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The natural history of traumatic glenohumeral dislocation is well-established in young adults, but it is less clear in pediatric patients. We aimed to determine the rate of recurrent instability and medium-term functional outcome following shoulder dislocation in patients aged 14 years or younger.

All patients aged 14 years or younger who sustained a glenohumeral dislocation from 2008 to 2019 presenting to our regional health-board were identified. Patients who had subluxations associated with generalized laxity were excluded. Data was collected regarding further dislocations, stabilization surgery, sporting activity and patient-reported outcomes using the Western Ontario Shoulder Instability (WOSI) Index and Quick Disabilities of the Arm, Shoulder, and Hand score.

Forty-one patients with a radiologically confirmed traumatic glenohumeral dislocation were suitable for study inclusion [mean age at injury 12.3 y (range 7.2 to 14.0 y), male sex 29 (70.7%), median 7.9 y follow-up]. The incidence rate of pedi2 patients experienced recurrent dislocation and 1 in 5 ultimately underwent surgical stabilization.

Level IV.
Level IV.
Diversity and inclusion are critical to providing the best possible health care. Previous studies have shown that diversity among physicians increases cultural competency, which in turn enhances the quality of care provided and increases minoritized patients' participation in decisions regarding their health care. However, physician diversity in both race and sex is lacking in orthopaedic surgery. This study seeks to determine the sex and racial diversity in the membership and leadership of the Pediatric Orthopaedic Society of North America (POSNA).

POSNA membership and leadership were reviewed for the years 2010, 2015, and 2020. This data was gathered from membership directories and committee reference books. All North American Active Members' race/ethnicity and sex were recorded for each year. The categories for race/ethnicity are Caucasian, East/South/Middle Eastern Asian American (Asian), Hispanic/Latin/South American (HLSA), and African American.

From 2010 to 2020, Active Members of POSNA increasedmore diverse in 2020 than it was in 2010.

Level II-retrospective.
Level II-retrospective.
To compare the rate of lost reduction between two groups of non-age segregated type III supracondylar humeral fracture patients a unicolumnar versus bicolumnar fixation group.

Retrospective cohort study.

Pediatric Academic Trauma Center.

We identified 257 patients with Type III supracondylar humerus fractures from surgical billing records over a 5-year period. There were 183 patients identified with bicolumnar fixation (71.2%) and 74 patients identified with unicolumnar fixation (28.8%).

Closed reduction percutaneous pinning of the distal humerus.

The primary outcome measure was difference in rate of lost reduction between patients with bicolumnar (lateral and medial column) and unicolumnar (lateral column only) fixation (Figure1). The reduction and fixation at time of fluoroscopy was assessed using the Baumann angle, Gordon index, and anterior humeral line. learn more Loss of reduction was assessed at time of healing, defined by a Baumann angle change ≥ 10 degrees and Gordon index of ≥ 50 percent (Figure2).

There were 183 patients with bicolumnar fixation and 74 patients with unicolumnar fixation included in the study (average age 5.8 years, range 2-14 years). The rate of lost reduction in patients with bicolumnar fixation was 6.01% (11/183) whereas 17.57% (13/74) of patients with unicolumnar fixation experienced lost reduction. These rates were significantly different (p=0.008) with a 3.3 times higher odds [95% CI = 1.3, 8.6] of lost reduction with unicolumnar fixation.

There is a statistically significant increase in the rate of supracondylar fracture loss of reduction for patients with unicolumnar fixation when compared to bicolumnar fixation.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
To evaluate the accuracy and reliability of a novel fluoroscopic technique for assessing tibial rotation and compare it to a previously described fluoroscopic method.

A multiplanar circular ring external fixator was secured to the tibial diaphysis of five cadaveric lower extremity specimens. Using deformity correction software, the frame and tibia were programmed to randomly rotate 5, 10, 15, 20, 25, and 30 degrees of internal and external rotation. Following each rotation, two blinded, independent observers measured the degree of tibial rotation using two different fluoroscopic methods the previously described "mortise" method and the novel "intermalleolar" method. A total of 65 measurements were made by each observer. Accuracy and inter-observer reliability were calculated.

Both intermalleolar and mortise methods had a mean absolute rotational difference from the true torsion of 3 degrees (SE 1, range 0-10 degrees intermalleolar versus 0-18 degrees mortise). We found that 98.5% (128/130) of measuremenaoperative rotational corrections.
To compare complications and functional outcomes of treatment with primary distal femoral replacement (DFR) versus open reduction and internal fixation (ORIF).

PubMed, Embase, and Cochrane databases were searched for English language studies up to May 19, 2020, identifying 913 studies.

Studies that assessed complications of periprosthetic distal femur fractures with primary DFR or ORIF were included. Studies with sample size ≤5, mean age <55, nontraumatic indications for DFR, ORIF with non-locking plates, native distal femoral fractures, or revision surgeries were excluded. Selection adhered to PRISMA criteria.

Study quality was assessed using previously reported criteria. There were 40 Level IV studies, 17 Level III studies, and 1 Level II study.

Fifty-eight studies with 1,484 patients were included in the meta-analysis. Complications assessed (Incidence Rate Ratio (IRR) (95%CI) 0.78 (0.59-1.03)) and reoperation or revision (IRR (95%CI) 0.71 (0.49-1.04)) were similar between the DFR and ORIF cohorts.
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