Pediatric Lateral Condyle Fractures With Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries.

Introduction: Lateral condyle fractures are the second most common pediatric elbow fracture and are at risk for malunion, nonunion or avascular necrosis. The Song or Jakob classification guides management and risk of complications. However, many lateral condyle fractures have accompanying bony or soft tissue injuries, including elbow dislocations, which are not represented in the current Song or Jakob classification systems.

Research Fellowships for Unmatched Orthopaedic Applicants: What Can They Expect?

Introduction: Unmatched orthopaedic surgery applicants often pursue research fellowships to strengthen their residency applications. The aims of this study were to (1) report the trend of the number of orthopaedic research fellowships offered online between 2019 and 2024, (2) describe the characteristics of research fellowships available to unmatched applicants, and (3) assess the quality of support received by unmatched applicants who complete research fellowships.

Methods: An online orthopaedic forum was retrospectively reviewed to identify job postings for medical student research fellowships in the 2019 to 2020 and 2024 to 2025 academic years.

A Survey of Post-Graduate Satisfaction With Orthopaedic Residency Training at a Single Institution.

Background: The Accreditation Council for Graduate Medical Education (ACGME) has called for self-study within residency programs. Post-graduate surveys allow the graduate to reflect upon their residency experience after years of autonomous practice. Despite their potential utility, a standardized assessment of residency training from the perspective of orthopaedic alumni does not exist.

The Thoracolumbar Injury Classification and Severity Score Appropriately Predicts Treatment in Children Aged 10 and Under.

Study Design: Retrospective cohort study.

Objective: This study aims to assess the validity of the Thoracolumbar Injury Classification and Severity Score (TLICS) in patients ≤10 years-old.

Summary Of Background Data: TLICS is a validated measure developed to help facilitate clinical decision-making regarding thoracolumbar spinal trauma in adults.

Growth modulation response in vertebral body tethering depends primarily on magnitude of concave vertebral body growth.

Purpose: There is variability in clinical outcomes with vertebral body tethering (VBT) partly due to a limited understanding of the growth modulation (GM) response. We used the largest sample of patients with 3D spine reconstructions to characterize the vertebra and disc morphologic changes that accompany growth modulation during the first two years following VBT.

Methods: A multicenter registry was used to identify idiopathic scoliosis patients who underwent VBT with 2 years of follow-up.

Analysis of three-dimensional spine growth for vertebral body tethering patients at 2 and 5 years post operatively.

Purpose: Scoliosis can be treated with vertebral body tethering (VBT) as a motion-sparing procedure. However, the knowledge of how growth is affected by a tether spanning multiple levels is unclear in the literature. Three-dimensional true spine length (3D-TSL) is a validated assessment technique that accounts for the shape of the spine in both the coronal and sagittal planes.

Information exchange on adolescent scoliosis discussion forums among patients and caregivers: a thematic analysis.

Purpose: Online health-related support groups have increasingly become a regular resource for patients and caregivers; however, the content of these forums is largely unknown to medical teams. The purposes of this study were to (1) review posts from scoliosis discussion forums to establish common themes related to the care experience of patients with scoliosis and (2) understand how common themes vary among pediatric and adult patients, as well as caregivers.

Methods: Posts were collected from two public scoliosis forums.

Orthopaedic Surgery Subspecialty Podcast Effectively Disseminates Peer-reviewed Articles Relative to Traditional Online Publishing.

Background: Podcasts have become increasingly utilized in medical education over the past decade, especially in orthopaedic surgery. Compared with more traditional learning tools, podcasts are easily accessible, free, and capable of use while multitasking. Despite these apparent benefits, the effectiveness of podcasts as a dissemination tool for emerging peer-reviewed literature is not well understood.

Flexibility-tilt agreement best predicts shoulder balance following posterior spine fusion for adolescent idiopathic scoliosis.

Purpose: We propose a novel concept, called flexibility-tilt agreement (FTA), which could be applied intra-operatively to improve shoulder balance following posterior spine fusion for Adolescent Idiopathic Scoliosis (AIS). We retrospectively applied this concept to a cohort with thoracic-only curves, seeking to: (1) evaluate the impact of FTA and other peri-operative variables on post-operative shoulder balance, and (2) evaluate deformity characteristics associated with achieving FTA.

Methods: A single-institution registry was queried for patients undergoing PSF from 2000 to 2017 with main thoracic and double thoracic curves with at least 2-year follow-up.

Clinical and radiographic outcomes following correction of idiopathic scoliosis in adolescence vs young adulthood.

Purpose: The natural history of adolescent idiopathic scoliosis (AIS) has been well documented, but the impact of age at the time of surgical correction is relatively understudied. In this study, we matched patients undergoing surgical correction of adult idiopathic scoliosis (AdIS) with a cohort of AIS patients to compare: (1) coronal and sagittal radiographic correction, (2) operative variables, and (3) postoperative complications.

Methods: A single-institution scoliosis registry was queried for patients undergoing idiopathic scoliosis surgery from 2000-2017.

Intraoperative Antibiotic Use in Patients With Early-onset Scoliosis: Current Practices and Trends.

Background: Best Practice Guidelines (BPGs) regarding antibiotic prophylaxis in early-onset scoliosis (EOS) patients were published in September 2019. Recommendations included using intravenous cefazolin and topical vancomycin for all index procedures, plus gram-negative coverage for neuromuscular patients. Guideline adherence is unknown.

Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosis.

Purpose: To assess the reliability of vertebral height and angular measurements for anterior vertebral body tethering (AVBT).

Methods: Eight observers measured PA radiographs of 15 idiopathic scoliosis patients treated with AVBT, pre-operative and 4-year follow-up. Vertebral wedging, disc wedging, convex vertebral body heights, and concave vertebral body heights of the 3 apical vertebrae were measured.

Nonaccidental Trauma in Pediatric Elbow Fractures: When You Should Be Worried.

Background: Nonaccidental trauma (NAT) is a rising source of morbidity and mortality in the pediatric population. Fractures are often the first cause for presentation to health care providers in the case of NAT but can be misidentified as accidental. Given that elbow fractures are the most common accidental injuries among pediatric patients, they are not traditionally associated with NAT.

Complications With Surgical Treatment of Pediatric Supracondylar Humerus Fractures: Does Surgeon Training Matter?

Introduction: National trends reveal increased transfers to referral hospitals for surgical management of pediatric supracondylar humerus (SCH) fractures. This is partly because of the belief that pediatric orthopaedic surgeons (POs) deliver improved outcomes compared with nonpediatric orthopaedic surgeons (NPOs). We compared early outcomes of surgically treated SCH fractures between POs and NPOs at a single center where both groups manage these fractures.

When Is a Growth-friendly Strategy Warranted? A Matched Comparison of Growing Rods Versus Primary Posterior Spinal Fusion in Juveniles With Early-onset Scoliosis.

Background: In 7 to 11-year-old juveniles with severe early-onset scoliosis (EOS) the optimal surgical option remains uncertain. This study compares growing rods (GRs) followed by definitive posterior spinal fusion (PSF) versus primary PSF in this population. We hypothesized that the thoracic height afforded by GRs would be offset by increased rigidity, more complications, and more operations.

Elastic Stable Intramedullary Nailing of Pediatric Tibial Fractures.

Background: Most pediatric tibial shaft fractures (75%) can be treated nonoperatively; however, unstable and open fractures require surgical intervention. Titanium elastic nails have become a popular technique for fixation of pediatric tibial shaft fractures. They act as internal splints that impart relative stability to the fracture, promoting callus formation at the fracture site.

Principles of Amputation Surgery, Prosthetics, and Rehabilitation in Children.

Pediatric patients may benefit from extremity amputations with potential prosthetic fitting when addressing limb deficiencies, trauma, infection, limb ischemia, or other pathologies. The performance of a quality amputation is a fundamental skill to an orthopaedic surgeon, yet avoidance of pitfalls can be elusive in children. The need for surgical precision and sound decision-making is amplified in pediatric amputations, where the skeleton is dynamic and growing, anatomy can be miniscule and (in the case of congenital anomalies) variable.

Comparison of Staged Versus Same-day Bilateral Hip Surgery in Nonambulatory Children With Cerebral Palsy.

Background: Bilateral hip reconstructions with osteotomies are commonly required in patients with severe cerebral palsy (CP) and dysplasia. These procedures can be performed by staging each hip surgery, separated by weeks to months, or by addressing both hips in a single-event surgery. The optimal timing of such surgery is yet to be determined.

Predicting epiphyseal stability of slipped capital femoral epiphysis with preoperative CT imaging.

Background: We analyzed preoperative CT scans of hips with slipped capital femoral epiphysis (SCFE) for characteristics that could be predictive of intraoperative epiphyseal stability and developed a set of imaging criteria for stable and unstable SCFE. We then compared this grading system with the Loder classification.

Methods: We reviewed preoperative CT imaging to develop a SCFE stability classification system.

Ten-Year Outcomes of Selective Fusions for Adolescent Idiopathic Scoliosis.

Background: Selective fusions of the structural curve remain a common treatment strategy for adolescent idiopathic scoliosis, yet long-term outcomes are not well-understood. The purpose of this study was to report 10-year prospective radiographic and patient-rated outcomes of selective fusions of the main thoracic (MT) or thoracolumbar/lumbar (TL/L) curve, with particular attention to the behavior of the uninstrumented, compensatory curve.

Methods: A prospectively collected multicenter database was used to identify patients who had been followed regularly for least 10 years after a selective MT or TL/L fusion for adolescent idiopathic scoliosis.

Impaired Annulus Fibrosus Development and Vertebral Fusion Cause Severe Scoliosis in Mice with Deficiency of c-Jun NH2-Terminal Kinases 1 and 2.

Mitogen-activated protein kinases, including c-Jun NH2-terminal kinase (JNK), play an important role in the development and function of a large variety of tissues. The skeletal phenotype of JNK1 and JNK2 double-knockout (dKO) mice (JNK1Col2-Cre/JNK2) and control genotypes were analyzed at different embryonic and postnatal stages. JNK1/2 dKO mice displayed a severe scoliotic phenotype beginning during development that was grossly apparent around weaning age.