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Children
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Pediatric Orthopaedic Surgery
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Pediatric Orthopaedic Surgery

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

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 14861

Special Issue Editor

Dr. Vincenzo De Rosa

E-Mail Website
Guest Editor
Pediatric Surgery and Orthopedics Department Pediatric, Bellinzona Regional Hospital, Bellinzona, Switzerland
Interests: pediatric orthopedic surgery

Special Issue Information

Dear Colleagues,

Pediatric orthopedic surgery is a very special discipline that involves taking care of children and parents with bone and soft tissues diseases.

The topics are wide, from birth, such as the treatment of a clubfoot as soon as a baby is born, to the diagnosis and treatment of DDH, which has a very different philosophy between the German part of Europe and the English and French protocols. Scoliosis is an important topic, especially in the adolescents but also in juvenile scoliosis and congenital disease. Cerebral palsy is an interesting challenge, sometimes with a difficult choice of treatments. Gait analysis in orthopedics is very useful to confirm diagnosis and to help in treatment in many fields of orthopedic disease. This Special Issue aims to provide a wide overview of recent advanced in pediatric orthopedic diseases to facilitate an interesting discussion and help colleagues to treat children with pediatric orthopedic diseases.

Dr. Vincenzo De Rosa
Guest Editor

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.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

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

  • pediatric orthopedic disease
  • research
  • clubfoot
  • DDH
  • Scoliosis

Published Papers (6 papers)

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Research

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9 pages, 1759 KiB  
Article
Clinical Examination Findings Can Accurately Diagnose Developmental Dysplasia of The Hip—A Large, Single-Center Cohort
by İzzet Özay Subaşı, Enejd Veizi, Şahin Çepni, Hilmi Alkan, Temel Oğuz and Ahmet Fırat
Children 2023, 10(2), 304; https://doi.org/10.3390/children10020304 - 04 Feb 2023
Cited by 1 | Viewed by 3977
Abstract
Background: Physical examination findings such as limited hip abduction (LHA), asymmetric skin creases (ASC), and a popping sensation in the hip facilitate the diagnosis of developmental dysplasia of the hip (DDH). Screening with a simple physical examination during the first weeks of infancy [...] Read more.
Background: Physical examination findings such as limited hip abduction (LHA), asymmetric skin creases (ASC), and a popping sensation in the hip facilitate the diagnosis of developmental dysplasia of the hip (DDH). Screening with a simple physical examination during the first weeks of infancy is important for early detection of the condition, and a wide range of medical professionals, including general practitioners, obstetricians, pediatricians, and orthopedic surgeons etc. are involved in this process. The aim of this study was to determine the correlation between easily recognizable physical examination findings such as LHA, thigh/groin ACSs, and Ortolani and Barlow tests with ultrasound findings for the diagnosis of DDH. Methods: This study included 968 patients undergoing routine hip ultrasonography between December 2012 and January 2015. All patients were examined by an experienced orthopedic surgeon who was not the physician who performed the ultrasound examination to exclude bias between physical examination findings and ultrasound findings. Asymmetric skin folds (thigh and groin), limited abduction, Barlow and Ortolani tests were recorded. The relationship between the physical examination findings, ultrasound findings, and developmental dysplasia was investigated. Results: Of the 968 patients, 523 were female (54%) and 445 were male. On ultrasonography examination, 117 patients were found to have DDH. The sensitivity, specificity and negative predictive values of patients who were found to have both LHA and thigh/groin ASCs in all three physical examinations were high (83.8%, 70.2%, and 96.9%, respectively) while positive predictive values were found to be low (27.8%). Conclusion: Asymmetric skin creases on the thigh and groin and limited hip abduction, when evaluated together, have high sensitivity and specificity with additional high negative predictive values and could help during the initial screening process of DDH. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
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11 pages, 2675 KiB  
Article
The Use and Complications of Halo Gravity Traction in Children with Scoliosis
by Mihai B. Popescu, Alexandru Ulici, Madalina Carp, Oana Haram and Nicolae S. Ionescu
Children 2022, 9(11), 1701; https://doi.org/10.3390/children9111701 - 06 Nov 2022
Cited by 3 | Viewed by 3322
Abstract
Scoliosis is one of the most frequent spine deformities encountered in children and is regularly discovered after 15 years of age with a girls to boys ratio of 2:1. Vertebral arthrodesis involves both short and long term complications. Neurological complications consist of nerve [...] Read more.
Scoliosis is one of the most frequent spine deformities encountered in children and is regularly discovered after 15 years of age with a girls to boys ratio of 2:1. Vertebral arthrodesis involves both short and long term complications. Neurological complications consist of nerve root injuries, cauda equina or spinal cord deficit. Traction is a good orthopaedic technique of progressive deformity correction which attempts to minimize complications. The purpose of this study is to assess the complications that arise during halo gravity traction and to evaluate the correction of the scoliotic curves under traction. A single centre prospective study was conducted on 19 paediatric patients suffering from scoliosis that were admitted between 2019–2022. Traction-related complications were encountered in 94.7% of patients, with the most frequent being cervical pain (89.5%). It was followed by back pain, in 36.8% of the cases, with just 5.3% of the cases having experienced vertigo or pin displacement. Neurological symptoms were present in 26.3% of the patients and pin pain and pin infection equally affected 26.3% of patients. Even though minor halo related complications are frequent, with proper patient monitoring they can be addressed, thus making traction a safe method for progressive curve correction. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
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8 pages, 1045 KiB  
Article
Risk of Avascular Necrosis with The Modified Dunn Procedure in SCFE Patients: A Meta-Analysis
by Julio J. Jauregui, Nichole M. Shaw, Tristan B. Weir, Sherwin A. Barvarz and Philip K. McClure
Children 2022, 9(11), 1680; https://doi.org/10.3390/children9111680 - 31 Oct 2022
Cited by 2 | Viewed by 1222
Abstract
In situ stabilization is a widely accepted treatment for slipped capital femoral epiphysis (SCFE) despite risks of avascular necrosis (AVN) and femoroacetabular impingement (FAI). The modified Dunn procedure with surgical hip dislocation attempts to maintain epiphyseal perfusion and allows anatomic epiphyseal repositioning, theoretically [...] Read more.
In situ stabilization is a widely accepted treatment for slipped capital femoral epiphysis (SCFE) despite risks of avascular necrosis (AVN) and femoroacetabular impingement (FAI). The modified Dunn procedure with surgical hip dislocation attempts to maintain epiphyseal perfusion and allows anatomic epiphyseal repositioning, theoretically reducing AVN and FAI risks. We systematically evaluated the literature, elucidating overall and stability-stratified rates of AVN following the modified Dunn procedure, and revision rates in non-AVN patients. Using Ovid and MEDLINE (PubMed), studies involving the modified Dunn procedure were evaluated for age, stability, preoperative slip (Southwick) angle, ROM at follow-up, outcome metrics, and revisions. Utilizing a random effect model of proportions, we determined overall and stability-stratified AVN rates, and revision rates in patients without AVN.673 patients (688 SCFEs) who underwent modified Dunn procedure were included. Overall AVN rate was 14.3% with a 95% Confidence Interval (CI) of 9.3 to 20.2%. AVN rate in stable slips was 10.9% (95% CI: 6.0 to 17.1%) and 19.9% (95% CI: 12.8% to 28.1%) in unstable slips. Revision rate in non-AVN patients was 13.3% (95% CI: 8.3% to 19.2%). Fixation failures occurred following K-wire or small-caliber (<6.5 mm) screw fixation. Overall mean Harris Hip Score (HHS) was excellent (>90 points). Mean HHS was 98.9 points (range of means: 86 to 99 points) in stable cases, and 90.5 points (range of means: 73 to 98 points) in unstable cases. Patients undergoing modified Dunn procedure had excellent clinical outcomes and low incidences of AVN. Further studies are needed to determine if modified Dunn osteotomy with surgical hip dislocation is a viable alternative to in situ pinning for treatment of severe SCFE. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
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10 pages, 240 KiB  
Article
LIMB-Q Kids—German Translation and Cultural Adaptation
by Bjoern Vogt, Jana Fresen, Georg Gosheger, Harpreet Chhina, Carolin Sophie Brune, Gregor Toporowski, Adrien Frommer, Andrea Laufer, Anthony Cooper, Robert Roedl and Jan Duedal Rölfing
Children 2022, 9(9), 1405; https://doi.org/10.3390/children9091405 - 16 Sep 2022
Cited by 2 | Viewed by 2129
Abstract
(1) Purpose: Lower limb deformities can have a severe impact on health-related quality of life (HRQL). LIMB-Q Kids is a new patient-reported outcome measure (PROM) aiming to elucidate the experience of 8–18-year-old patients before, during and after treatment, and to measure the different [...] Read more.
(1) Purpose: Lower limb deformities can have a severe impact on health-related quality of life (HRQL). LIMB-Q Kids is a new patient-reported outcome measure (PROM) aiming to elucidate the experience of 8–18-year-old patients before, during and after treatment, and to measure the different aspects of HRQL. The aim of this study was to translate and culturally adapt LIMB-Q Kids to German. (2) Methods: The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were followed. Three forward translations, a backward translation, an expert panel meeting with eight participants, and twenty cognitive debriefing interviews led to the final German version of LIMB-Q Kids. (3) Results: In the forward translations, 4/159 items were difficult to translate, and 2/159 items in the backward translation differed from the original English version. Cognitive debriefing interviews with 20 patients identified 7/159 items that were difficult to comprehend/answer, and 2 of these items were changed. (4) Conclusions: Lower limb deformities can have a great impact on children, and it is important to measure and consider the impact on HRQL. In order to be able to use PROMs in different countries, conceptually equivalent translations and cultural adaptations should be performed in order to ensure comprehensibility. The final German version of LIMB-Q Kids is ready for use in an international field test. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
10 pages, 1012 KiB  
Article
Pubo-Femoral Distances Measured Reliably by Midwives in Hip Dysplasia Ultrasound
by Hans-Christen Husum, Michel Bach Hellfritzsch, Rikke Damkjær Maimburg, Mads Henriksen, Natallia Lapitskaya, Bjarne Møller-Madsen and Ole Rahbek
Children 2022, 9(9), 1345; https://doi.org/10.3390/children9091345 - 02 Sep 2022
Cited by 4 | Viewed by 1842
Abstract
The pubo-femoral distance (PFD) has been suggested as an ultrasound screening tool for developmental dysplasia of the hip (DDH). The aim of this study was to examine if midwives undergoing minimal training could reliably perform pediatric hip ultrasound and PFD measurements. Eight recruited [...] Read more.
The pubo-femoral distance (PFD) has been suggested as an ultrasound screening tool for developmental dysplasia of the hip (DDH). The aim of this study was to examine if midwives undergoing minimal training could reliably perform pediatric hip ultrasound and PFD measurements. Eight recruited midwives performed two rounds of independent blinded PFD measurements on 15 static ultrasound images and participated in four supervised live-scanning sessions. The midwives were compared to a group of three experienced musculoskeletal radiologists. Reliability was evaluated using inter-rater correlation coefficients (ICC). Linear regression was used to quantify the learning curve of the midwives as a group. There was near complete intra- and inter-rater agreement (ICC > 0.89) on static ultrasound images across both rounds of rating for midwives and radiologists. The midwives performed a mean of 29 live hip scans (range 24–35). The mean difference between midwives and supervising radiologists was 0.36 mm, 95% CI (0.12–0.61) for the first session, which decreased to 0.20 mm, 95% CI (0.04–0.37) in the fourth session. ICC for PFD measurements increased from 0.59 mm, 95% CI (0.37–0.75) to 0.78 mm, 95% CI (0.66–0.86) with progression in sessions. We conclude that midwives reliably perform PFD measurements of pediatric hips with minimal training. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
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20 pages, 3396 KiB  
Systematic Review
Prevalence of Avascular Necrosis Following Surgical Treatments in Unstable Slipped Capital Femoral Epiphysis (SCFE): A Systematic Review and Meta-Analysis
by Vijayanagan Veramuthu, Ismail Munajat, Md Asiful Islam, Emil Fazliq Mohd and Abdul Razak Sulaiman
Children 2022, 9(9), 1374; https://doi.org/10.3390/children9091374 - 11 Sep 2022
Cited by 2 | Viewed by 1696
Abstract
The choice of treatment for unstable and severely displaced slipped capital femoral epiphysis (SCFE) is controversial. This meta-analysis was conducted to determine the prevalence of femoral head avascular necrosis (AVN) following various treatments for unstable SCFE. Various databases were searched to identify articles [...] Read more.
The choice of treatment for unstable and severely displaced slipped capital femoral epiphysis (SCFE) is controversial. This meta-analysis was conducted to determine the prevalence of femoral head avascular necrosis (AVN) following various treatments for unstable SCFE. Various databases were searched to identify articles published until 4 February 2022. A random-effects model was used to examine prevalence as well as risk ratios with confidence intervals (CIs) of 95%. Thirty-three articles were analyzed in this study. The pooled prevalences of AVN in pinning in situ, pinning following intentional closed reduction, pinning following unintentional closed reduction, and open reduction via the Parsch method, subcapital osteotomy and the modified Dunn procedure were 18.5%, 23.0%, 27.6%, 9.9%, 18.6% and 19.9%, respectively. The risk of developing AVN in pinning following intentional closed reduction was found to be 1.62 times higher than pinning in situ; however, this result was not significant. The prevalence of AVN in open reduction was lowest when performed via the Parsch method; however, this finding should be interpreted with caution, since the majority of slips so-treated are of mild and moderate types as compared with the subcapital osteotomy and modified Dunn procedures, which are predominantly used to treat severely displaced slips. As the risk ratio between intentional closed reduction and the modified Dunn method showed no significant difference, we believe that the modified Dunn method has the advantage of meticulously preserving periosteal blood flow to the epiphysis, thus minimizing AVN risk. In comparison with intentional closed reduction, the modified Dunn method is used predominantly in cases of severe slips. Full article
(This article belongs to the Special Issue Pediatric Orthopaedic Surgery)
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