Journal of pediatric orthopedics
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Spinal muscle atrophy (SMA) is a progressive neuromuscular disease predominantly presenting in infancy and early childhood. Scoliosis is the most common spinal deformity in these patients and treatment in SMA patients is controversial. Treatment is usually definitive fusion. The purpose of this study is to evaluate a novel growing rod technique used to treat more involved children with SMA types I and II with scoliosis at an earlier age. ⋯ Growing rod construct is an effective option in the treatment of scoliosis in SMA patients with scoliosis.
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Comparative Study
A prospective study on the effectiveness of cotton versus waterproof cast padding in maintaining the reduction of pediatric distal forearm fractures.
Distal forearm fractures, one of the most common fractures seen in the pediatric population, are regularly treated by closed reduction and casting. Our study investigates the effectiveness of Gore-Tex-lined casting in maintaining the reduction of 100% displaced distal forearm fractures compared with traditional cotton-lined casts. ⋯ Therapeutic level II.
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Forearm shaft fractures are the third most common fracture in children. Although closed reduction and casting is the preferred treatment; outcomes remain variable. The purpose of this study was to identify factors associated with failure of nonoperative treatment for pediatric complete forearm shaft fractures and to explore the time frame in which failure is likely. ⋯ Prognostic Level II.
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The primary goals of spinal deformity surgery are to prevent the progression of further deformity and to improve sagittal and coronal balance. Although increasingly powerful instrumentation has greatly facilitated these treatment goals, osteotomy of the spine is sometimes necessary to address more significant deformity. This review provides a detailed overview of posterior spinal osteotomies, which have gained increased attention as an adjunct to the treatment of complex pediatric spine deformity. The indications, operative technique, and advantages and disadvantages of the Smith-Petersen, pedicle subtraction and vertebral column resection osteotomies will be discussed, as well as operative considerations generally applicable to spinal deformity surgery involving correction with osteotomies.
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Supracondylar humeral fractures are the most common elbow fractures in children. In case of displacement and instability, the standard procedure is closed reduction and percutaneous Kirschner wire fixation. As Kirschner wire fixation requires postoperative cast immobilization, does not allow early mobilization, and is associated with the risk of damage of the ulnar nerve, innovative techniques should be evaluated. Therefore, the aim of the study was to assess both radiologic and functional outcome of supracondylar humeral fractures treated by elastic stable intramedullary nailing (ESIN) in a large pediatric cohort. ⋯ IV.