Pediatric orthopedic injury prevention for team sports post COVID-19.

Queries of youth orthopedic sports injuries from the U.S. National Electronic Surveillance System, a database from the Consumer Product Safety Commission, demonstrate decreased orthopedic injuries related to team sports during the COVID-19 pandemic, indicative of reduced sports participation. Multiple articles have shown that COVID-19 had a marked effect on the physical and psychological wellbeing of the youth. The lockdown resulted in a cessation in school attendance and sports activities, especially team sports. Though increased emphasis has been placed on children infected by COVID-19, less attention has been given to healthy children. Numerous articles discussed the physical and psychological benefits for the youth returning to physical activity and sports; however, few have addressed detraining and deconditioning concerns postpandemic. This article discusses a safe return to team sports for the youth experiencing physical and psychological changes related to the pandemic. Orthopedic injuries are anticipated to increase as restrictions are relaxed. A multidisciplinary team presents a review of common youth sports orthopedic injuries, a discussion of psychological issues youths have experienced during COVID and why sports participation is beneficial for youth, and a risk assessment for pain and limited range of motion for youth returning to sports. The intent of this article is to increase awareness of the physical and psychological changes experienced by youth due to their inability to participate in team sports during the pandemic. Family medicine and primary care providers need to recognize the increased risks for injury and proactively encourage the youth to return to sports in a safe manner.

Single-Event Multilevel Surgery to Correct Movement Disorders in Children with Cerebral Palsy.

Cerebral palsy (CP) is a common motor disability that may be congenital or acquired. Children with CP often have gait, balance, and posture abnormalities, some of which may be severe enough to interfere with safe ambulation or other activities of daily living. Nonsurgical and surgical interventions are part of the management plan for children with CP. Historically, surgeons addressed gait deviations individually and sequentially with single-level surgeries. However, computerized motion analysis and advances in orthopedic internal fixation devices have improved the outcomes for patients undergoing single-event multilevel surgery. This article provides perioperative RNs with a basic understanding of movement disorders that can be corrected with single-event multilevel surgery, the role of computerized motion analysis in making treatment decisions for ambulatory pediatric orthopedic patients with CP, and various treatment options for the movement disorders of children with CP.

Rotationplasty--a unique surgical procedure with a functional outcome.

ROTATIONPLASTY is a surgical procedure that may be appropriate for children with severe congenital femoral deficiency or children with malignant tumors of the femur or proximal tibia. OSTEOTOMIES AND RESECTION of the femur and tibia are performed, allowing the patient's foot to be rotated 180 degrees and reattached while preserving the nerves, muscles, and blood supply. THE POSTERIOR-FACING FOOT functions as the patient's knee joint in a specially fitted prosthesis. Although the outcome is visually unusual, for some children, regaining function and physical capabilities outweighs cosmetic concerns. The surgical procedure is technically challenging and requires a multidisciplinary approach.

Meningococcemia: the pediatric orthopedic sequelae.

Meningococcal disease affects as many as 3,000 people in the United States per year, with the highest incidence in children younger than two years of age and two-thirds of cases occurring in children younger than five years of age. Children who survive meningococcemia face quality-of-life issues that result from limb deficiencies. Consultation with an experienced pediatric orthopedic surgeon in the early stages of the illness is vital for planning surgical approaches for amputation of the resulting necrotic tissue and for minimizing eventual tissue loss. Early surgical intervention is rarely indicated in cases of extremity gangrene unless a secondary infection is present. Allowing time for tissue demarcation and recovery can be essential for limb length preservation. Maintaining functional joints is important for long-term quality of life and activities of daily living.

A magnetic approach to treating progressive early-onset scoliosis.

Early-onset scoliosis presents at birth and up to five years of age. Growing rods are a treatment option when early-onset scoliosis cannot be controlled by serial casts or braces. The function of a growing rod is to allow a child's spine to continue to grow under controlled conditions until a definitive correction can be made when the patient nears skeletal maturity. This article presents two case reports describing the use of an expandable magnetic growing rod in children with progressive, early-onset scoliosis. After implantation, caregivers expand the rod nonsurgically using an external magnet to obtain and maintain correction while the child grows. The first case report describes the use of a magnetic growing rod in a patient with a rigid spinal curve and a significant rotational deformity; the second case report describes a patient with a more flexible neuromuscular curve. These were the first two patients to be offered treatment with an expandable rod in North America after the surgeon obtained approval to use the device based on compassionate grounds from the US Food and Drug Administration and institutional review board consent and approval for both surgeries.