ATV-Related Trauma in the Pediatric Population.

Background: All-terrain vehicles (ATVs) are prevalent in Appalachia and cause significant morbidity and mortality in the pediatric population. This study investigated the injury types and severity in pediatric patients over a 15-year period.

Methods: A retrospective chart review was performed on pediatric ATV-related traumas presenting to our institution from 2005 to 2020.

Surgical Outcomes of Obese Patients With Adolescent Idiopathic Scoliosis From Endemic Areas of Obesity in the United States.

Background: Obesity rates continue to rise among children and adolescents across the globe. A multicenter research consortium composed of institutions in the Southern US, located in states endemic for childhood obesity, was formed to evaluate the effect of obesity on pediatric musculoskeletal disorders. This study evaluates the effect of body mass index (BMI) percentile and socioeconomic status (SES) on surgical site infections (SSIs) and perioperative complications in patients with adolescent idiopathic scoliosis (AIS) treated with posterior spinal fusion (PSF).

Pain Medication Disposal Rates After Pediatric Surgery.

Objectives: To investigate prescription opiate usage, disposal rates, and methods of disposal after pediatric surgery.

Methods: This was a retrospective chart review of patients <18 years of age who underwent a surgical procedure at our institution and were given a postoperative opiate prescription between April 2017 and June 2018. A follow-up phone survey was conducted between 60 and 90 days postoperatively to ask about prescription opiate usage and disposal.

Electronic Medical Record Use and Satisfaction Among Pediatric Orthopaedic Surgeons.

Introduction: Electronic medical record (EMR) use among pediatric orthopaedic surgeons has evolved substantially within the past decade. In response to the Patient Protection and Affordable Care Act, large hospitals and tertiary pediatric medical centers rapidly acquired and implemented EMRs with uncertainty as to the potential impact on patient care and operational efficiency of subspecialists. This study reviews the background and regulatory framework for Meaningful Use of EMR and assesses the current landscape of EMR utilization by pediatric orthopaedic surgeons.

"Clinical triad" findings in pediatric Klippel-Feil patients.

Background: It has been propagated that patients with Klippel-Feil syndrome (KFS) exhibit "clinical triad" findings (CTFs), known as a short neck, low posterior hairline, and limited cervical range of motion (ROM). However, the literature has noted that up to 50 % of KFS cases may not present with such findings and the reasoning behind such assertions remains speculative. As such, the following study addressed the association between CTFs to that of congenitally-fused cervical segments and other risk factors in KFS patients.

Type of bone graft or substitute does not affect outcome of spine fusion with instrumentation for adolescent idiopathic scoliosis.

Study Design: Retrospective cohort analysis.

Objective: To compare clinical outcomes after spine instrumentation and fusion using 3 different bone grafts in children with adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Autogenous iliac crest bone graft (AIC) is the "gold standard" to promote fusion in posterior AIS operations, although the morbidity of harvest is a concern.

Cervical scoliosis in the Klippel-Feil patient.

Study Design: Retrospective study.

Objective: This study addressed in patients with Klippel-Feil syndrome (KFS), the role of congenitally fused cervical patterns, risk factors, and cervical symptoms associated with cervical scoliosis.

Summary Of Background Data: KFS is an uncommon condition, characterized as improper segmentation of one or more cervical spine segments with or without associated spinal or extraspinal manifestations.

Instrumentation constructs in pediatric patients undergoing deformity correction correlated with Scoliosis Research Society scores.

Study Design: Data collected prospectively from the Prospective Pediatric Scoliosis Study (PPSS) were analyzed statistically to address the hypothesis that covered specific aspects of treatment and its outcome.

Objective: To assess and contrast Scoliosis Research Society (SRS) outcome scores for patients assigned to one of three types of spinal instrumentation constructs. The study hypothesis was that the instrumentation strategy that provides the best curve correction will be associated with the best SRS scores.

Convex hemiepiphysiodesis: the limits of vertebral stapling.

Study Design: We performed a retrospective chart review of patients with nonadolescent idiopathic scoliosis who underwent open vertebral stapling for treatment of spinal deformity.

Objective: The objective of this study was to determine the efficacy of vertebral stapling in patients with scoliosis. Measurements included initial deformity correction and maintenance of correction.

Patient self-assessment of appearance is improved more by all pedicle screw than by hybrid constructs in surgical treatment of adolescent idiopathic scoliosis.

Study Design: A multicenter prospective cohort study.

Objective: To compare the effect of all pedicle screw versus hybrid constructs on patient self-assessment of appearance after posterior spinal fusion with instrumentation for adolescent idiopathic scoliosis (AIS). This will contribute to future cost-effective analyses on surgical management of AIS.

Use and outcome of MRI in the surgical treatment of adolescent idiopathic scoliosis.

Study Design: Multicenter, prospective, consecutive clinical series. OBJECTIVE.: To report on the use and outcomes of preoperative magnetic resonance imaging (MRI) in a prospective cohort study of 2206 children undergoing posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis.

Community-associated methicillin-resistant Staphylococcus aureus in acute musculoskeletal infection in children: a game changer.

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a virulent pathogen responsible for an increasing number of invasive musculoskeletal infections in healthy children. The purpose of this study is to characterize the presentation, clinical course, treatment, complications, and long-term morbidity of CA-MRSA musculoskeletal infection in children.

Methods: A retrospective study of children with CA-MRSA musculoskeletal infections from 2 institutions was conducted.

Pediatric lateral condyle humeral fractures with and without associated elbow dislocations: a retrospective study.

In the pediatric population, lateral condyle fractures are relatively common elbow injuries, but not nearly as common are traumatic elbow dislocations, and these 2 types of injuries in combination are even less common. Our literature search showed only 2 reports on these concomitant injuries. In the study reported here, we evaluated a consecutive series of pediatric patients with lateral humeral condyle fractures with and without elbow dislocation and compared the groups' results.

Fractures and amputations in children and adolescents requiring hospitalization after farm equipment injuries.

Background: The majority of farm-related injuries in children are caused by farm machinery. The aim of this study is to report the incidence of children requiring hospitalization for orthopaedic trauma after injury secondary to farm equipment accidents.

Methods: Data for this study were culled from the Kids' Inpatient Database for the years 2000, 2003, and 2006 using the E-code for injuries caused by agricultural machinery to identify the study group.

Adult outcomes following amputation or lengthening for fibular deficiency.

Background: Fibular deficiency results in a small, unstable foot and ankle as well as a limb-length discrepancy. The purpose of this study was to assess outcomes in adults who, as children, had had amputation or limb-lengthening, commonly used treatments for fibular deficiency.

Methods: Retrospective review of existing data collected since 1950 at six pediatric orthopaedic centers identified 248 patients with fibular deficiency who were twenty-one years of age or older at the time of the review.

The extent of fusion within the congenital Klippel-Feil segment.

Study Design: Retrospective radiographic review.

Objective: To evaluate in patients with Klippel-Feil syndrome (KFS) the presence and extent of specific fusion patterns across involved cervical segments and their association with age-specific parameters.

Summary Of Background Data: While the radiographic hallmark of KFS is characterized by congenital fusion of at least one cervical motion segment, the relation between age and the extent of segmental congenital fusion remains speculative.

2008 Young Investigator Award: The role of congenitally fused cervical segments upon the space available for the cord and associated symptoms in Klippel-Feil patients.

Study Design: A prospective radiographic and retrospective clinical chart review.

Objective: This study evaluated the role of congenitally fused cervical segments in relation to the space available for the cord (SAC) and associated cervical spine-related symptoms (CSS) in patients with Klippel-Feil Syndrome (KFS).

Summary Of Background Data: KFS is a developmental disorder presenting with congenital fusion of at least 2 cervical vertebrae.

Sprengel's deformity in Klippel-Feil syndrome.

Study Design: A retrospective study.

Objectives: To address the role of congenitally fused cervical segments, the degree of cervical scoliosis, and other risk factors on the presence of Sprengel's deformity (SD) in young patients with Klippel-Feil syndrome (KFS).

Summary Of Background Data: Numerous abnormalities are associated with KFS, one of the most common being SD.