Urinary tract infections in pediatric orthopedic surgical patients: a Single Institution National Surgical Quality Improvement Program Study.

Objective: Perioperative urinary tract infections (UTIs) are poorly studied among pediatric orthopedic surgical patients. We evaluated the incidence of and risk factors for UTI in a large volume of pediatric orthopedic surgical patients.

Methods: Children <18 who underwent orthopedic surgery between March 2015 and December 2018 were analyzed using our institution's National Surgical Quality Improvement Program (NSQIP) data.

New Injury Patterns in Pediatric Supracondylar Fractures During COVID-19: Beds Are the New Monkey Bars.

Background: The coronavirus disease 2019 (COVID-19) pandemic drastically altered children's activity patterns. Our goal was to investigate how COVID-19 affected demographics, injury characteristics, treatment patterns, follow-up, and outcomes in pediatric supracondylar humerus (SCH) fractures.

Methods: This was an Institutional Review Board-approved retrospective analysis of patients undergoing surgery for a SCH fracture from May to November 2019 (pre-COVID-19) and from May to November 2020 (during COVID-19) at 2 tertiary children's hospitals.

Use of Digital Tomosynthesis in Assessing Accurate Medial Epicondyle Fracture Displacement as Compared With Conventional Radiography and Computed Tomography.

Introduction: Medial epicondyle fracture displacement is notoriously difficult to determine on conventional radiography, and follow-up computed tomography (CT) is often obtained to measure precise displacement. Another option for fracture characterization is digital tomosynthesis (DT), a technology providing high in-plane resolution of bony anatomy by acquiring multiple low-dose images in a linear arc. Advantages of DT include lower radiation exposure and lower cost than CT, rapid image acquisition, and a similar patient experience to conventional radiography.

The Prevalence of Bullying Among Pediatric Orthopaedic Patients.

Background: Bullying is destructive and pervasive. Although the literature suggests children with chronic health conditions are at higher risk of being bullied, there is minimal research regarding the prevalence of bullying among children with orthopaedic conditions. Our study aimed to assess the prevalence of bullying among pediatric orthopaedic outpatients and evaluate the association of orthopaedic conditions and use of orthopaedic devices with perceptions of bullying.

Orthopedic Injuries Associated with Hoverboard Use in Children: A Multi-center Analysis.

Background: Since its release in 2015, the hoverboard has been associated with injuries in children and adolescents. However, its public health implications have yet to be explored in the orthopedic literature across multiple centers.

Purpose/questions: We sought to assess the nature of orthopedic injuries and the use of clinical resources related to the hoverboard at four high-volume, regional pediatric hospitals.

Improved diagnostic confidence and accuracy of pediatric elbow fractures with digital tomosynthesis.

Background: Pediatric elbow fractures are common but remain challenging to accurately diagnose. Digital tomosynthesis is a technique that has shown promise in difficult adult fracture patterns but has not been formally studied in the pediatric population.

Objective: To assess the added value of digital tomosynthesis on the detection and diagnostic confidence of pediatric elbow fractures.

Digital tomosynthesis of the pediatric elbow.

Imaging pediatric elbow trauma in the acute setting remains diagnostically challenging given difficult patient positioning, multiple ossification centers of the pediatric elbow, overlapping structures, and complex joint anatomy. Digital tomosynthesis is a technique where the X-ray source travels across a limited arc angle, obtaining a series of low-dose exposures that are in turn digitally reconstructed to produce high in-plane resolution at a relatively low overall radiation dose. Digital tomosynthesis is now more commonly integrated into standard radiographic machines and offers a new and exciting way to assess the pediatric elbow.

Wash, Rinse, Repeat: Which Patients Undergo Serial Joint Irrigation in Pediatric Septic Hip Arthritis?

Background: The purpose of this study is to identify risk factors associated with repeat surgical irrigation in pediatric septic hip arthritis.

Methods: A single center retrospective case-control study was performed. Patients who underwent ≥2 washouts (cases) were compared with those who had only 1 washout (controls).

Radiographic Evaluation of First Metatarsal and Medial Cuneiform Morphology in Juvenile Hallux Valgus.

Background: Operative treatment of juvenile hallux valgus (JHV) has a high recurrence rate. The aim of this study was to better understand the pattern of radiographic deformity.

Methods: Standing radiographs of 93 feet in 57 patients with JHV, and 50 feet in 36 normal patients were measured.

Pediatric Acute Compartment Syndrome.

Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS.

Does Weather Matter? The Effect of Weather Patterns and Temporal Factors on Pediatric Orthopedic Trauma Volume.

Objectives: Orthopaedists often speculate how weather and school schedule may influence pediatric orthopedic trauma volume, but few studies have examined this. This study aims to determine: how do weather patterns, day, month, season and public school schedule influence the daily frequency of pediatric orthopedic trauma consults and admissions?

Methods: With IRB approval, orthopedic trauma data from a level 1 pediatric trauma center, including number of daily orthopedic trauma consults and admissions, were collected from July 2009 to March 2012. Historical weather data (high temperatures, precipitation and hours of daylight), along with local public school schedule data were collected for the same time period.

Acute Exertional Compartment Syndrome in Young Athletes: A Descriptive Case Series and Review of the Literature.

Objectives: Acute exertional compartment syndrome (AECS) is a rare presentation of acute compartment syndrome (ACS) after exertion without injury. Unfamiliarity with this entity can lead to delay in diagnosis. The purpose of this study was to increase awareness of AECS and illustrate the morbidities associated with delayed diagnosis.

Parasol Rib Deformity in Hypotonic Neuromuscular Scoliosis: A New Radiographical Definition and a Comparison of Short-term Treatment Outcomes With VEPTR and Growing Rods.

Study Design: Retrospective review of 2 multicenter national databases, Growing Spine Study Group and Chest Wall and Spine Deformity.

Objective: To derive an objective measure of parasol rib deformity from spine radiographs and to compare efficacy of rib-based (vertical expandable prosthetic titanium rib (VEPTR)) versus spine-based growing rods ("GR") instrumentation to improve parasol rib deformity and pulmonary function.

Summary Of Background Data: Children with low tone neuromuscular scoliosis often develop collapse of the rib cage ("parasol rib deformity") that may be associated with poor pulmonary function.

Pediatric Nonfracture Acute Compartment Syndrome: A Review of 39 Cases.

Background: Compartment syndrome in the absence of fracture is rare and poorly described within the pediatric literature. The purpose of this study was to report the varying etiologies, risk factors, and treatment outcomes associated with pediatric nonfracture acute compartment syndrome (NFACS).

Methods: We conducted a retrospective chart review on 37 children who suffered a NFACS and were treated at a single pediatric trauma center between 1997 and 2013.