Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-422
B. Striano, D. Talwar, J. Flynn, B. Williams, Stuart L. Mitchell, Apurva S. Shah
Background: 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. children’s hospitals by hospital treatment volume and ranking. Secondarily, we investigated costs associated with ORPP and closed reduction and percutaneous pinning (CRPP). Methods: The Pediatric Health Information System (PHIS), a database of U.S. children’s hospitals, was queried for patients 3-10 years treated with ORPP or CRPP for closed SCH fractures from 2010-2014. Pediatric orthopaedic hospital rankings were collected from U.S. News and World Report . To account for differences in patient population, hospital ORPP rates were adjusted for patient characteristics. Analysis then assayed the effect of hospital treatment and ranking on cost of care and likelihood to treat with ORPP. Results: 28,100 patients were treated at 42 pediatric hospitals. 26,465 (94.2%) SCH fractures underwent CRPP and 1,635 (5.8%
{"title":"High-Volume Hospitals Have Lower Open Reduction Rates and Lower Cost of Care for Pediatric Supracondylar Humerus Fractures","authors":"B. Striano, D. Talwar, J. Flynn, B. Williams, Stuart L. Mitchell, Apurva S. Shah","doi":"10.55275/jposna-2023-422","DOIUrl":"https://doi.org/10.55275/jposna-2023-422","url":null,"abstract":"Background: 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. children’s hospitals by hospital treatment volume and ranking. Secondarily, we investigated costs associated with ORPP and closed reduction and percutaneous pinning (CRPP). Methods: The Pediatric Health Information System (PHIS), a database of U.S. children’s hospitals, was queried for patients 3-10 years treated with ORPP or CRPP for closed SCH fractures from 2010-2014. Pediatric orthopaedic hospital rankings were collected from U.S. News and World Report . To account for differences in patient population, hospital ORPP rates were adjusted for patient characteristics. Analysis then assayed the effect of hospital treatment and ranking on cost of care and likelihood to treat with ORPP. Results: 28,100 patients were treated at 42 pediatric hospitals. 26,465 (94.2%) SCH fractures underwent CRPP and 1,635 (5.8%","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116468764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-575
Tristen N. Taylor, Callie S. Bridges, E. Ezeokoli, Tyler S. Smith, Nicole I. Montgomery
Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare aseptic autoinflammatory disease with a wide and vague clinical presentation that often mimics infection, malignancy, or benign conditions, leading to a delayed diagnosis. We aimed to evaluate the clinical characteristics, differential diagnoses from evaluating pediatric orthopaedic surgeons, and compared the number of patients that could have avoided a biopsy in 80 patients with CRMO. Methods: Children diagnosed with CRMO at a single tertiary pediatric hospital in the United States between 2012 and 2022 who were evaluated by a pediatric orthopaedic surgeon were retrospectively reviewed. The differential diagnoses from the surgeons were recorded from their initial presentation. The Jansson criteria and Bristol Criteria were retrospectively applied to evaluate patients who could have been spared a biopsy. Results: 80 children (65% female) with CRMO were identified. The mean age at diagnosis was 10.28 ± 3.52 years, follow-up of 37.13 ± 27.67 months, and delay in diagnosis of 6.21 ± 9.75 months. Common presenting symptoms were antalgic gait (
{"title":"Retrospective Review of 80 Patients with Chronic Recurrent Multifocal Osteomyelitis Evaluated by Pediatric Orthopaedic Surgeons","authors":"Tristen N. Taylor, Callie S. Bridges, E. Ezeokoli, Tyler S. Smith, Nicole I. Montgomery","doi":"10.55275/jposna-2023-575","DOIUrl":"https://doi.org/10.55275/jposna-2023-575","url":null,"abstract":"Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare aseptic autoinflammatory disease with a wide and vague clinical presentation that often mimics infection, malignancy, or benign conditions, leading to a delayed diagnosis. We aimed to evaluate the clinical characteristics, differential diagnoses from evaluating pediatric orthopaedic surgeons, and compared the number of patients that could have avoided a biopsy in 80 patients with CRMO. Methods: Children diagnosed with CRMO at a single tertiary pediatric hospital in the United States between 2012 and 2022 who were evaluated by a pediatric orthopaedic surgeon were retrospectively reviewed. The differential diagnoses from the surgeons were recorded from their initial presentation. The Jansson criteria and Bristol Criteria were retrospectively applied to evaluate patients who could have been spared a biopsy. Results: 80 children (65% female) with CRMO were identified. The mean age at diagnosis was 10.28 ± 3.52 years, follow-up of 37.13 ± 27.67 months, and delay in diagnosis of 6.21 ± 9.75 months. Common presenting symptoms were antalgic gait (","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133212178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-658
C. Vuillermin, Matthew W. Konigsberg
Postoperative Immobilization and Occupational Therapy The patient was immobilized for a total of 12 weeks postoperatively, and this course was split into 4-week intervals. For the first 4 weeks, the patient remained in a long arm cast in supination. For the second 4-week interval, she was transitioned into a long arm thermoplastic splint which was to be worn at all times except while at occupational therapy. Eight weeks postoperatively, the patient was transitioned to a below elbow thermoplastic splint to be worn during the day for 4 more weeks, wearing the above elbow splint at night. Nighttime splinting continued for 12 months postoperatively.
{"title":"Tutorial on the Treatment of the Upper Extremity in Cerebral Palsy: Patient Outcome","authors":"C. Vuillermin, Matthew W. Konigsberg","doi":"10.55275/jposna-2023-658","DOIUrl":"https://doi.org/10.55275/jposna-2023-658","url":null,"abstract":"Postoperative Immobilization and Occupational Therapy The patient was immobilized for a total of 12 weeks postoperatively, and this course was split into 4-week intervals. For the first 4 weeks, the patient remained in a long arm cast in supination. For the second 4-week interval, she was transitioned into a long arm thermoplastic splint which was to be worn at all times except while at occupational therapy. Eight weeks postoperatively, the patient was transitioned to a below elbow thermoplastic splint to be worn during the day for 4 more weeks, wearing the above elbow splint at night. Nighttime splinting continued for 12 months postoperatively.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115628365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-502
K. Sborov, Kelly L Vittetoe, Teresa Benvenuti, M. Benvenuti, Kirsten E. Ross, G. Mencio, Jeffrey A. Mencio, Jeffrey E. Martus, M. Danko, J. Schoenecker, Stephanie N. Moore-Lotridge, Craig R. Louer Jr.
Background: Motor vehicle crashes (MVC) cause variable injury to the thoracolumbar (
背景:机动车碰撞(MVC)对胸腰椎造成不同程度的损伤(
{"title":"Thoracolumbar Injury Classification and Severity Scale Can Help Identify Intra-Abdominal Injury in Children Injured in an MVC","authors":"K. Sborov, Kelly L Vittetoe, Teresa Benvenuti, M. Benvenuti, Kirsten E. Ross, G. Mencio, Jeffrey A. Mencio, Jeffrey E. Martus, M. Danko, J. Schoenecker, Stephanie N. Moore-Lotridge, Craig R. Louer Jr.","doi":"10.55275/jposna-2023-502","DOIUrl":"https://doi.org/10.55275/jposna-2023-502","url":null,"abstract":"Background: Motor vehicle crashes (MVC) cause variable injury to the thoracolumbar (","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116615911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-621
Walter Truong
{"title":"Reviewer Profile","authors":"Walter Truong","doi":"10.55275/jposna-2023-621","DOIUrl":"https://doi.org/10.55275/jposna-2023-621","url":null,"abstract":"","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129506607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-632
V. Prusick, R. Muchow
Lateral condyle fractures are the second most common elbow fracture in pediatric patients. Unlike supracondylar humerus fractures, these injuries involve the articular surface and present unique challenges. These injuries are graded based on the degree of displacement and this dictates your treatment. Both closed and open techniques are appropriate depending on the degree of displacement. Our preferred technique for open reduction and internal fixation is described and illustrated in the accompanying video
{"title":"Open Reduction and Pinning of Lateral Condyle Fractures","authors":"V. Prusick, R. Muchow","doi":"10.55275/jposna-2023-632","DOIUrl":"https://doi.org/10.55275/jposna-2023-632","url":null,"abstract":"Lateral condyle fractures are the second most common elbow fracture in pediatric patients. Unlike supracondylar humerus fractures, these injuries involve the articular surface and present unique challenges. These injuries are graded based on the degree of displacement and this dictates your treatment. Both closed and open techniques are appropriate depending on the degree of displacement. Our preferred technique for open reduction and internal fixation is described and illustrated in the accompanying video","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127712250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-580
Arin E. Kim, H. Chi, K. Niknam, I. Swarup
,
，
{"title":"Management of Pediatric Proximal Humerus Fractures","authors":"Arin E. Kim, H. Chi, K. Niknam, I. Swarup","doi":"10.55275/jposna-2023-580","DOIUrl":"https://doi.org/10.55275/jposna-2023-580","url":null,"abstract":",","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127043146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-619
Maike van Niekerk, Kali R. Tileston, Maryse Bouchard, M. Christino, R. Goldstein, George D. Gantsoudes, Cordelia Carter, A. Atanda
Background: Burnout is characterized by depersonalization, emotional exhaustion, and low personal achievement. Occupational demands can lead to burnout in orthopaedic surgeons, negatively impacting patients and surgeons alike. A high-level overview of burnout is lacking; we therefore aimed to conduct an umbrella review (i
{"title":"A Comprehensive Umbrella Review for Understanding Burnout in Orthopaedic Surgery","authors":"Maike van Niekerk, Kali R. Tileston, Maryse Bouchard, M. Christino, R. Goldstein, George D. Gantsoudes, Cordelia Carter, A. Atanda","doi":"10.55275/jposna-2023-619","DOIUrl":"https://doi.org/10.55275/jposna-2023-619","url":null,"abstract":"Background: Burnout is characterized by depersonalization, emotional exhaustion, and low personal achievement. Occupational demands can lead to burnout in orthopaedic surgeons, negatively impacting patients and surgeons alike. A high-level overview of burnout is lacking; we therefore aimed to conduct an umbrella review (i","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130996753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-620
Maike van Niekerk, Kali R. Tileston, Maryse Bouchard, A. Atanda, R. Goldstein, George D. Gantsoudes, Cordelia Carter, M. Christino
Burnout is characterized by feelings of depersonalization, emotional exhaustion
倦怠的特征是人格解体，情绪衰竭
{"title":"System-Level Interventions for Addressing Burnout and Improving Professional Wellness for Orthopaedic Surgeons","authors":"Maike van Niekerk, Kali R. Tileston, Maryse Bouchard, A. Atanda, R. Goldstein, George D. Gantsoudes, Cordelia Carter, M. Christino","doi":"10.55275/jposna-2023-620","DOIUrl":"https://doi.org/10.55275/jposna-2023-620","url":null,"abstract":"Burnout is characterized by feelings of depersonalization, emotional exhaustion","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121969812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-23DOI: 10.55275/jposna-2023-627
C. Iobst, N. Ferreira, S. Kold
Hexapod external fixators, allowing for multiaxial deformity correction and fracture treatment, have been on the market for more than 25 years. The recent increase in the number of hexapod circular external fixators establishes the need for an easy-to-access overview of the different systems. An overview of the current options is provided, and a comparison is made of seven common hexapod circular external fixators. Highlights of each system’s hardware, software, and educational opportunities are provided. The information collected from the manufacturers of each system was carefully and objectively edited to fit the structure of the review without including any additional subjective comments or recommendations. The authors believe that the development of multiple systems has had a positive effect on this technology. Only two clinical retrospective studies were found comparing the results of different systems, and there seems to be a clear opportunity for collaborative, multi-center comparative studies. The authors recommend choosing one hexapod system that feels comfortable and fits patient demands prior to pursuing mastering several systems.
{"title":"A Review and Comparison of Hexapod External Fixators","authors":"C. Iobst, N. Ferreira, S. Kold","doi":"10.55275/jposna-2023-627","DOIUrl":"https://doi.org/10.55275/jposna-2023-627","url":null,"abstract":"Hexapod external fixators, allowing for multiaxial deformity correction and fracture treatment, have been on the market for more than 25 years. The recent increase in the number of hexapod circular external fixators establishes the need for an easy-to-access overview of the different systems. An overview of the current options is provided, and a comparison is made of seven common hexapod circular external fixators. Highlights of each system’s hardware, software, and educational opportunities are provided. The information collected from the manufacturers of each system was carefully and objectively edited to fit the structure of the review without including any additional subjective comments or recommendations. The authors believe that the development of multiple systems has had a positive effect on this technology. Only two clinical retrospective studies were found comparing the results of different systems, and there seems to be a clear opportunity for collaborative, multi-center comparative studies. The authors recommend choosing one hexapod system that feels comfortable and fits patient demands prior to pursuing mastering several systems.","PeriodicalId":412478,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127488781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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