A Genetic Test Predicts Providence Brace Success for Adolescent Idiopathic Scoliosis When Failure Is Defined as Progression to >45 Degrees.

Study Design: Retrospective cohort.

Objective: To determine whether a genetic test is associated with successful Providence bracing for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Genetic factors have been defined that predict the risk of progression of AIS in a polygenic fashion.

Clinical and radiographic outcomes of supracondylar humerus fractures treated surgically by pediatric and non-pediatric orthopedic surgeons.

Purpose: This study compares clinical and radiographic outcomes of operatively managed pediatric supracondylar humerus fractures between patients treated by pediatric orthopedists (POs) and patients treated by non-pediatric orthopedists (NPOs).

Patients And Methods: A retrospective cohort study of pediatric patients with surgically managed supracondylar humerus fractures was conducted. For clinical outcomes analyses, 3 months of clinical follow-up were required, resulting in a sample size of 90 patients (33 treated by NPOs, 57 by POs).

Effectiveness of Providence nighttime bracing in patients with adolescent idiopathic scoliosis.

Interest has increased in adolescent idiopathic scoliosis braces that are worn only part time. One such brace, the Providence brace, is being used with increasing frequency despite limited literature evaluating its ability to alter the natural course of disease. The authors retrospectively identified 34 patients meeting modified Scoliosis Research Society (SRS) inclusion criteria who were treated with the Providence brace.

Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases.

Purpose: To describe outcomes after surgical management of pediatric elbow dislocation with incarceration of the medial epicondyle.

Methods: We conducted a retrospective case review of 11 consecutive children and adolescents with an incarcerated medial epicondyle fracture after elbow dislocation. All patients underwent open reduction internal fixation using a similar technique.

Distal rectus femoris intramuscular lengthening for the correction of stiff-knee gait in children with cerebral palsy.

Purpose: To evaluate the effects of rectus femoris intramuscular lengthening, a novel procedure to treat stiff-knee gait in ambulatory patients with cerebral palsy, using preoperative and postoperative 3-dimensional gait analysis.

Methods: This study was a retrospective data review of ambulatory patients with a diagnosis of cerebral palsy who had undergone rectus femoris intramuscular lengthening. The indications for rectus femoris intramuscular lengthening were identical to those of rectus femoris transfer.

Direct intraosseous pressure monitoring of the femoral head during surgery for slipped capital femoral epiphysis.

Preventing avascular necrosis following surgical management of pediatric slipped capital femoral epiphysis is a critical goal. The direct intraosseous pressure monitor is a readily available and affordable technique that can easily be used by surgeons around the world.

Kinematic and kinetic outcomes after identical multilevel soft tissue surgery in children with cerebral palsy.

This study evaluates the outcomes of multilevel soft tissue surgery in 31 ambulatory children (n = 39 sides) with cerebral palsy. All children had undergone rectus femoris transfer, hamstring lengthening, and gastrosoleus lengthening for the purpose of correcting sagittal plane abnormalities. There were no simultaneous bony surgeries.

Optimization of walking ability of children with cerebral palsy.

A new paradigm based on an appreciation of the biomechanics of normal and pathologic gait and a better understanding of muscle-tendon unit anatomy and physiology has emerged for orthopaedic clinical decision making to optimize the ambulatory abilities of children with cerebral palsy. This quantitative, biomechanically based approach has been accepted as a research and teaching tool and as an instrument of outcome assessment; however, controversy remains concerning the expense of using this approach and about its accuracy and repeatability. This paradigm is used within a diagnostic matrix consisting of five data sources.

Natural progression of gait in children with cerebral palsy.

Twenty-eight children with cerebral palsy had two gait analyses an average of 4.4 years apart with no surgical intervention between the tests. The effects of growth and age were examined using three-dimensional kinematics, temporal and stride parameters, and clinical examination measures.