Loss of Reduction in Pediatric Distal Radius Fractures: Risk Factors From a Prospective Multicenter Registry.

Objectives: Despite numerous single-center studies, uncertainty regarding the management of unstable pediatric distal radius fractures persists. The purpose of this investigation was to report patient factors and fracture characteristics that influence loss of reduction (LOR) or need for secondary procedures following closed reduction of pediatric distal radius fractures in a large, prospective multicenter cohort.

Methods: Children aged 4-18 years old undergoing closed reduction for a displaced distal radius fracture were identified from the multicenter Pediatric Distal Radius Fracture (PDRF) Registry.

Changes in mental health problems and access to mental health care among US adolescents before and during the COVID-19 pandemic: results from the national survey of children's health.

Objectives: The increase in mental health problems among adolescents is a vital public health issue in the United States. It is crucial to understand how this concerning trend was exacerbated by the COVID-19 pandemic. Using a national representative sample, we assessed the impact of COVID-19 on mental health and access to mental health care access among adolescents.

How Does Anterior Vertebral Body Tethering Compare to Posterior Spinal Fusion for Thoracic Idiopathic Scoliosis? A Nonrandomized Clinical Trial.

Background: Recently, there has been an increased interest in alternative surgical options for treating idiopathic scoliosis. For instance, anterior vertebral body tethering (AVBT) is an emerging surgical solution used in lieu of posterior spinal fusion (PSF). This technology has been gaining in popularity because of its potential benefits of preservation of spinal growth, motion, and functional activity.

Defining the Impact of Short-Term Surgical Education Courses in Low- and Middle-Income Countries: A Systematic Review.

Objective: There is a high burden of surgical disease in low- and middle-income countries (LMICs). One approach for improving surgical service delivery in LMICs is education of health professionals, including short-term education courses. The goal of this review is to evaluate short-term education courses in terms of content, evaluation, and impact.

Can a New, Satellite Inpatient Hospital Maintain the Efficiency of an Ambulatory Surgery Center with No Difference in Patient-reported Outcomes? A Prospective Study.

Background: Previous research has found that anterior cruciate ligament (ACL) reconstructions performed at ambulatory surgery centers (ASCs) are more time-efficient. However, recent literature investigating this phenomenon within the pediatric population is limited and primarily retrospective. The goal of this study was to prospectively compare the operating room (OR) efficiency of pediatric ACL reconstructions performed across different surgical settings.

Nerve Recovery in Pediatric Supracondylar Humeral Fractures: Assessing the Impact of Time to Surgery.

Background: Nerve injuries in pediatric supracondylar humeral (SCH) fractures occur in 2% to 35% of patients. Previous research has suggested that isolated anterior interosseous nerve injuries are not influenced by the time to surgery; however, little is known about other nerve injuries or mixed, motor, and sensory injuries. With this study, we aimed to examine the impact of time to surgery on nerve recovery in patients with traumatic nerve injuries associated with SCH fractures.

Predicting Blood Loss in Aneurysmal Bone Cyst Surgery.

Background: Preoperative estimation of intraoperative blood loss is essential for its management and literature is lacking with respect to factors influencing blood loss in aneurysmal bone cysts (ABC) surgery. The purpose of this study is to identify risk factors and predictors for blood loss in ABC surgery.

Methods: An IRB-approved retrospective review was performed from 2011 to 2021 at a pediatric tertiary care center.

Who is the PROM King? Patient-reported Outcome Measures in Pediatric Musculoskeletal Oncology: A Systematic Review.

Background: Patient-reported outcome measures (PROMs) are important companions to traditional, physician-reported measures. The purpose of this study was to systematically review and identify PROMs used in pediatric musculoskeletal oncology and evaluate these instruments.

Methods: A systematic literature review was conducted for studies pertaining to pediatric musculoskeletal tumors from 2010 to 2024.

An Assessment of Mental Health Challenges of Lesbian, Gay, Bisexual, and Transgender College Students during the COVID-19 Pandemic.

Introduction: Collegiate mental health continues to be a worrisome public health concern among college students in the U.S. The unprecedented COVID-19 pandemic has caused an upward trend of mental health crises, especially among lesbian, gay, bisexual, and transgender (LGBTQ+) college students.

A Neglected Fracture: Treatment and Infection of Seymour Fractures of the Hallux in the Pediatric Population.

Introduction: Seymour physeal fractures of the distal phalanx of the Hallux in children are common but rarely described in the literature. There is limited literature investigating how these fractures should be specifically treated. Generally, good results are reported when open fractures are treated with debridement and antibiotics.

High-Volume Hospitals Have Lower Open Reduction Rates and Lower Cost of Care for Pediatric Supracondylar Humerus Fractures.

Open reduction and percutaneous pinning (ORPP) of pediatric supracondylar humerus (SCH) fractures is associated with increased morbidity compared to closed reduction. This investigation sought to assess variation in ORPP rates among U.S.

New Classification for Pediatric Proximal Fifth Metatarsal Fractures.

Proximal fifth metatarsal fractures are the most common foot fractures in children. Attempts to classify these injuries are misapplied and inadequately predict outcomes. This is the first study to identify factors associated with healing in pediatric fifth metatarsal fractures.

Opioid Analgesia Compared with Non-Opioid Analgesia After Operative Treatment for Pediatric Supracondylar Humeral Fractures: Results from a Prospective Multicenter Trial.

Background: Minimal pain and opioid use after operative treatment for pediatric supracondylar humeral fractures have been previously described; however, opioid-prescribing practices in the United States remain variable. We hypothesized that children without an opioid prescription would report similar postoperative pain compared with children prescribed opioids following closed reduction and percutaneous pinning (CRPP) of supracondylar humeral fractures.

Methods: Children who were 3 to 12 years of age and were undergoing CRPP for a closed supracondylar humeral fracture were prospectively enrolled in a multicenter, comparative study.

Has Sustained Time Away From Sports Due to the COVID-19 Pandemic Led to Increased Sport-Related Soft Tissue Injuries?

Background: A decrease in sport-related injuries was observed in 2020, which has been attributed to COVID-19 and recommendations to suspend organized sports. In adult populations, increased injury rates have been noted in athletes returning to play after an extended period of reduced play, attributable to deconditioning. There is growing literature surrounding concern over increased injury risk after return to sport after the COVID-19 shutdowns.

Pediatric Diving-Related Injuries in Swimming Pools Presenting to US Emergency Departments: 2008-2020.

Objectives: Recreational swimming/diving is among the most common physical activities in US children and a significant cause of morbidity across the United States. This study updates the national epidemiology of diving-related injuries.

Methods: The Consumer Product Safety Commission's National Electronic Injury Surveillance System database was queried for patients aged 0 to 19 from 2008 to 2020 who presented to any of the 100 National Electronic Injury Surveillance System-participating emergency departments for a diving-related injury.

A Corresponding Point Measurement System Provides Reliable Measurement of Displacement for Medial Epicondyle Fractures.

Unlabelled: Little consensus exists on the best method for evaluation and management of pediatric medial epicondyle fractures because of an inability to reliably evaluate fracture displacement with standard imaging techniques. This study aimed to determine the performance of various radiographic views in evaluating displaced medial epicondyle fractures when using a standardized measurement methodology.

Methods: Ten fellowship-trained pediatric orthopaedic surgeons assessed fracture displacement in 6 patients with displaced medial epicondyle fractures using radiographic views (anteroposterior, lateral, axial, internal oblique [IO], and external oblique [EO]) and computed tomographic (CT) views (axial, 3-dimensional [3D] horizontal, and 3D vertical).

Patient and Disease Related Risk Factors Associated With Return to Sport Rates After AVN Treatment.

Background: Avascular necrosis (AVN) is a rare albeit serious condition that has a high risk for long term morbidity given the risk of chronic pain and arthroplasty after diagnoses. The recent rise in sports participation in the pediatric population demonstrates the importance of evaluating functional limitations after AVN treatment. Return to sport (RTS) rates after treatment for AVN have not been evaluated in pediatric or adolescent populations.

Getting the Message: The Declining Trend in Opioid Prescribing for Minor Orthopaedic Injuries in Children and Adolescents.

Background: Opioids constitute the fastest-growing drug problem among children and adolescents in the United States. Recent heavy media coverage on the opioid prescription epidemic has garnered increased attention from prescribers and policymakers. The purpose of this study was to analyze trends in opioid prescribing for nonoperatively managed pediatric fractures and dislocations in order to examine changes in opioid-prescribing patterns across various U.

A Comparison of Motorized and Nonmotorized Scooter Injuries in Pediatric Patients Seen in US Emergency Departments.

Objectives: We sought to characterize and compare trends in pediatric injuries sustained on motorized and nonmotorized scooters across the United States, to assess the use of safety equipment in children presenting with scooter-related injuries, and provide strategies for injury prevention.

Methods: The National Electronic Injury Surveillance System was queried for motorized and nonmotorized scooter-related pediatric injuries from 2014 to 2018 in patients ages 6 to 12 years. Patient demographics, diagnosis, injury location, and narrative of the incident were collected.

Pediatric Softball Injuries Presenting to Emergency Departments.

Introduction: This study sought to characterize the mechanisms of injury responsible for common softball-related injuries in recent years.

Methods: The National Electronic Injury Surveillance System database was queried for all pediatric softball-related injuries presenting to participating US emergency departments from 2010 to 2019. Patients were classified by age as children (7-12 years), adolescents (13-18 years), or young adults (19-21 years).

Flexible Flat Foot, Short Tendo-Achilles, and Altered Gait.

Background Pediatric patients often present with vague complaints involving the anterolateral foot and ankle, the medial knee, the lower back, and the hip. In our experience, closer examination of these patients reveals a constellation of symptoms that involve pathology in the ankle, knee, back, and hip. This study aimed to detail the identification and treatment of patients with the triad of flexible flat feet, tight Achilles complex, and altered gait, and their clinical course over time.

Trends in Pediatric Anterior Cruciate Ligament Reconstruction: The Effect of COVID-19.

Context: The number of pediatric anterior cruciate ligament reconstructions (ACLRs) occurring yearly increased almost 6-fold from 2004-2014. We find it interesting that limited recent data exist on rates of ACL injury and reconstruction in children and adolescents, especially in the context of COVID-19.

Objective: Given the effect of the COVID-19 pandemic on youth sports seasons and the postponement of many elective surgeries, we sought to examine the changes in rates of ACLR during this period.

Trends in pediatric baseball and softball injuries presenting to emergency departments.

Background: Millions of youth participate in baseball and softball in the United States and these youth account for a large number of pediatric sports injuries. This study sought to characterize annual, seasonal, and age-related trends in pediatric softball and baseball injuries presenting to the Emergency Department (ED).

Methods: The National Electronic Injury Surveillance System (NEISS) database was retrospectively examined for all softball and baseball injuries from 2010 to 2019 involving pediatric patients aged 7-21 years.

Reliability and Validity of an MRI-Based Knee Sagittal Alignment Measure in a Pediatric Cohort.

Background: Magnetic resonance imaging (MRI) sagittal alignment is a measure that has been described and validated in the adult population as a means of distinguishing normal knees from those with anterior cruciate ligament (ACL) injury, but this measure has not been formally assessed among pediatric patients. The purpose of this study was to (1) assess the reliability of this MRI-based measure in a pediatric cohort, and (2) validate its ability to distinguish between ACL and non-ACL-injured knees in this population.

Methods: A consecutive series of knee MRI examinations performed at our center were reviewed to identify studies of pediatric patients (1) with ACL injury, and (2) without significant pathology.

Perioperative Pain Management Practices Vary Across Time and Setting for Pediatric ACL Reconstruction: Trends From a National Database in the United States.

Background: Surgical and anesthetic techniques have enabled a shift to the ambulatory setting for the majority of patients with anterior cruciate ligament (ACL) tears. While this change likely reflects improvements in acute pain management, little is known about national trends in pediatric perioperative pain management after ACL reconstruction (ACLR).

Purpose: To describe recent trends in the United States in perioperative pain management for pediatric ACLR.