AACPDM meeting and highlights the moments, conversations, and clinical insights most relevant to pediatric orthopedic surgeons. Hosted, recorded, and produced by Tyler McDonald. Intro music by A. A. Aalto. Additional royalty-free music provided by Pixabay.

Link to Jon David's diagnostic matrix for gait analysis: https://journals.lww.com/jbjsjournal/pages/articleviewer.aspx?year=2003&issue=11000&article=00028&type=Citation

Vaulting into your Clinic: A Gymnastics Medicine Primer with Elspeth Hart

All about gymnastics! We interview Dr. Elspeth Hart from Boston Children's on her latest article on Gymnastics Medicine and what to look out for when treating gymnasts in the orthopedic setting. We also highlight recent articles on the urgency of stable SCFE, a lesser-known method for pinning supracondylar humerus fractures, and short versus long leg casting for distal tibia physeal fractures. Your hosts are Tyler McDonald (University of South Alabama), and Stephanie Logterman (Arnold Palmer Hospital for Children), Josh Holt (University of Iowa), and Carter Clement (Manning Family Children’s in New Orleans). Music by A. A. Aalto.

Gymnastics Upper Extremity Article mentioned: Hart E, Bauer AS, Bae DS. Common upper extremity gymnastics injuries and gymnastic specific return to play protocols. J Pediatr Soc North Am. 2024 Feb 28;6:100016. doi: 10.1016/j.jposna.2024.100016. PMID: 40433250; PMCID: PMC12088353.

Link to the non profit Gymnastics Medicine: Education and Research: GymnasticsMedicine.org

Link to learn more about the 7^th annual Gymnastics Medicine Symposium (use code "Gym15" to save 15% if interested in signing up!): Symposium 2025 - Gymnastics Medicine

 

References:

1. Hart E, Bair K, Broz J, Griffith K, Herrera-Set A, Lattimore D, Melvin E, Sweeney E. Gymnastics Medicine: A New Subspecialty in Sports Medicine. Curr Sports Med Rep. 2025 May 1;24(5):126-134. doi: 10.1249/JSR.0000000000001249. PMID: 40323057.

2. White AB, Keil LG, Bardsley H, Selberg C, Mansour A, Brooks AC, Manickam R, Mayassi HA, Zhao L, Uchtman M, Whitlock P, Stone J. How Urgent Are Stable SCFEs? A Multisite Retrospective Study of Surgical Timing and Complications Among Patients With Stable Slipped Capital Femoral Epiphysis. J Pediatr Orthop. 2025 Sep 1;45(8):485-491. doi: 10.1097/BPO.0000000000002997. Epub 2025 May 1. PMID: 40314216.

3. Grewal RS, Kitchen BT, Bomar JD, Cidambi EO, Dexter MJ, Edmonds EW, Pring ME, Upasani VV, Wallace CD, Pennock A. Displaced Distal Tibia Physeal Fractures: Short Leg Versus Long Leg Casting-A Prospective Study. J Pediatr Orthop. 2025 Aug 1;45(7):e614-e617. doi: 10.1097/BPO.0000000000002961. Epub 2025 Apr 7. PMID: 40191914.

4. Muto S, Niwa S, Fujihara Y, Ota H, Kumagai H. Comparative Analysis of Postoperative Rotational Malalignment in Pediatric Supracondylar Humerus Fractures: Cross Pinning Versus Lateral Para-olecranon Pinning. J Pediatr Orthop. 2025 Sep 1;45(8):458-465. doi: 10.1097/BPO.0000000000003000. Epub 2025 May 5. PMID: 40323798.

"Femoral Fracture Braces and the Perils of Price Is Right Rules" with Lindsay Andras

Dr. Lindsay Andras from Children’s Hospital of Los Angeles joins the show to discuss her recent randomized control trial comparing outcomes of functional bracing and spica casting for pediatric femoral shaft fractures. Drs. Andras and co-author Dr. Julia Sanders share insights from their experience conducting a randomized control trial and the pearls and pitfalls of implementing the functional brace. The lightning round highlights articles on spinal involvement in hereditary multiple osteochondromas, outcomes of pediatric multi-ligamentous knee injuries, and the impact of Pavlik harness treatment on breastfeeding efficacy.

 

Your hosts are Will Morris (Scottish Rite for Children in Dallas), Julia Sanders (Children’s Hospital of Colorado), Tyler McDonald (University of South Alabama), and Steph Logterman (Arnold Palmer Hospital for Children). Music by A. A. Aalto.

 

Disclosure: Drs. Lindsay Andras and Julia Sanders each receive royalties from Orthopediatrics who produce a version of the fracture brace discussed in this episode.

 

References:

1. Andras LM, Sanders JS, Phan TN, Purtell SR, Gasca J, Wren TAL, Sim AT, Skaggs D, Kramer A, Chavez M, Kay R. A Prospective, Randomized Comparison of Functional Bracing and Spica Casting for Femoral Fractures Showed Equivalent Early Outcomes. J Bone Joint Surg Am. 2025 Jun 26;107(16):1769-1776. doi: 10.2106/JBJS.24.01081. PMID: 40570075.

2. Casey VF, Chandler CC, Graham GD, Frick SL. Dynamic Femur Fracture Brace vs Hip Spica Cast for Pediatric Femoral Shaft Fractures: A Retrospective Comparative Cohort Study. J Pediatr Soc North Am. 2025 May 23;12:100203. doi: 10.1016/j.jposna.2025.100203. PMID: 40704087; PMCID: PMC12284357.

3. Lang PJ, Feroe A, Franco H, Hussain ZB, Tepolt FA, Kocher MS. Outcomes of Operative Management of Multi-Ligament Knee Injuries in an Adolescent Population: A Retrospective Case Series. J Pediatr Soc North Am. 2024 Feb 5;5(4):742. doi: 10.55275/JPOSNA-2023-742. PMID: 40432936; PMCID: PMC12088175.

4. Bram JT, Tracey OC, Trotzky Z, Jones RH, Jochl O, Cirrincione PM, Nichols E, Dodwell ER, Scher DM, Doyle SH, Sink EL. Pavlik Harness Treatment for Infantile Hip Dysplasia Lowers Breastfeeding Self-efficacy. J Pediatr Orthop. 2025 Sep 1;45(8):e701-e705. doi: 10.1097/BPO.0000000000002976. Epub 2025 Apr 21. PMID: 40256838.

5. Legler J, Benaroch LR, Pirshahid AA, Serhan O, Cheng D, Bartley D, Carey T, Rasoulinejad P, Singh S, Thornley P. Rate of Spinal Osteochondromas Diagnosed in Pediatric Patients With Hereditary Multiple Osteochondromas: A Systematic Review and Meta-Analysis. J Pediatr Orthop. 2025 Sep 1;45(8):e718-e723. doi: 10.1097/BPO.0000000000002975. Epub 2025 Apr 23. PMID: 40266849.

Deep Dive in DDH - Part 1 - Infants Under 6 Months

Deep Dive in DDH is a three part limited series where experts in the field of DDH have been invited to discuss the controversies in the management of hip dysplasia. Episode 1 discusses the management of DDH in infants under 6 months of age from stable sonographic dysplasia through refractory developmental hip dislocation. We are joined by Kishore Mulpuri from BC Children's hospital, Simon Kelley from Texas Children's Hospital, and Wudbhav Sankar from Children's hospital of Philadelphia as we discuss areas of consensus and discord in Pavlik harness treatment, second line therapy, and what to do when problems arise.

Hosted by Will Morris (Scottish Rite for Children). Edited by Carter Clement (Manning Family Children's Hospital). Music by A. A. Aalto.

Referenced Publications

• Behman AL, Bradley CS, Maddock CL, Sharma S, Kelley SP. Testing of an Ultrasound-Limited Imaging Protocol for Pavlik harness Supervision (TULIPPS) in developmental dysplasia of the hip: a randomized controlled trial. Bone Joint J. 2022 Sep;104-B(9):1081-1088. doi: 10.1302/0301-620X.104B9.BJJ-2022-0350.R2. PMID: 36047018.
• Gans I, Flynn JM, Sankar WN. Abduction bracing for residual acetabular dysplasia in infantile DDH. J Pediatr Orthop. 2013 Oct-Nov;33(7):714-8. doi: 10.1097/BPO.0b013e31829d5704. PMID: 23812157.
• Swarup I, Talwar D, Sankar WN. Part-time Abduction Bracing in Infants With Residual Acetabular Dysplasia: Does Compliance Monitoring Support a Dose-dependent Relationship? J Pediatr Orthop. 2021 Feb 1;41(2):e125-e129. doi: 10.1097/BPO.0000000000001704. PMID: 33165268.
• Striano B, Schaeffer EK, Matheney TH, Upasani VV, Price CT, Mulpuri K, Sankar WN; International Hip Dysplasia Institute. Ultrasound Characteristics of Clinically Dislocated But Reducible Hips With DDH. J Pediatr Orthop. 2019 Oct;39(9):453-457. doi: 10.1097/BPO.0000000000001048. PMID: 31503230.
• Harper P, Joseph BM, Clarke NMP, Herrera-Soto J, Sankar WN, Schaeffer EK, Mulpuri K, Aarvold A; International Hip Dysplasia Institute (IHDI). Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns. J Pediatr Orthop. 2020 Sep;40(8):408-412. doi: 10.1097/BPO.0000000000001602. PMID: 32555048; PMCID: PMC7458090.
• Murnaghan ML, Browne RH, Sucato DJ, Birch J. Femoral nerve palsy in Pavlik harness treatment for developmental dysplasia of the hip. J Bone Joint Surg Am. 2011 Mar 2;93(5):493-9. doi: 10.2106/JBJS.J.01210. PMID: 21368082.

"Behold the power of casting!" with Reid Nichols

Dr. Reid Nichols from Nemours joins the show to discuss her recent article on Ponseti treatment of arthrogrypotic clubfeet. The discussion spans numerous foot pathologies including bunions, coalitions, flatfeet, and some stuff you've probably never heard of! The gang is also excited to welcome a new host, Steph Logterman, to the podcast!

 

Your hosts are Carter Clement (Manning Family Children’s in New Orleans), Tyler McDonald (University of South Alabama), Craig Louer (Vanderbilt), and Steph Logterman (Arnold Palmer Hospital for Children). Music by A. A. Aalto.

 

References:

 

The 10-Year Functional Outcome of Ponseti Treatment of Idiopathic and Arthrogrypotic Clubfeet With an Age-Matched Control. Church et al. JPO 2025.

 

Surgical Treatment for Painful Pediatric Pes Planovalgus: How Does Subtalar Extra-articular Screw Arthroereisis Compare to the Standard Technique of Modified Evans Reconstruction? Nasreddine et al. JPO 2025.

 

Bedside Aspiration for Workup of the Pediatric Septic Hip: Avoid Trips to the OR and Expedited Time to Diagnosis. K Skaggs et al. JPO 2025.

 

Timing Matters: Challenges in Delayed Surgical Management of Pediatric Humeral Medial Epicondyle Fractures. Lee et al. JPO 2025.

POSNA 2025 Part II

Part 2 of a 2-part series recapping the 2025 POSNA Annual Meeting in Las Vegas. In this episode, we sit down with the 2025 Program Committee — Drs. Julie Samora, Tony Riccio, John Vorhies, and Christine Ho — to hear what’s new and what makes this year’s meeting stand out. Drs. Lindsay Andras, Apurva Shah, Firoz Miyanji, and Christine Ho highlight some standout presentations from the Awards Papers session. Drs. Stu Weinstein and John Birch share their thoughts on memorable Case Reports and how this new format adds a unique dimension to the meeting. We also chat with Dr. Jon Schoenecker, winner of the Best Basic Science Paper, and Dr. Dan Sucato, winner of the Best Clinical Paper, to learn more about their award-winning research. Hosted by Tyler McDonald (University of South Alabama) and Will Morris (Scottish Rite for Children). Music by A. A. Aalto.

POSNA 2025 Part I

Part 1 of a 2-part series recapping the 2025 POSNA Annual Meeting in Las Vegas. In this episode, we’re joined by Drs. Julia Sanders and David Spence (Trauma Session), Drs. Amy McIntosh and Lorena Flocarri (Spine Session), Drs. Ray Liu and Sean Tabaie (Neuromuscular and Lower Extremity Session), and Drs. Eduardo Novais and Eric Fornari (Hip Session) to discuss highlights from their respective sessions. Hosted by Tyler McDonald (University of South Alabama) and Will Morris (Scottish Rite for Children). Music by A. A. Aalto.