Controversies in the Management of Pediatric Musculoskeletal Infections: An International Viewpoint.

Pediatric musculoskeletal infections (MSIs) are a major contributor to the global burden of musculoskeletal disease in children and young adults. If untreated, or treated inappropriately or inadequately, pediatric bone and joint infections can be fatal or result in morbidity that causes significant functional disabilities to the patient and economic burden to the family and the community at large. The past decade has witnessed many advances in this field with respect to early diagnosis, management, and prevention of complications.

Fungal Osteomyelitis of the Proximal Tibial Epiphysis and Septic Arthritis Secondary to an Open Wound: A Case Report.

Case: A 9-year-old boy presented with a painful, swollen knee. He had a wound on the knee 2 months ago after a fall in contaminated water. At another hospital, this was treated with debridement twice, and the patient received several antibiotics.

Primary Fibular Osteomyelitis in Children: A Systematic Review.

Osteomyelitis of the fibula is rare and is especially rare in children. The published literature is limited to case series and is thus lacking a comprehensive description of the disease. The purpose of this systematic review is to provide the first comprehensive summary of the demographics, presenting symptoms, laboratory values, microbiology, and treatment results of osteomyelitis of the fibula in children based on the existing literature.

Submuscular nonlocking plates: an effective option for pediatric extra-articular proximal femur fractures.

The aim of this study is to evaluate the results of submuscular plating using nonlocking plates for extra-articular proximal femur fractures (EPFF) in children. From our hospital records, we retrieved data of 15 children treated with submuscular plating with nonlocking dynamic compression plates (DCP) for EPFF between January 2010 and September 2021. EPFF was defined as a proximal femur fracture within 10% of the femoral length below the lesser trochanter.

Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature.

Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births.

Acute Isolated Irreducible Proximal Interphalangeal Joint Dislocation of the Fifth Toe in a Toddler: A Case Report.

A male child aged three years and three months presented after stubbing his right fifth toe. Imaging revealed a dorsolateral dislocation of the proximal interphalangeal joint (PIPJ). After failed attempts at closed reduction, open reduction and internal fixation was pursued.

Progressive Ankle Subluxation Following Panfibular Osteomyelitis Requiring Fibular Resection.

A 10-month-old boy presented with fever, a swollen left leg, and septicemic shock. He was diagnosed with panfibular osteomyelitis. Failure of combined medical and surgical treatment to achieve source control necessitated fibular resection.

Lower Limb Alignment in Indian Children: A Radiographic Analysis of Coronal Plane Parameters.

Objectives: Indian children are known to have variations in the tibiofemoral angle as compared to children of other ethnicities. There is no study describing radiographic angles in coronal plane in Indian children. Our aim was to evaluate coronal plane alignment in Indian children.

Primary Bacterial Pyomyositis in Children: A Systematic Review.

Background: Tropical pyomyositis has had a recent increase in the United States, Europe, and other nontropical areas. The purpose of this study was to provide an accurate description of the demographics, presenting features, sites of involvement, microbiology, imaging modalities, medical and surgical management, complications, and predictors of clinical course.

Methods: We searched PubMed, Cochrane, Web of Science Collection, Scopus, and Embase databases yielding 156 studies.

Tension-Sided Femoral Neck Stress Fracture in an Adolescent with Vitamin D Deficiency and Osteomalacia: A Case Report.

Case: An adolescent girl presented with groin pain without any history of trauma. Imaging showed a tension-sided stress fracture of the femoral neck. Vitamin D deficiency (VDD), and raised alkaline phosphatase and parathyroid hormone levels were found.

Intraoperative Kirschner Wire Breakage in a Pediatric Supracondylar Humerus Fracture.

A displaced supracondylar humerus in a child is usually treated with closed reduction and percutaneous Kirschner (K)-wire fixation. The procedure is straightforward and usually yields excellent outcomes. In general, intraoperative complications are uncommon and intraoperative complications related to K-wires are exceedingly rare.

Prospective Study of Gross Motor Milestones in Children with Severe Idiopathic Clubfoot Treated by Ponseti Method.

Background: A prospective study of motor milestones achieved in severe clubfeet treated by Ponseti method and comparison between unilateral and bilateral clubfoot will help us gain further insight of motor milestones in these children.

Methods: Prospective study of 150 consecutive children with idiopathic clubfoot who were treated by Ponseti method and in whom percutaneous tendoachilles tenotomy was performed. The gross motor milestones recorded were: rolls from back to stomach, sitting without support, standing with assistance, walks with assistance, standing alone, walking alone.

Radiation Safety Knowledge and Practices: Is the Indian Orthopaedic Community Well-informed?

Background: In spite of frequent exposure to radiation, orthopaedic surgeons lack knowledge about radiation safety and do not comply with safety practices. We surveyed orthopaedic trainees and consultants in India to determine their knowledge and practices regarding radiation safety.

Methods: A questionnaire with 16 multiple choice questions was sent out using Google forms.

A Novel Technique for the Removal of Elastic Intramedullary Nail in Pediatric Long Bones: A Technical Note.

Elastic stable intramedullary nails have been commonly used to treat unstable long bone fractures in children. The nail tip at the insertion site can cause problems. The nail tip should be of optimal length as a prominent nail tip or a short nail tip, or both, may cause different sets of problems.

YouTube as an information source for clubfoot: a quality analysis of video content.

Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube.

Back pain and school bag weight - a study on Indian children and review of literature.

Back pain in children is a complex phenomenon, which has been shown to be associated with physical and psychosocial factors. None of the studies on Indian children have investigated the possible association between back pain and psychosocial factors. We decided to determine the prevalence of back pain in students and association with both physical and psychosocial factors.

Paediatric Salter-Harris type IV injury of distal tibia with talus fracture.

Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning.

A Case Report of an Unusual Case of Tuberculous Osteomyelitis Causing Spontaneous Pathological Fracture of Humerus in a Middle Aged Female.

Introduction: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement.

Atypical Presentation of Tuberculosis of Elbow Joint in Operated Case of Distal Humerus Fracture.

Introduction: A typical presentations of tuberculosis are not uncommon. Periprosthetic infection with tuberculosis after total joint replacement has well published. Tuberculosis of the elbow following open reduction internal fixation of a distal humerus fraeture is extremely rare.

Inter- and intra-observer reliability of measurement of pedicle screw breach assessed by postoperative CT scans.

Background: Pedicle screws are used increasingly in spine surgery. Concerns of complications associated with screw breach necessitates accurate pedicle screw placement. Postoperative CT imaging helps to detect screw malposition and assess its severity.

Interobserver variability using a commercially available system of archived digital radiography with integrated computer-assisted measurements for scoliosis Cobb angles.

Background: The purpose of this study was to determine if digital enhancements could improve upon published and interobserver variability for Cobb angle measurements of idiopathic scoliosis using a commercially available PACS system. The study also sought to determine if experience of the observer affected overall variability and to evaluate the time required to measure Cobb angles using 3 different techniques. As the decision for scoliosis treatment requires serial radiographic measurements by 1 or more observers at different times, precise landmark identification and curve measurement should decrease variability and improve accuracy.

Qualitative assessment of the challenges to the treatment of idiopathic clubfoot by the Ponseti method in urban India.

The Ponseti method of clubfoot treatment has been shown to be a very safe, effective and minimally invasive technique when performed in medical centers in Europe and North America. However, only a limited number of studies have helped identify the challenges for effective treatment with the Ponseti method in India. In this study a qualitative approach was used through distribution of questionnaires, personal interviews and focus groups with orthopedic surgeons (in urban centers) and parents of patients with clubfoot.

TC MDP bone scan in evaluation of painful scoliosis.

A 18-year-old male presented with low back ache. The patient was investigated and was diagnosed to have painful scoliosis. X-ray and other examinations could not reveal any diagnosis.

Triggered electromyography for placement of thoracic pedicle screws: is it reliable?

Reliable electromyography (EMG) thresholds for detecting medial breaches in the thoracic spine are lacking, and there is a paucity of reports evaluating this modality in patients with adolescent idiopathic scoliosis (AIS). This retrospective analysis evaluates the ability of triggered EMG to detect medial breaches with thoracic pedicle screws in patients with AIS. We reviewed 50 patients (937 pedicle screws) undergoing posterior spinal fusion (PSF) with intraoperative EMG testing.

Angular deformity in pediatric transtibial amputation stumps.

Introduction: Progressive angular deformity after surgical transtibial amputation in the pediatric population has not been described in the literature. Angular deformity in amputation stumps may lead to problems with pain and fitting of the prosthesis. The aim of this study was to evaluate the incidence and pattern of angular deformity and its treatment.