Peds Ortho

Lit. Update with Henry Ellis

Dr Henry Ellis from TSRH joins the show to discuss his research on the functional outcomes of open vs. arthroscopic cam resection. Highlights from the lightning round include the impacts of seemingly benign parts of care like saw blades/Dermabond/Pavlik harnesses, the recovery process after femoral flex nails, and more. Your hosts are Carter Clement from Children’s Hospital of New Orleans, Julia Sanders from Children’s Hospital Colorado, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. This episode is sponsored by Nuvasive. Music by A. A. Alto.

 

Citations for papers discussed:

 

1) Morris et al. Comparison of Gait and Functional Outcomes between Arthroscopic and Open Treatment of Adolescent and Young Adult Femoroacetabular Impingement. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37791636/

 

2) Koritz et al. Incidence of Skin Sensitivity Following Dermabond Application in Pediatric Orthopaedic Surgery. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37820062/

 

3) Gettleman et al. Use of Surgical Adjuvants does not Decrease Recurrence of Aneurysmal Bone Cysts in Surgical Intervention with Pediatric Patients. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37815299/

 

4) Greenhill et al. Metaphyseal Fracture Displacement is Predictive of Intra-articular Diastasis in Adolescent Triplane Ankle Fractures. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37779308/

 

5) Batley et al. What are the Psychosocial Effects of Pavlik Harness Treatment? A Prospective Study on Perceived Impact on Families and Maternal-Infant Bonding. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37807604/

 

6) Stevens et al. Coated Cast Saw Blades Decrease Temperature During Cast Removal. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37796155/

 

7) Flinck et al. Recovery of Gait in Children and Adolescents after Pediatric Femoral Shaft Fracture treated with Intramedullary Nail Fixation: a Longitudinal Prospective Study. JPO E-pub Oct 2023. https://pubmed.ncbi.nlm.nih.gov/37791633/

 

Lit. Update with Ishaan Swarup

Dr Ishaan Swarup from UCSF joins the show this month to discuss distal tibial physeal fractures. Highlights from the lightning round include the interplay of race, socioeconomic status and self-image in scoliosis, measuring rotation with advanced imaging and clinical examination, and selective dorsal rhizotomy. Your hosts are Julia Sanders from Children’s Hospital Colorado, Carter Clement from Children’s Hospital of New Orleans, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. Music by A. A. Alto.

 

Citations for papers discussed can be found below:

 

Swarup I, Pearce R, Sanborn R, Shore BJ; Children’s Orthopaedic Trauma and Infection Consortium for Evidence Based Studies (CORTICES). Variations in the Management of Closed Salter-Harris II Distal Tibia Fractures. J Pediatr Orthop. 2023;43(9):e742-e746.

 

Onay T, Çelen ZE, Bayhan M, Kandemir İ, Kiliç NC, Kayaalp ME. A More Conservative Approach in the Surgical Management of Pediatric Physeal Ankle Fractures Should be Preferred: Mid to Long-term Functional Outcomes of Three Different Surgical Techniques for Salter-Harris Type II and Triplane Distal Tibial Fractures. J Pediatr Orthop. 2023;43(9):e734-e741.

 

Sheth M, Kitziger R, Bindner C, Rosenfeld SB. Computed Tomography Analysis of Distal Tibia Physeal Fracture Patterns: A Classification and Technique for Optimizing Screw Trajectory [published online ahead of print, 2023 Aug 29]. J Pediatr Orthop. 2023;10.1097/BPO.0000000000002498.

 

Erkkila, I. P., Reynolds, C. A., Weissman, J. P., Levine, O. P., Aronson, H., Knoll, J. M., & Larson, J. E. (2023). Factors Associated with Presentation of Severe Adolescent Idiopathic Scoliosis: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(3).

 

Cirrincione PM, Thakur A, Zucker CP, et al. Exploring Correlations Between Pain and Deformity in Idiopathic Scoliosis With Validated Self-reported Pain Scores, Radiographic Measurements, and Trunk Surface Topographic Measurements [published online ahead of print, 2023 Aug 21]. J Pediatr Orthop. 2023;10.1097/BPO.0000000000002493.

 

Edmonds, E. W., Parvaresh, K. C., Price, M. J., Farnsworth, C. L., Bomar, J. D., Hughes, J. L., & Upasani, V. V. (2023). The Reliability of Measurements for Tibial Torsion: A Comparison of CT, MRI, Biplanar Radiography, and 3D Reconstructions With and Without Standardized Measurement Training: Original Research. Journal of the Pediatric Orthopaedic Society of North America, 5(3).

 

Miller SD, Juricic M, Bone JN, Steinbok P, Mulpuri K. The Effect of Selective Dorsal Rhizotomy on Hip Displacement in Children With Cerebral Palsy: A Long-term Follow-up Study. J Pediatr Orthop. 2023;43(9):e701-e706.

Lit. Update with Chris Makarewich

Dr. Christopher Makarewich from University of Utah and the Salt Lake City Shriners Hospital returns to the show to discuss his recent research on guided growth in achondroplasia. The lightning round delves deeper into achondroplasia including medical treatment and elective limb lengthening. Your hosts are Josh Holt from University of Iowa, Carter Clement from Children’s Hospital of New Orleans, and Julia Sanders from Children's Hospital Colorado. Music by A. A. Aalto.

 

Citations

 

Hemiepiphysiodesis for Lower Extremity Coronal Plane Angular Correction in the Distal Femur and Proximal Tibia in Children with Achondroplasia. Makarewich et al. JPO Sept 2023.

 

Once-daily, subcutaneous vosoritide therapy in children with achondroplasia: a randomised, double-blind, phase 3, placebo-controlled, multicentre trial. Savarirayan et al. Lancet 2020.

 

What’s New in Limb Lengthening and Deformity Correction? Bafor and Iobst. JBJS Aug 2023.

 

Achondroplasia and limb lengthening: Results in a UK cohort and review of the literature. Donaldson et al. Journal of Orthopaedics 2015.

 

Extensive Limb Lengthening for Achondroplasia and Hypochondroplasia. Paley. Children 2021.

Innovation in Pediatric Orthopaedics, Part II

Ira Zaltz, Peter Newton, James Wall, Rene Caissie, and Manoj Ramachandran join the show to discuss their experiences developing innovative products in the field of pediatric orthopaedic surgery and beyond. The broad-ranging conversation covers their personal journeys, raising funding for new ventures, partnering with industry, mistakes they made, and more! Your hosts are Carter Clement from Children's Hospital of New Orleans and Kevin Shea from Stanford. Music by A.A. Aalto.

Innovation in Pediatric Orthopaedics, Part I

Ira Zaltz, Peter Newton, James Wall, Rene Caissie, and Manoj Ramachandran join the show to discuss their experiences developing innovative products in the field of pediatric orthopaedic surgery and beyond. The broad-ranging conversation covers their personal journeys, raising funding for new ventures, partnering with industry, mistakes they made, and more! Your hosts are Carter Clement from Children's Hospital of New Orleans and Kevin Shea from Stanford. Music by A.A. Aalto.

Lit. Update with Ben Shore

Dr. Ben Shore from Boston Children's joins the show to discuss his recent research on trauma, infection, discharge planning, neuromuscular hips, and more. The lightning round covers Vitamin D deficiency, scoliosis bracing, guided growth, and shared decision making. This episode is sponsored by Depuy Synthes Spine. Your hosts are Craig Louer from Vanderbilt, Carter Clement from Children’s Hospital of New Orleans, Julia Sanders from Children's Hospital Colorado, and Josh Holt from University of Iowa. Music by A. A. Aalto.

 

References:

 

Watkins et al. The Reliability of Intraoperative Hip Arthrography in Cerebral Palsy Hip Reconstruction. JPOSNA 2023. https://doi.org/10.55275/JPOSNA-2023-595

 

Flaugh et al. Barriers to Discharge After Hip Reconstruction Surgery in Non-ambulatory Children With Neurological Complex Chronic Conditions. JPO Sept 2022.

 

Upasani et al with CORTICES Study Group. Practice Variation in the Surgical Management of Children With Acute Hematogenous Osteomyelitis. JPO 2022.

 

Montgomery et al. Minimizing Surgeon Radiation Exposure During Operative Treatment of Pediatric Supracondylar Humerus Fractures. JPO 2023.

 

Lightning Round

 

Karkenny et al. Pediatric Fractures: Does Vitamin D Play a Role? JPO 2023.

 

Catanzano et al. Cast or Nail? Using a Preference-Based Tool for Shared Decision-Making in Pediatric Femoral Shaft Fracture Treatment. JPO 2023.

 

Zapata et al. Early brace treatment for idiopathic scoliosis may change the paradigm to improve curves. Spine Deformity 2023.

 

McGinley et al. Faster Rate of Correction with Distal Femoral Transphyseal Screws Versus Plates in Hemiepiphysiodesis for Coronal-Plane Knee Deformity: Age- and Sex-Matched Cohorts of Skeletally Immature Patients. JBJS 2023.

Lit. Update with Coleen Sabatini

Dr. Coleen Sabatini from UCSF joins the show to discuss implicit bias and bullying in our field, changing and international trends in supracondylars, and two international orthopedic public health issues she is immersed in solving: gluteal fibrosis and post-injection paralysis. The lightning round highlights new ultrasound techniques, SCFE implants, and more. 

 

Your hosts are Carter Clement from Children’s Hospital of New Orleans, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. Music by A. A. Alto.

 

References:

 

New Injury Patterns in Pediatric Supracondylar Fractures During COVID-19: Beds Are the New Monkey Bars. Soriano et al. JPO Apr 2023. https://pubmed.ncbi.nlm.nih.gov/36662751/

 

Supracondylar humerus fractures in low- and lower middle-income countries: a scoping review of the current epidemiology, treatment modalities, and outcomes. Challa et al. International Orthopedics 2020. https://pubmed.ncbi.nlm.nih.gov/32691122/

 

Implicit Racial Bias in Pediatric Orthopaedic Surgery. Guzek et al. JPO 2022. https://pubmed.ncbi.nlm.nih.gov/35522848/

 

The Prevalence of Bullying Among Pediatric Orthopaedic Patients. Carrillo et al. JPO 2021. https://pubmed.ncbi.nlm.nih.gov/34294669/

 

Epidemiology and treatment outcomes in pediatric patients with post-injection paralysis. Song et al. BMC Musculoskeletal Disorders 2022. https://pubmed.ncbi.nlm.nih.gov/35932071/

 

Surgical Release of Gluteal Fibrosis in Children Results in Sustained Benefit at 5-Year Follow-up. Reilly et al. JPO 2021. https://pubmed.ncbi.nlm.nih.gov/33481480/

 

Gluteal Fibrosis and Its Surgical Treatment. Alves et al. JBJS 2019. https://pubmed.ncbi.nlm.nih.gov/30801376/

 

Gluteal fibrosis, post-injection paralysis, and related injection practices in Uganda: a qualitative analysis. Alves et al. BMC Health Services Research 2018. https://pubmed.ncbi.nlm.nih.gov/30477506/

 

Burden of gluteal fibrosis and post-injection paralysis in the children of Kumi District in Uganda. BMC Musculoskeletal Disorders 2018. https://pubmed.ncbi.nlm.nih.gov/30249239/

 

Lightning Round:

 

The Usefulness of Dynamic Ultrasonography in Nursemaid's Elbow: A Prospective Case Series of 13 Patients Reconsideration of the Pathophysiology of Nursemaid's Elbow. Tsai et al. JPO July 2023. https://pubmed.ncbi.nlm.nih.gov/36962080/

 

Seven-year Outcomes of Adolescent Forearm Fractures Treated With Plate Fixation. Folkman et al. JPO June 2023. https://pubmed.ncbi.nlm.nih.gov/37072917/

 

The Addition of Daytime Physiotherapeutic Scoliosis-specific Exercises to Adolescent Idiopathic Scoliosis Nighttime Bracing Reduces Curve Progression. Zapata et al. JPO July 2023. https://pubmed.ncbi.nlm.nih.gov/36922003/

 

Who Benefits From Allowing the Physis to Grow in Slipped Capital Femoral Epiphysis? Winger et al. JPO July 2023. https://pubmed.ncbi.nlm.nih.gov/36977364/

 

 

 

 

POSNA Annual Meeting 2023 Part II

This special episode brings you highlights from the 2023 annual POSNA meeting in Nashville. Guests include Pat Cahill from CHOP, Jeanne Franzone from Nemours, Neeraj Patel from Lurie Children's Hospital, Greg Mencio from Vanderbilt, and Jonathan Schoenecker from Vanderbilt. Your hosts are Carter Clement from Children's Hospital of New Orleans, Craig Louer from Vanderbilt, and Julia Sanders from Children's Hospital Colorado. Music by A.A. Aalto.

POSNA Annual Meeting 2023 Part I

This special episode brings you highlights from the 2023 annual POSNA meeting in Nashville. Special guests include Colin May from Boston Children's and Jaime Denning from Cincinnati Children's (foot & ankle subspecialty session), Ben Sheffer from Campbell Clinic and Ryan Muchow from the Lexington Shriners Hospital (trauma subspecialty session), Ben Shore from Boston Children's (CORTICES study group), Salil Upasani from Rady Children's Hospital (hip subspecialty session), and Nirav Pandya from UCSF (sports subspecialty session). Your hosts are Carter Clement from Children's Hospital of New Orleans, Craig Louer from Vanderbilt, and Julia Sanders from Children's Hospital Colorado. Music by A.A. Aalto.

Lit. Update with Matt Ellington

Dr Matt Ellington from Central Texas Pediatric Orthopedics joins the show this month! We discuss pain management for ACL reconstruction and the danger of opioid use disorders, as well as grit scores and Dr Ellington’s pearls for a variety of sports cases. The lightning round highlights the outcomes of THA in pediatric patients, spinal trauma classification systems, and long term outcomes after scoliosis surgery. 

 

Your hosts are Julia Sanders from Children’s Hospital Colorado, Carter Clement from Children’s Hospital of New Orleans, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. This episode is sponsored by Nuvasive. Music by A. A. Alto.

 

References:

 

Akazawa et al. Health-Related Quality of Life of Patients With Adolescent Idiopathic Scoliosis at Least 40 Years After Surgery. Spine (Phila Pa 1976). 2023.

 

Pascual-Leone N et al. Higher Grit Scores Are Associated With Earlier Increases in Knee Flexion Following Anterior Cruciate Ligament Reconstruction With Meniscus Repair in Pediatric Patients. JPO. 2023.

 

Sborov KD et al. Thoracolumbar Injury Classification and Severity Scale Can Help Identify Intra-Abdominal Injury in Children Injured in an MVC. JPOSNA. 2023.

 

Whitmarsh-Brown MA et al. Modernizing Our Understanding of Total Hip Arthroplasty in the Pediatric and Young Adult Patient: A Single-center Experience. JPO. 2023..

 

Cahan et al. Opioid Represcriptions After ACL Reconstruction in Adolescents Are Associated With Subsequent Opioid Use Disorder. JPO. 2023..

 

O'Neill NP et al. The Reliability of the AO Spine Upper Cervical Classification System in Children: Results of a Multi-Center Study. JPO. 2023.

 

Wagner et al. Variability in Pain Management Practices for Pediatric Anterior Cruciate Ligament Reconstruction. JPO. 2023.