Timely Surgical Intervention Leads to Better Sustained Coverage after Reconstructive Hip Surgery in Patients with Cerebral Palsy.

Background: In up to 45-90% of non-ambulatory patients with cerebral palsy (CP), progressive hip migration can be observed. The goal of this study was to determine whether the implementation of a national hip surveillance guideline affected the outcome of hip reconstructions.

Methods: We reviewed 48 primary hip reconstructions at a median follow-up of 4.

Effect of tranexamic acid on intraoperative blood loss in pediatric osteotomies around the hip: Study protocol for a double-blind randomized placebo-controlled trial.

Background: Proximal femoral and/or pelvic osteotomies (PFPOs) can be indicated for a multitude of hip pathologies in (often asymptomatic) children, to prevent future hip problems. These procedures can result in significant blood loss. Tranexamic acid (TXA) is an antifibrinolytic agent routinely administered in adult trauma and joint reconstruction surgery to reduce blood loss.

Current practices in the management of closed femoral shaft fractures in children: A nationwide survey among Dutch orthopaedic surgeons.

Background: There remains a lack of high-quality evidence on the treatment of pediatric femur shaft fractures. Therefore, treatment choices may still be based on personal preference of treating surgeons. To gain insight in considerations regarding treatment options, we conducted a survey among Dutch trauma and orthopedic surgeons.

The Predictive Value of Radiographs and the Pirani Score for Later Additional Surgery in Ponseti-Treated Idiopathic Clubfeet, an Observational Cohort Study.

There are few validated predictors of the need for additional surgery in idiopathic clubfeet treated according to the Ponseti method. Our aim was to examine if physical examination (Pirani score) and radiographs at the age of three months (after initial correction of the clubfeet) can predict the future need for additional surgery. In this retrospective cohort study, radiographs of idiopathic clubfeet were made at the age of three months.

Three-dimensional printing in paediatric orthopaedic surgery.

Three-dimensional (3D) printing is a rapidly evolving and promising field to improve outcomes of orthopaedic surgery. The use of patient-specific 3D-printed models is specifically interesting in paediatric orthopaedic surgery, as limb deformity corrections often require an individual 3D treatment. In this editorial, various operative applications of 3D printing in paediatric orthopaedic surgery are discussed.

Treatment of closed femoral shaft fractures in children aged 2-10 years: a systematic review and meta-analysis.

Objective: To review current literature on treatment of closed femoral shaft fractures in children of 2-10 years old, with subgroup analysis of children aged 2-6 years, comparing intramedullary nailing (IMN) to conservative treatment modalities.

Methods: We included clinical trials and observational studies that compared traction and subsequent casting (TSC), spica casting and IMN for treatment of femur shaft fractures in children of 2-10 years of age. Subgroup analysis of children aged 2-6 years was performed.

Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies.

Purpose: Proximal femoral and/or pelvic osteotomies (PFPO) are associated with significant blood loss, which can be harmful, especially in paediatric patients. Therefore, considering methods to reduce blood loss is important. The purpose of this study was to examine the efficacy of tranexamic acid (TXA) in reducing intraoperative estimated blood loss (EBL) in paediatric patients undergoing a PFPO.

Congenital Forearm Pseudarthrosis, a Systematic Review for a Treatment Algorithm on a Rare Condition.

Background: A congenital forearm pseudarthrosis is a rare condition and is strongly associated with neurofibromatosis type 1. Several surgical techniques are described in the literature, but the most optimal treatment strategy remains unclear. This systematic review aims to develop a treatment algorithm that may aid in clinical decision making.

Diagnosis and management in Pitt-Hopkins syndrome: First international consensus statement.

Pitt-Hopkins syndrome (PTHS) is a neurodevelopmental disorder characterized by intellectual disability, specific facial features, and marked autonomic nervous system dysfunction, especially with disturbances of regulating respiration and intestinal mobility. It is caused by variants in the transcription factor TCF4. Heterogeneity in the clinical and molecular diagnostic criteria and care practices has prompted a group of international experts to establish guidelines for diagnostics and care.

Screening program for neonates at risk for developmental dysplasia of the hip: comparing first radiographic evaluation at five months with the standard twelve week ultrasound. A prospective cross-sectional cohort study.

Purpose: To assess whether delayed radiological hip screening at five months (versus ultrasound at 3 months) results in a higher incidence of persistent developmental dysplasia of the hip (DDH) at 18 months.

Methods: We analyzed 3536 screened neonates (2009-2013) at age two to three weeks. In the case of risk factors for DDH, 460 infants were assigned to a pelvic radiograph at five months between 2009 and 2010 and 651 infants were assigned to an ultrasound at three months (2011-2013).

[Müller-Weiss disease: idiopathic avascular necrosis of the navicular bone].

Background: Müller-Weiss disease is a rare and complex foot disorder. The underlying aetiology of this condition involves abnormal loading of the navicular bone combined with delayed ossification. Müller-Weiss disease is progressive and ultimately results in deformation and fragmentation of the navicular bone with plantar-flexed hindfoot varus.

[A boy with a painful upper leg].

A 13-year-old boy came to the Emergency Department with a Salter Harris type 1 epiphysiolysis of the distal femur. These fractures can be treated with a closed reduction and possible fixation. They cause a growth disturbance in 65 % of dislocated cases and therefore should be clinically evaluated until skeletal maturity.

[A man with a dell over the symphysis pubica].

A 46-year-old man was referred to our emergency room after minimal trauma. He was diagnosed with symphysiolysis, which was based on a congenital variant instead of a traumatic injury.