What's New in Pediatric Orthopaedics
Mininder S. Kocher, MD, MPH; John F. Sarwark, MD

The purpose of this fourth Specialty Update is to serve as a primary source and review for the general orthopaedic surgeon who wishes to stay up-to-date in pediatric orthopaedics. The topics that have been selected have value for the practicing orthopaedist as well as for the pediatric orthopaedic specialist and are important in their own right for the advancement of knowledge and skills in the subspecialty. The material is not intended to represent the only, or necessarily best, method or procedure appropriate for the medical situations discussed.

Sources for this article were presentations at meetings of the Pediatric Orthopaedic Society of North America (POSNA) (Amelia Island, Florida, May 2003), the American Academy of Orthopaedic Surgeons (AAOS) (New Orleans, Louisiana, February 2003), the Scoliosis Research Society (SRS) (Quebec City, Quebec, September 2003), the American Academy of Pediatrics (AAP) (New Orleans, Louisiana, November 2003), and selected references. Orthopaedic surgeons, residents, and fellows are encouraged to attend educational programs on topics in pediatric orthopaedics presented at the AAOS conferences and courses, Specialty Day at the AAOS annual meeting, and the POSNA annual meeting. Upcoming educational events are listed at the end of this update.

Pediatric Orthopaedic Conditions and Management


Brachial Plexus Palsy

The management of children who have brachial plexus palsy continues to be an area of active research interest. In preparation of a POSNA-sponsored prospective, multicenter study of brachial plexus palsy, Bae et al. studied eighty children who had this condition and found that the modified Mallet Classification, the Toronto Test Score, and the Hospital for Sick Children Active Movement Scale had acceptable interobserver and intraobserver reliability for use in outcomes assessment1. Pearl et al. compared magnetic resonance imaging and arthrographic findings with arthroscopic findings in a study of eightyfour children with brachial plexus palsy who were treated for internal rotation contracture of the shoulder2. They …

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