Inter-observer and intra-observer agreement in the radiographic diagnosis of avascular necrosis of the femoral head following slipped capital femoral epiphysis.

Introduction: Slipped capital femoral epiphysis (SCFE) is a common pediatric hip disorder. Avascular necrosis (AVN) of the femoral head is a devastating complication of SCFE. The frequency of this complication reported in the literature has been variable.

The effect of surgical timing on operative duration and quality of reduction in Type III supracondylar humeral fractures in children.

Purpose: To determine the influence of the time from injury to surgery of Type III supracondylar fractures on operative duration and quality of reduction.

Methods: A retrospective review of Type III supracondylar fractures treated by closed reduction and percutaneous pinning over a 3-year period was performed.

Results: The subjects were divided into two groups based on the time from injury to surgery (IST): Group 1 (<8 h) 48 subjects and Group 2 (>8 h) 39 subjects.

The epidemiology of nonaccidental trauma in children.

Background: Abuse of children is abhorrent in Western society and, yet, is not uncommon. Nonaccidental trauma (NAT) is the result of a complex sociopathology. Not all of the causative factors of NAT are known, many are incompletely described, not all function in each case, and many are secondary to preexisting pathology in other areas.

Outcome analysis of chance fractures of the skeletally immature spine.

Study Design: Observational.

Objective: The authors present a detailed description of 25 skeletally immature patients with Chance fractures with a mean follow-up of 6.4 years.

A clinicoradiologic study of the shoulder in Apert syndrome.

Unlabelled: To provide a comprehensive radiographic, clinical, and functional description of the shoulder in Apert syndrome.

Methods: A cohort of 9 Apert syndrome patients (ages, 9-27 years) followed at a tertiary care facility was included in this prospective study. Patients were clinically assessed with physical examination and completion of 2 validated functional assessment tools, the Shoulder Pain and Disability Index (SPADI) and American Academy of Orthopaedic Surgeons Pediatric Outcomes Data Collection Instrument (AAOS PODCI).

The mutant guppy syndrome curveback as a model for human heritable spinal curvature.

Study Design: This study investigated the morphology, pathogenesis, and inheritance of idiopathic-like spinal curvature in the guppy syndrome, curveback.

Objective: To determine whether curveback could be applied as a model for the primary factors that contribute to heritable spinal curvature in humans, specifically, the etiopathogenesis of human familial idiopathic scoliosis.

Summary Of Background Data: Although a genetic basis is accepted, phenotypic complexity and the lack of an animal model with noninduced curvature have made identification of idiopathic scoliosis etiology difficult.

Abdominal aortic injuries associated with chance fractures in pediatric patients.

Injury to the abdominal aortic artery from blunt trauma is an infrequent event with few cases reported in either the adult or the pediatric literature. Injury to the thoracic aorta after blunt abdominal trauma is more common. It has been estimated that 95% to 99% of all aortic disruptions are in the thoracic region.

The effect of interbody cage positioning on lumbosacral vertebral endplate failure in compression.

Study Design: A biomechanical investigation using a human cadaver, multisegmental lumbosacral spine model.

Objectives: To determine if 2 small, posterolaterally positioned titanium mesh interbody cages would provide superior construct strength and stiffness in compression compared to central cage placement. In addition, determine construct stiffness with interbody cages as opposed to an intact spine and assess the effect of bone mineral density (BMD).

Clinical usefulness of somatosensory evoked potentials for detection of brachial plexopathy secondary to malpositioning in scoliosis surgery.

Study Design: A retrospective longitudinal study of 434 consecutive pediatric patients who underwent surgical correction of scoliosis, while being monitored for positional brachial plexopathy.

Objective: To evaluate the effectiveness of intermittent monitoring of ulnar nerve somatosensory evoked potentials (SSEPs) for detecting brachial plexus injury caused by malpositioning during scoliosis surgery.

Summary Of Background Data: Continuous intraoperative SSEP monitoring for spinal cord function has been well reported, and is widely accepted as the standard for spinal deformity correction surgery to detect and avoid neurologic injury.

Sternal split approach to the cervicothoracic junction in children.

Study Design: We present a descriptive case series outlining the surgical technique and outcome in six patients managed with a combined anterior neck and sternal splitting approach.

Objectives: To describe a surgical approach used in the management of severe cervicothoracic kyphosis and/or scoliosis in pediatric patients.

Summary Of Background Data: There are few reports in the literature that address the problem of accessing multileveled spinal deformities around the cervicothoracic junction requiring stabilization in the pediatric population.

Treatment of idiopathic clubfoot utilizing botulinum A toxin: a new method and its short-term outcomes.

A pivotal point in most clubfoot management protocols is Achilles tendon lengthening or tenotomy to address hindfoot deformity. The effectiveness of botulinum A toxin (BTX-A) in attenuating the function of the triceps surae muscle complex as an alternative to tenotomy was investigated. Fifty-one patients with 73 idiopathic clubfeet were recruited.

Vertebral scalloping in neurofibromatosis type 1: a quantitative approach.

Objective: To investigate quantitative differences in vertebral scalloping between children who have scoliosis with and without neurofibromatosis type 1 (NF1).

Design: A retrospective study.

Setting: A university-affiliated children's hospital.

Intra-Operative Analysis of Scoliosis Surgery in 3-D.

Scoliosis is a three-dimensional deformity characterized by coronal, sagittal and axial rotation of the spine. Surgical fusion of the spine is required in severe cases. Assessment of the surgical procedure requires enough accuracy and flexibility to allow planning of individual interventions or implant designs.