Search

This study aimed to describe the femoral groove morphology using ultrasound in children under 6 months, estimate the incidence of trochlear dysplasia, and evaluate associated risk factors. A prospective study included 298 patients who underwent universal ultrasound screening for hip dysplasia [developmental dysplasia of the hip (DDH)] and knee ultrasound. Measurements of sulcus angle (SA), trochlear depth (TD), and trochlear facet asymmetry (TFA) were analyzed. Trochlear dysplasia was considered present if the ASO was ≥159°. Reproducibility was assessed using the intraclass correlation coefficient (ICC) in 60 knees. Logistic regression adjusted for confounders, presenting odds ratios (OR) and 95% confidence intervals (CI). Significance was set at P  < 0.05. Analysis included 596 knees (298 patients). Females accounted for 51% of patients, with 7% having breech presentation, 4.4% DDH, 6.4% family history of DDH, and 5% family history of patellofemoral instability. ICC showed excellent agreement for SA and TD, but poor for TFA. Trochlear dysplasia incidence was 3% (9/298; 67% bilateral). Median (IQR) values were 147.5 (144.0-150.5) for SA, 2.4 (2.2-2.8) for TD, and 1.1 (1.0, 1.1) for TFA. Breech presentation (OR, 9.68; 95% CI 1.92-48.71, P  = 0.006) and concomitant DDH (OR 6.29, 95% CI 1.04-37.78, P  = 0.044) were associated with trochlear dysplasia. Ultrasound effectively evaluates femoral groove morphology and diagnoses trochlear dysplasia in newborns. Trochlear dysplasia incidence was 3%, with a 10-fold higher risk in breech presentation and 6-fold higher risk in concomitant DDH. Standardized screening and timely treatment protocols should be further investigated. Level of evidence: Diagnostic Level II., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Proximal humerus fractures account for approximately 3 to 5% of all pediatric-adolescent fractures, with a higher incidence observed in older children, particularly between the ages of 10 and 15 years. Non-displaced or minimally displaced fractures can often be treated conservatively. However, the management of displaced or unstable proximal humerus fractures in adolescents may involve surgical intervention, with closed reduction and percutaneous pinning (CRPP) being commonly employed techniques. Closed reduction and percutaneous pinning is not without its challenges and potential difficulties. This article aims to describe a technique that can facilitate CRPP and minimize complications associated with this surgical approach., Competing Interests: Conflito de Interesses Os autores não têm conflitos de interesse a declarar., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ( https://creativecommons.org/licenses/by/4.0/ ).)

Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)