Journal of pediatric orthopedics. Part B
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The management of pediatric patients with complex spinal deformity often requires both an orthopedic and a neurosurgical intervention. The reasons for multiple subspecialty involvement include, but are not limited to, the presence of a tethered cord requiring release or a syrinx requiring decompression. It has been common practice to perform these procedures in a staged manner, although there is little evidence in the literature to support separate interventions. ⋯ One patient developed a sore associated with postoperative cast immobilization that led to a deep wound infection. It appears that concurrent orthopedic and neurosurgical procedures in pediatric patients with significant spinal deformities can be performed safely and with minimal intraoperative and postoperative complications when utilizing modern surgical and neuromonitoring techniques. Level of evidence=Level IV.
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Quantity of citation is often used as a surrogate measurement of an article's importance or relevance in a given field. To date, there has been no study on citation quantity or density in pediatric orthopedics. We present such an analysis. ⋯ We describe the top 50 articles in pediatric orthopedics by citation and citation density. The level of evidence for highly cited papers was low. Although many of these articles were written by the great thinkers of our field, a need exists for more rigorous methodology.
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Over the last 40 years, anatomic reduction with plate stabilization has become the standard in adult patients with diaphyseal fractures of the radius and ulna. When operative fixation has been indicated in skeletally immature patients with these fractures, a variety of techniques have been reported, with intramedullary fixation becoming increasingly accepted. There is currently significant variability in the treatment of adolescents with forearm fractures. ⋯ Only three major complications occurred, two refractures and one ulnar hardware migration, and subsequent radius nonunion occurred in the one grade 3b injury. Flexible intramedullary nailing of both bone forearm fractures provides reliable bony union and excellent postoperative clinical results in adolescents. Level of evidence, IV.
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Pigmented villonodular synovitis is a rare condition in children. We report a case of a 7-year-old girl with pigmented villonodular synovitis in her left hip. The diagnosis was confirmed with an arthroscopic hip biopsy. ⋯ There was, however, joint space narrowing in the affected hip. In addition, there was early closure of the proximal femoral epiphysis in the affected limb, leading to a discrepancy in leg length. This case report suggests that pigmented villonodular synovitis should be considered in children with a painful hip.