Peds Ortho

Lit. Update with Drs. Bauer and Bouton

Jeremy Bauer and Daniel Bouton from the Portland Shriners Hospital are this month’s esteemed guests. They discuss 3 of their recent publications in JPO (listed below). They also weigh in on controversies in sports medicine and spine surgery. Your hosts are Carter Clement from Children’s Hospital of New Orleans, Josh Holt from University of Iowa, Craig Louer from Vanderbilt, and Julia Sanders from Children’s Hospital Colorado. Music by A. A. Alto.

 

1) The Effects of Lower Extremity Rotational Malalignment on Pediatric Patient-reported Outcomes Measurement and Information System (PROMIS) Scores. https://pubmed.ncbi.nlm.nih.gov/35818169/

 

2) 3D Gait Analysis and Patient-reported Outcomes of Femoral Osteotomies for Torsional Deformity. https://pubmed.ncbi.nlm.nih.gov/35968999/

 

3) Patient-Reported Outcome Measurement Information System (PROMIS) Scores in Pediatric Idiopathic Toe Walkers. https://pubmed.ncbi.nlm.nih.gov/35797178/

 

 

Lightning Round Articles

 

1) Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy: A Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/35980635/

 

2) Predictive Scoring for Recurrent Patellar Instability After a First-time Patellar Dislocation https://pubmed.ncbi.nlm.nih.gov/35797419/

 

3) Degree of Postoperative Curve Correction Decreases Risks of Postoperative Pneumonia in Patients Undergoing Both Fusion and Growth-friendly Surgical Treatment of Neuromuscular Scoliosis https://pubmed.ncbi.nlm.nih.gov/35709684/

 

4) Noninvasive Hemoglobin Monitoring for Postoperative Pediatric Orthopaedic Patients: A Preliminary Study https://pubmed.ncbi.nlm.nih.gov/35819308/

 

5) An Anatomic Study of the Proximal Tibial Epiphysis With Relevance to Percutaneous Epiphysiodesis Using Transphyseal Screws (PETS) https://pubmed.ncbi.nlm.nih.gov/35941093/

 

Lit. Update with Paul Sponseller

Dr. Sponseller from Johns Hopkins joins Peds Ortho this month to discuss his work on long term outcomes and pelvic osteotomies after sacral-alar-iliac (SAI) fixation. Dr. Sponseller shares his expertise on several controversies in spine surgery during our new “stirring the pot” segment, and we highlight recent papers on AIS, trauma, sports medicine, deformity, and infection.

 

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.

 

Papers discussed:

 

Mun, Vankara, Suresh, Margalit, Crasta, Sponseller. Pelvic Osteotomy in Patients With Previous Sacral-Alar-Iliac (SAI) Fixation. JPO.

 

Mun, Vankara, Suresh, Margalit, Kebaish, Sponseller. Sacral-Alar-Iliac (SAI) Fixation in Children With Spine Deformity: Minimum 10-Year Follow-Up. JPO.

 

Zloof, Ankory, Braun, et al. The Hereditary Nature of Adolescent Spinal Deformities: A Study of Over 600,000 Adolescents. Spine (Phila Pa 1976).

 

Stavinoha, Randhawa, Trivedi, Dingel, Shea, Frick. The Axillary Nerve Danger Zone in Percutaneous Fixation in the Pediatric Shoulder: The "1-Mountain-3-Valleys" Principle. JBJS.

 

Dahmen, Steman , Buck, et al. Treatment of Osteochondral Lesions of the Talus in the Skeletally Immature Population: A Systematic Review [published online ahead of print, 2022 May 20]. JPO.

 

Gerges, Messner, Lim, Chhina, Cooper. Efficacy and Safety of "Sleeper Plate" in Temporary Hemiepiphysiodesis and the Observation of "Tethering". JPO.

 

Bisht, Burns, Smith, Kang, Shrader, Belthur. The modified Kocher criteria for septic hip: Does it apply to the knee?. JCO.

Lit. Update with Crystal Perkins

Crystal Perkins from Children's Healthcare of Atlanta joins the show to discuss her recent research on pediatric hip dislocations and several additional topics and controversies in pediatric trauma and sports medicine. This episode was sponsored by Orthofix (www.orthofix.com). 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.

 

Articles discussed:

 

Clifton Willimon, Anthony C. Egger, Crystal A. Perkins.Traumatic Hip Dislocations in the Pediatric Patient: Injury Patterns, Need for Axial Imaging, Outcomes, and Selective Hip Arthroscopy. JPOSNA, May 2022.

 

Bhargavi Maheshwer, Evan M Polce, Kevin C Parvaresh et al. Establishing Clinically Significant Outcomes After Anterior Cruciate Ligament Reconstruction in Pediatric Patients. JPO, July 2022.

 

Allyson M Zakrzewski, Austin J Bryant, James J McCarthy. Can Over-containment Prevent Recurrence in Children With Cerebral Palsy and Hip Dysplasia Undergoing Hip Reconstruction? JPO, July 2022.

 

Andrew T Pennock, Benton E Heyworth, Tracey Bastrom, et al. Changes in superior displacement, angulation, and shortening in the early phase of healing for completely displaced midshaft clavicle fractures in adolescents: results from a prospective, multicenter study. J Shoulder Elbow Surg, Dec 2021.

POSNA Annual Meeting 2022 Part II

Part II of the POSNA 2022 Annual Meeting content.  In this episode, we interview moderators and course chairs from the final days of the POSNA 2022 Annual Meeting in Vancouver, BC, Canada--INCLUDING the Awards Sessions, Friday's Concurrent Spine, Sports, and Hip Sessions, and the Saturday Critical Issues Symposia.

Your hosts are Dr. Craig Louer from Vanderbilt , Dr. Carter Clement from Children's Hospital of New Orleans, and Dr. Julia Sanders of Children's Hospital Colorado.  Music by A. A. Aalto.

 

Registration link for the Inaugural POSNA Community Webinar is below:

Come discuss Pediatric Orthopedics Cases & Careers in a regular interactive webinar hosted by the POSNA Resident Communications Committee (RCC).

When: Jun 28, 2022 07:00 PM Central Time (US and Canada)

Please Register and join:

https://zoom.us/webinar/register/WN_LKnNkpQIR_mH09wPvwSqJg

After registering, you will receive a confirmation email containing information about joining the webinar.

POSNA Annual Meeting 2022 Part I

Part I of the POSNA 2022 Annual Meeting content.  In this episode, we interview moderators and course chairs from the first few days of the POSNA 2022 Annual Meeting in Vancouver, BC, Canada--INCLUDING the Pre-Course, Wednesday Scientific Sessions, POPS (Pediatric Orthopedic Practitioners Society) Conference, and the ever-popular Sub-Specialty Day.

Your hosts are Dr. Craig Louer from Vanderbilt , Dr. Carter Clement from Children's Hospital of New Orleans, and Dr. Julia Sanders of Children's Hospital Colorado.  Music by A. A. Aalto.  Support for this episode provided by Nemours Children's Health network.

Lit. Update with Peter Newton

Peter Newton from Rady Children's Hospital in San Diego discusses 15 of his recent studies, spanning many areas of spine surgery as well as trauma. 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. Music by A. A. Aalto.

 

Papers discussed:

 

1) To tether or fuse? Significant equipoise remains in treatment recommendations for idiopathic scoliosis. https://pubmed.ncbi.nlm.nih.gov/35316524/

 

2) The classification of scoliosis braces developed by SOSORT with SRS, ISPO, and POSNA and approved by ESPRM. https://pubmed.ncbi.nlm.nih.gov/35190896/

 

3) Surgical outcomes of severe spinal deformities exceeding 100° or treated by vertebral column resection (VCR). Does implant density matter?: an observational study of deformity groupings. https://pubmed.ncbi.nlm.nih.gov/35305251/

 

4) Elastic Intramedullary Nails in the Treatment of Pediatric Length Unstable Femur Fractures. https://pubmed.ncbi.nlm.nih.gov/35089881/

 

5) Are patients who return for 10-year follow-up after AIS surgery different from those who do not? https://pubmed.ncbi.nlm.nih.gov/35067897/

 

6) When successful, anterior vertebral body tethering (VBT) induces differential segmental growth of vertebrae: an in vivo study of 51 patients and 764 vertebrae. https://pubmed.ncbi.nlm.nih.gov/35064912/

 

7) Anterior vertebral body tethering for thoracic idiopathic scoliosis leads to asymmetric growth of the periapical vertebrae. https://pubmed.ncbi.nlm.nih.gov/34982419/

 

8) Distal adding-on in adolescent idiopathic scoliosis results in diminished health-related quality of life at 10 years following posterior spinal fusion. https://pubmed.ncbi.nlm.nih.gov/34822135/

 

9) Selecting the "Touched Vertebra" as the Lowest Instrumented Vertebra in Patients with Lenke Type-1 and 2 Curves: Radiographic Results After a Minimum 5-Year Follow-up. https://pubmed.ncbi.nlm.nih.gov/32804885/

 

10) Factors associated with increased back pain in primary thoracic adolescent idiopathic scoliosis 10 years after surgery. https://pubmed.ncbi.nlm.nih.gov/34251608/

 

11) Paraspinal muscle morphology and composition in adolescent idiopathic scoliosis: A histological analysis. https://pubmed.ncbi.nlm.nih.gov/34611591/

 

12) In Search of the Ever-Elusive Postoperative Shoulder Balance: Is the T2 UIV the Key? https://pubmed.ncbi.nlm.nih.gov/30348348/

 

13) Is Anterior Release Obsolete or Does It Play a Role in Contemporary Adolescent Idiopathic Scoliosis Surgery? A Matched Pair Analysis. https://pubmed.ncbi.nlm.nih.gov/31368923/

 

14) What is the effect of intraoperative traction on correction of adolescent idiopathic scoliosis (AIS)? https://pubmed.ncbi.nlm.nih.gov/34133013/

 

15) Intraoperative neuromonitoring practice patterns in spinal deformity surgery: a global survey of the Scoliosis Research Society. https://pubmed.ncbi.nlm.nih.gov/33230669/

 

 

 

 

 

 

Lit. Update with Brian Scannell

Brian Scannell from CMC discusses his research on pre-operative antibiotics for CRPP of supracondylar humerus fractures as well as the residency match process and resident education. We also highlight papers on toddler’s fractures, slip progression after in-situ SCFE pinning, and stem cell treatment for physeal injuries.

 

Your hosts are Julia Sanders from Children’s Hospital Colorado, Craig Louer from Vanderbilt, and Josh Holt from University of Iowa. Music by A. A. Aalto.

 

Citations for papers discussed:

 

Chen AF, Secrist ES, Scannell BP, Patt JC. Matching in Orthopaedic Surgery. J Am Acad Orthop Surg. 2020 Feb 15;28(4):135-144. doi: 10.5435/JAAOS-D-19-00313. PMID: 31567523.

 

Bloomer AK, Coe KM, Brandt AM, Roomian T, Brighton B, Scannell BP. Hold the Antibiotics: Are Preoperative Antibiotics Unnecessary in the Treatment of Pediatric Supracondylar Humerus Fractures? J Pediatr Orthop. 2022 Feb 24. doi: 10.1097/BPO.0000000000002118. Epub ahead of print. PMID: 35200212.

 

Fox J, Enriquez B, Bompadre V, Carlin K, Dales M. Observation Versus Cast Treatment of Toddler's Fractures. J Pediatr Orthop. 2022 Feb 18. doi: 10.1097/BPO.0000000000002086. Epub ahead of print. PMID: 35180728.

 

Makarewich CA, Wait ES, Fedorak GT, MacWilliams BA. Factors Affecting Slip Progression After In Situ Screw Fixation of Stable Slipped Capital Femoral Epiphysis. J Pediatr Orthop. 2022 Feb 24. doi: 10.1097/BPO.0000000000002098. Epub ahead of print. PMID: 35200211.

 

Wong KL, Zhang S, Heng Tan SS, Cheow YA, Lai RC, Lim SK, Po Hui JH, Toh WS. Mesenchymal Stem Cell Exosomes Promote Growth Plate Repair and Reduce Limb-Length Discrepancy in Young Rats. J Bone Joint Surg Am. 2022 Feb 17. doi: 10.2106/JBJS.21.00789. Epub ahead of print. PMID: 35175995.

Social Media Pearls & Pitfalls

Jennifer Weiss of Kaiser Permanente in Los Angeles, Dave Bennett of Phoenix Children's Hospital, and Matt Schmitz of San Antonio Military Medical Center are POSNA Social Media Ambassadors and join the show to share some pearls and pitfalls for Twitter, Instagram, Facebook, and other platforms (including lots of pointers for beginners!). Kaitlyn Petrando, POSNA's social media mastermind, also joins the episode to share some wisdom. Your hosts are Carter Clement from Children's Hospital of New Orleans, Phil Nowicki with Spectrum Health in Grand Rapids, Corinna Franklin of the Philadelphia Shriner's, and Craig Louer of Vanderbilt. Music by A.A. Aalto.

Lit. Update with Chuck Goldfarb & Chris Dy

Special guests and hosts of "The Upper Hand" Podcast, Dr. Charles Goldfarb and Dr. Chris Dy from Washington University in St. Louis, join the podcast crew for a wide-ranging discussion on upper extremity conditions and the role of information technology in modern orthopedic care.  We review a recent article from the Wash U group about thematic analysis of online message boards for congenital upper extremity differences. Our guests contribute their insights on elbow stiffness and nerve injuries following pediatric trauma, as well as thoughts on bruise location in supracondylar humerus fractures, treatment of Monteggia injuries, cost-consciousness in parents, nerve transfers for brachial plexus birth palsy, and predicting radial head dislocations in MHE. Hosts of the episode are Craig Louer from Vanderbilt, 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. Alto.

____________________________________________

Feb 2022 Podcast Session Notes:

Guests – Charles Goldfarb MD, Chris Dy MD MPH

Hosts – Craig Louer MD, Carter Clement MD MBA, Joshua Holt MD, Julia Sanders MD

 

Links:

pedsorthopodcast@gmail.com

Twitter: @CraigLouer

Twitter: @CarterClementMD

 

Upper Hand Podcast:

https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Dr. Goldfarb Blog: https://congenitalhand.wustl.edu/

Dr. Goldfarb Twitter: @CongenitalHand

Dr. Dy Twitter: @ChrisDyMD

 

Primary article:

Cogsil T, Kim DJ, Morris M, Goldfarb CA, Wall LB. Congenital Upper-Extremity Differences: A Thematic Analysis of On-Line Discussion Boards. J Hand Surg Am. 2021 Apr;46(4):337.e1-337.e10. doi: 10.1016/j.jhsa.2020.08.006. Epub 2020 Oct 3. PMID: 33023778.

 

Lightning Round:

Schultz JD, Rees AB, Wollenman LC, Lempert N, Moore-Lotridge SN, Schoenecker JG. Bruise Location in Supracondylar Humerus Fractures Predicts Specific Neurovascular Injuries. J Pediatr Orthop. 2021 Dec 20. doi: 10.1097/BPO.0000000000002027. Epub ahead of print. PMID: 34923508.

 

Lawrence, J. Todd R. MD, PhD*,†; MacAlpine, Elle M. BA*,‡; Buczek, Matthew J. MSEd*; Horn, B. David MD*,†; Williams, Brendan A. MD*,†; Manning, Kassidy BSc*; Shah, Apurva S. MD, MBA*,† Impact of Cost Information on Parental Decision Making: A Randomized Clinical Trial Evaluating Cast Versus Splint Selection for Pediatric Distal Radius Buckle Fractures, Journal of Pediatric Orthopaedics: January 2022 - Volume 42 - Issue 1 - p e15-e20

doi: 10.1097/BPO.0000000000001980

 

Kluemper, Chase MD*; Aversano, Mike MD†; Kozin, Scott MD†; Zlotolow, Dan A. MD*,† Long Thoracic Nerve Transfer for Children With Brachial Plexus Injuries, Journal of Pediatric Orthopaedics: July 2021 - Volume 41 - Issue 6 - p 374-378

doi: 10.1097/BPO.0000000000001774

 

Hart, Christopher M. MD*; Alswang, Jared BS†; Bram, Joshua BS‡; Kim, Samuel T. BA§; Arkader, Alexandre MD‡; Silva, Mauricio MD*,† Operative Versus Nonoperative Management of Acute Pediatric Monteggia Injuries With Complete Ulna Fractures, Journal of Pediatric Orthopaedics: August 2021 - Volume 41 - Issue 7 - p 412-416

doi: 10.1097/BPO.0000000000001868

 

Feldman, D. , Rand, T. , Deszczynski, J. , Albrewczynski, T. , Paley, D. & Huser, A. (2021). Prediction of Radial Head Subluxation and Dislocation in Patients with Multiple Hereditary Exostoses. The Journal of Bone and Joint Surgery, 103 (23), 2207-2214. doi: 10.2106/JBJS.20.02205.

 

JPOSNA Update II: Sports Medicine with JR Cruz

Dr. Aristides "JR" Cruz of Brown University returns to the podcast for a 2nd JPOSNA episode. This installment focuses on sports medicine (and you may also catch it on Peds Sports, which is available on all the same podcast platforms as Peds Ortho). Dr. Cruz serves as Deputy Editor of JPOSNA, and on today's episode, he shares his thoughts on 4 recent sports-related JPOSNA articles as well as some of his own techniques and clinical pearls. Your host is Carter Clement from Children’s Hospital of New Orleans. Music by A. A. Alto.

 

JPOSNA Publications Discussed:

 

Arthroscopic Saucerization and Repair of the Lateral Discoid Meniscus. JPOSNA. Nov 2021. https://www.jposna.org/ojs/index.php/jposna/article/view/373

 

The Bare Bones of Concussion: What the Sideline Orthopaedic Surgeon Needs to Know. JPOSNA. Nov 2021. https://www.jposna.org/ojs/index.php/jposna/article/view/320

 

Physical Exam for Sports Medicine Knee Injuries in Pediatric Patients. JPOSNA. Nov 2021. https://www.jposna.org/ojs/index.php/jposna/article/view/369

 

Youth Elbow Throwing Injuries. JPOSNA. Nov 2021. https://www.jposna.org/ojs/index.php/jposna/article/view/355