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Special Issue "Research in Paediatric Orthopaedic Surgery"

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Orthopedics".

Deadline for manuscript submissions: closed (10 November 2023) | Viewed by 5708

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Special Issue Editors

Dr. Tomas Novotny

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Guest Editor

Department of Orthopaedics, University J.E. Purkyne, Masaryk Hospital, Usti nad Labem, Czech Republic
Interests: paediatric orthopaedics; soft tissue research (clubfoot, Dupuytren, scars); motion analysis; musculoskeletal ultrasound

Prof. Dr. Randall T. Loder

E-Mail Website
Guest Editor

Department of Orthopaedic Surgery, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, IN, USA
Interests: pediatric orthopaedic surgery; pediatric trauma/fractures; hip dysplasia

Special Issue Information

Dear Colleagues,

Paediatric orthopaedics has seen remarkable advancement in knowledge in recent decades, which has been further coupled with the considerable worldwide enthusiasm of researchers in this medical field. This research has resulted in new information about the aetiology, progression, diagnostics, and therapy of many paediatric musculoskeletal disorders.

Novel technical options and solutions have allowed us to gain knowledge about ultrastructural tissue composition in various paediatric deformities, such as clubfoot, and brought us one step closer to discovering the origin of these diseases. These findings will hopefully enable us to base new therapeutic approaches on cellular and tissue engineering in the future.

Three-dimensional printing and computer navigation allow us to perform surgical procedures more efficiently through minimally invasive approaches, and thus with lower tissue damage. The development of techniques of motion analysis has enabled us to describe the changes in movement patterns after various surgical procedures.

We welcome reviews and original papers based on research in paediatric orthopaedics.

We look forward to receiving your contributions.

Dr. Tomas Novotny
Prof. Dr. Randall T. Loder
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

research and basic science
paediatric orthopaedics
hip disorders
foot deformities
spinal disorders
neuromuscular disorders
paediatric trauma
ultrasound
motion analysis

Published Papers (7 papers)

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Research

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12 pages, 971 KiB

Open AccessArticle

Lengthening Patients Previously Treated for Massive Lower Limb Reconstruction for Bone Tumors with the PRECICE 2 Nail

Laura Campanacci

Luca Cevolani

Marco Focaccia

Giovanni Luigi Di Gennaro

and

Children 2023, 10(11), 1772; https://doi.org/10.3390/children10111772 - 31 Oct 2023

Viewed by 412

Abstract

The objective of this study was to determine the efficacy of the PRECICE 2^® nail in the treatment of lower limb length discrepancy in patients with a history of bone tumors. This study reports on outcomes, complications, and the safety of the PRECICE 2 limb lengthening nail in a cohort of pediatric patients with limb length discrepancy after surgery for bone tumors. Seventeen patients were treated with intramedullary magnetic nails. The average patient age at the time of surgery was 19 (range 11–32). The PRECICE 2 nail was used on 14 femurs (6 retrograde and 8 anterograde) and 3 tibias. The average consolidation time was 141 days (range 50–360) with a mean CI of 31 ± 12 days/cm. The ASAMI bone score showed 14 (82%) excellent results, 1 (6%) good result, and 2 (12%) poor results. The ASAMI functional score showed 13 (84.6%) excellent results, 3 (11.5%) good results, and 1 (3.8%) fair result. Patients treated with chemotherapy for bone cancer did not show any increase in distraction time or consolidation time. A total of 3 (17%) problems, 1 obstacle (5.5%), and 1 complication (5.5%) were encountered in our case series. The PRECICE 2 nail allows for effective and accurate lengthening preserving the range of motion in patients treated for bone tumors. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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15 pages, 2014 KiB

Open AccessArticle

Using Virtual Reality to Reduce Anxiety and Improve Hospital Experience in Paediatric Orthopaedic Patients and Their Parents

and

Children 2023, 10(8), 1409; https://doi.org/10.3390/children10081409 - 18 Aug 2023

Viewed by 925

Abstract

The hospital environment can be a stressful environment for paediatric patients and their parents, which is often characterised by heightened levels of pain and anxiety. To address these challenges, many innovative intervention methods has been explored. For example, immersive virtual reality (VR) headsets as a distraction method has become an increasingly popular intervention in recent years. This study aimed to evaluate the effectiveness of VR using ‘Rescape DR.VR Junior’ in reducing pain, anxiety, and enhancing the overall hospital experience for paediatric orthopaedic patients and their parents. A total of 64 patients aged 4–18 years were included in this study, which utilised a control group (interacting with a play specialist) and a VR intervention group (including pre-operative patients and fracture clinic patients). Anxiety and pain levels were measured using a 10-point Likert scale before and after the intervention, and validated questionnaires were used to assess parental anxiety and overall hospital experience. The results indicated that VR intervention significantly reduced patient and parental anxiety both before surgery and in the fracture clinic setting (p < 0.5). However, no significant reduction in pain scores was observed in either environments. Comparatively, VR intervention was found to be comparable to traditional play methods in terms of reducing anxiety in the pre-operative environment. All patients and parents agreed that the use of VR distraction methods significantly improved their hospital experience. In conclusion, VR is an effective method for reducing child and parental anxiety and enhancing the hospital experience and can be used alone or in conjunction with a play specialist. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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15 pages, 29546 KiB

Open AccessArticle

Changing Treatment Philosophy of Slipped Capital Femoral Epiphysis (SCFE) after Introduction of the Modified Dunn Procedure (MDP): Our Experience with MDP and Its Complications

Enrico Micciulli

Laura Ruzzini

Giulio Gorgolini

Pier Francesco Costici

Fernando De Maio

and

Ernesto Ippolito

Children 2023, 10(7), 1163; https://doi.org/10.3390/children10071163 - 03 Jul 2023

Viewed by 765

Abstract

Background. The modified Dunn procedure (MDP) has become popular during the last 16 years to treat severely displaced slipped capital femoral epiphysis (SCFE) while “in situ” pinning (ISP) has remained valid to treat mild to moderate SCFE, although the indication limit of the Southwick angle (SA) has not yet been established for either procedure. In this context, we reviewed two cohorts of patients with SCFE, one treated by ISP and the other by MDP. We also tried to better elucidate the etiopathogenesis of hip instability, a severe complication of MDP. Methods. Fifty-one consecutive patients with 62 hips affected by SCFE were treated by us from 2015 to 2019: 48 hips with a SA ≤ 40° had ISP while 14, with the SA > 40°, had MDP. The latter also had a CT scan to better investigate the SCFE morphology. Results were assessed using the Harris Hip Score. Results. The mean length of follow up of the two cohorts was 5.4 years (range: 3 to 8 years). Of the 35 hips operated by ISP with a full follow-up evaluation, 30 had an excellent or good result, 3, fair, and 2, poor. Of the 14 hips that underwent MDP, 11 had an excellent or good result, 1, fair, and 2, poor. A CT scan showed femoro-acetabular incongruency in two unstable hips following MDP. Conclusions. We performed ISP in chronic SCFE with the SA ≤ 40° and MDP in acute and chronic SCFE with the SA > 40°, with satisfactory results. In both acute-on-chronic and chronic long-lasting SCFE with severe displacement, planned for MDP, a CT scan should be carried out to evaluate possible femoro-acetabular incongruency that may cause hip instability. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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21 pages, 2384 KiB

Open AccessArticle

Fractures in Children Due to Firearm Activity

Randall T. Loder

and

Taylor Luster

Children 2023, 10(4), 651; https://doi.org/10.3390/children10040651 - 30 Mar 2023

Viewed by 803

Abstract

The purpose of this study was to investigate fracture patterns due to pediatric firearm injuries. The data used was from the US Firearm Injury Surveillance Study 1993–2019. Over these 27 years, there were 19,033 children with fractures due to firearm activity with an average age of 12.2 years; 85.2% were boys and the firearm was a powder type in 64.7%. The finger was the most common fracture location, while the tibia/fibula was the most common location for those admitted to the hospital. Children ≤ 5 years of age sustained more skull/face fractures; most spine fractures occurred in the 11–15-year age group. The injury was self-inflicted in 65.2% of the non-powder and 30.6% of the powder group. The injury intent was an assault in 50.0% of the powder and 3.7% of the non-powder firearm group. Powder firearms accounted for the majority of the fractures in the ≤5 and 11–15 year-olds, non-powder firearms accounted for the majority of the fractures in the 6–10 year-olds. Injuries occurring at home decreased with increasing age; there was an increase in hospital admissions over time. In conclusion, our findings support the need for safe storage of firearms in the home away from children. This data will be helpful to assess any changes in prevalence or demographics with future firearm legislation or other prevention programs. The increasing acuity of firearm-associated injuries seen in this study is detrimental to the child, impacts familial wellbeing, and results in significant financial costs to society. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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10 pages, 248 KiB

Open AccessFeature PaperArticle

Perioperative Risk Factors for Bleeding in Adolescents Undergoing Pedicle Screw Instrumentation for Scoliosis

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Children 2023, 10(2), 381; https://doi.org/10.3390/children10020381 - 15 Feb 2023

Cited by 3 | Viewed by 809

Abstract

Progressive scoliosis eventually leads to extensive spinal fusion surgery, which carries a risk for significant bleeding. Neuromuscular scoliosis (NMS) patients have an additional inherent risk of major perioperative bleeding. The purpose of our research was to investigate the risk factors for measured (intraoperative, drain output) and hidden blood loss related to pedicle screw instrumentation in adolescents, divided into adolescent idiopathic scoliosis (AIS) and NMS patient groups. A retrospective cohort study with prospectively collected data of consecutive AIS and NMS patients undergoing segmental pedicle screw instrumentation at a tertiary level hospital between 2009 and 2021 was conducted. In total, 199 AIS (mean age 15.8 years, 143 females) and 81 NMS patients (mean age 15.2 years, 37 females) were included in the analysis. In both groups, levels fused, increased operative time, and smaller or larger size of erythrocytes were associated with perioperative blood loss (p < 0.05 for all correlations). In AIS, male sex (p < 0.001) and the number of osteotomies correlated with more drain output. In NMS, levels fused correlated with drain output, p = 0.00180. In AIS, patients’ lower preoperative MCV levels (p = 0.0391) and longer operation times, p = 0.0038, resulted into more hidden blood loss, but we did not find any significant risk factors for hidden blood loss in NMS patients. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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8 pages, 2324 KiB

Open AccessCase Report

10-Year Clinical Follow-Up after Decompression of Lipofibromatous Hamartoma of the Median Nerve in a 3-Year-Old Patient: Case Report and Review of the Literature

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Children 2023, 10(9), 1581; https://doi.org/10.3390/children10091581 - 21 Sep 2023

Viewed by 485

Abstract

Lipofibromatous hamartoma, first reported in 1953, is a rare, slowly progressive soft tissue tumor, the characteristics of which include the enlargement of the affected nerve via the epineurial and perineurial proliferation of adipose and fibrous tissues. Out of 200 previously reported cases of lipofibromatous hamartoma of the median nerve, there have been approximately 25 pediatric cases under the age of 18. Herein, we report a case of lipofibromatous hamatoma of the median nerve in a 3-year-old female patient who was surgically decompressed via carpal tunnel release and epineurolysis. The patient was followed-up on an outpatient clinic basis annually with sonographic evaluations, and the postoperative 10th-year follow-up did not show recurrence or any deficits in motor and sensory functions. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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8 pages, 3719 KiB

Open AccessCase Report

Acute Progressive Pediatric Post-Traumatic Kyphotic Deformity

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Children 2023, 10(6), 932; https://doi.org/10.3390/children10060932 - 25 May 2023

Viewed by 754

Abstract

Cervical kyphosis is a rare entity with challenging management due to the limitations of pediatric age, along with a growing spine. The pathogenesis is made up of a large group of congenital, syndromic and acquired deformities after posterior element deterioration or as a result of previous trauma or surgery. In rare progressive cases, kyphotic deformities may result in severe “chin-on-chest” deformities with severe limitations. The pathogenesis of progression to severe kyphotic deformity after minor hyperflexion trauma is not clear without an obvious MR pathology; it is most likely multifactorial. The authors present the case of a six-month progression of a pediatric cervical kyphotic deformity caused by a cervical spine hyperflexion injury, and an MR evaluation without the pathology of disc or major ligaments. Surgical therapy with a posterior fixation and fusion, together with the preservation of the anterior growing zones of the cervical spine, are potentially beneficial strategies to achieve an excellent curve correction and an optimal long-term clinical outcome in this age group. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

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Special Issue "Research in Paediatric Orthopaedic Surgery"

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