Fixation Strategy Does Not Affect Risk of Growth Disturbance After Surgical Treatment of Pediatric Tibial Spine Fracture.

Purpose: To characterize growth abnormalities after surgical treatment of tibial spine fractures and to investigate risk factors for these abnormalities.

Methods: A retrospective analysis of children who underwent treatment of tibial spine fractures between January 2000 and January 2019 was performed, drawing from a multicenter cohort among 10 tertiary care children's hospitals. The entire cohort of surgically treated tibial spine fractures was analyzed for incidence and risk factors of growth disturbance.

Patient and Disease Related Risk Factors Associated With Return to Sport Rates After AVN Treatment.

Background: Avascular necrosis (AVN) is a rare albeit serious condition that has a high risk for long term morbidity given the risk of chronic pain and arthroplasty after diagnoses. The recent rise in sports participation in the pediatric population demonstrates the importance of evaluating functional limitations after AVN treatment. Return to sport (RTS) rates after treatment for AVN have not been evaluated in pediatric or adolescent populations.

Does Insurance Status Affect Treatment of Children With Tibial Spine Fractures?

Background: Previous studies have reported disparities in orthopaedic care resulting from demographic factors, including insurance status. However, the effect of insurance on pediatric tibial spine fractures (TSFs), an uncommon but significant injury, is unknown.

Purpose: To assess the effect of insurance status on the evaluation and treatment of TSFs in children and adolescents.

A Comparison of Nonoperative and Operative Treatment of Type 2 Tibial Spine Fractures.

Background: Tibial spine fractures (TSFs) are typically treated nonoperatively when nondisplaced and operatively when completely displaced. However, it is unclear whether displaced but hinged (type 2) TSFs should be treated operatively or nonoperatively.

Purpose: To compare operative versus nonoperative treatment of type 2 TSFs in terms of overall complication rate, ligamentous laxity, knee range of motion, and rate of subsequent operation.

Complications and Controversies in the Management of 5 Common Pediatric Sports Injuries.

Growing participation in sports among children, along with increasingly intense training regimens, has contributed to an increasing rate of sports-related injuries. Despite the similarities to adult sports injuries, pediatric patients have distinctive injury patterns because of the growing physis and therefore necessitate unique treatment algorithms. Caring for these injured children requires in-depth knowledge of not only pediatric injury patterns, but also the scope of age-specific treatments, the associated complications, and the controversies.

Tibial Spine Fractures: How Much Are We Missing Without Pretreatment Advanced Imaging? A Multicenter Study.

Background: There is a high rate of concomitant injuries reported in pediatric patients with tibial spine fractures, ranging from 40% to 68.8%. Many tibial spine fractures are treated without initial magnetic resonance imaging (MRI).

Four Risk Factors for Arthrofibrosis in Tibial Spine Fractures: A National 10-Site Multicenter Study.

Background: Tibial spine fractures (TSFs) are relatively rare pediatric injuries. Postoperative arthrofibrosis remains the most common complication, with few studies having examined factors associated with its development.

Purpose: To identify risk factors for arthrofibrosis and required MUA or lysis of adhesions in the largest known cohort of patients with TSFs.

Do Year-Out Programs Make Medical Students More Competitive Candidates for Orthopedic Surgery Residencies?

Objective: As orthopedic surgery residency programs are becoming more competitive, medical students interested in orthopedics are increasingly completing "year-out" programs. This study sought to evaluate student and faculty perceptions of these programs.

Design: A survey evaluating baseline characteristics was disseminated to directors of year-out programs identified through postings on the orthopedics forum, Orthogate.

Analysis of Outcomes in Living Donor Liver Transplants Involving Reconstructive Microsurgeons.

Background:  Living donor transplantation is becoming increasingly popular as a modality for patients necessitating liver transplantation. Hepatic artery thrombosis (HAT) remains the most feared acute postoperative complication associated with living-donor liver transplantation. Preoperative planning, including scheduling reconstructive microsurgeons to perform the hepatic artery anastomosis using a surgical microscope or loupes, can decrease HAT rates.

Lawnmower Injuries in Children: A National 13-Year Study of Urban Versus Rural Injuries.

Introduction: Although the American Academy of Orthopaedic Surgery, American Academy of Pediatrics, and Pediatric Orthopedic Society of North America have established lawnmower safety guidelines, a notable number of injuries continue to occur. We sought to elaborate on the epidemiology of lawnmower injuries in the pediatric age group and compare urban versus rural injuries.

Methods: The Pediatric Health Information System database was queried for patients of 1 to 18 years of age from 2005 to 2017 who presented with a lawnmower injury.

Pediatric Type II Tibial Spine Fractures: Addressing the Treatment Controversy With a Mixed-Effects Model.

Background: Tibial spine fractures, although relatively rare, account for a substantial proportion of pediatric knee injuries with effusions and can have significant complications. Meyers and McKeever type II fractures are displaced anteriorly with an intact posterior hinge. Whether this subtype of pediatric tibial spine fracture should be treated operatively or nonoperatively remains controversial.

MR imaging of the shoulder in youth baseball players: Anatomy, pathophysiology, and treatment.

With an increasing participation in youth sports and a growing popularity of overhead sports, shoulder pain and injuries are common in pediatric baseball players. In contrast to traumatic and collision injuries, which are more frequent with high-impact sports, many of the shoulder injuries are the result of repetitive overuse. Undiagnosed and untreated injury to the growth plates of skeletally immature athletes can lead to remodeling, which can negatively impact the biomechanics of the shoulder and produce long-term morbidity.

Pediatric ACL Tears: Natural History.

Background: Increased participation in youth sports is associated with increased rates of anterior cruciate ligament (ACL) tears in the skeletally immature. Historically, ACL reconstruction was avoided in the skeletally immature, or delayed until skeletal maturity, to avoid physeal injury and growth disturbance. Current practices and meta-analyses support early ACL reconstruction in some groups, to allow for return to activities and to avoid delayed cartilage/meniscus injury.

Mechanical and Microstructural Properties of Native Pediatric Posterior Cruciate and Collateral Ligaments.

Background: Although anterior cruciate ligament (ACL) tears have received the most attention, the medial collateral ligament (MCL) is thought to be the most commonly injured knee ligament overall. The lateral collateral ligament (LCL) and posterior collateral ligament (PCL) are less frequently compromised but can be involved in severe multiligament injuries. The paucity of information on the native properties of these ligaments in the pediatric population hinders the overall optimization of treatment for these injuries.

Mechanical and Microstructural Properties of Pediatric Anterior Cruciate Ligaments and Autograft Tendons Used for Reconstruction.

Background: Over the past several decades, there has been a steady increase in pediatric anterior cruciate ligament (ACL) tears, particularly in young female basketball and soccer players. Because allograft tissue for pediatric ACL reconstruction (ACLR) has shown high rates of failure, autograft tissue may be the best option for ACLR in this population. However, differences in the structure and mechanical behavior of these tissues are not clear.

The Utility of Pulmonary Function Testing in Patients Presenting With Dysphonia.

Objective: We aimed to evaluate the utility of pulmonary function testing (PFT), particularly forced expiratory flow (FEF) 25-75%, in patients presenting with dysphonia.

Study Design: A retrospective chart review was carried out.

Methods: Records of 199 patients who presented with dysphonia were reviewed to determine whether in-office PFTs, which we perform routinely, lead to new pulmonary diagnoses or the need for additional pulmonary medications, after assessment by a pulmonologist.