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Research Highlight | Overview

Each “Research Highlight” in Boston Children’s Orthopedics and Sports Medicine Advancing Orthopedics newsletter takes a closer look at one research publication of interest.

Modified surgical technique for missed Monteggia lesions

Monteggia fractures are fairly common in young children, but signs of the initial injury are often missed on x-ray. Surgeons in the Hand and Orthopedic Upper Extremity Program recently reported results of a modified surgical technique for missed Monteggia fracture-dislocations. Despite the promising results of this study, timely diagnosis of acute Monteggia lesions remains the best way to restore upper arm function.

Autologous osteochondral grafting: Promising results in repairing severe capitellar osteochondritis dissecans

Capitellar osteochondritis dissecans (OCD) is a relatively common injury among athletes who play sports with a large amount of overhead throwing or weight-bearing activities. Autologous osteochondral grafting (AOG) replaces diseased bone and cartilage with healthy tissue taken from a donor site. Surgeons in Boston Children’s Orthopedic Center have successfully used the procedure, originally developed to repair OCD of the knee, to repair OCD of the elbow.

Slipped capital femoral epiphysis: Radiographic images may support earlier diagnosis

Slipped capital femoral epiphysis (SCFE) is the most common hip disorder of adolescence, affecting 10.8 per 100,000 children. Although early intervention leads to better outcomes, SCFE is often not diagnosed in its earliest stages. A team of researchers at Boston Children’s Hospital have identified a radiographic sign that could help clinicians identify the condition earlier.

Robotic navigation and the future of spine surgery

In June 2019, the Spine Division at Boston Children’s Hospital became one of the first pediatric orthopedic centers in the world to use the Mazor X Stealth Edition Robotic Guidance System. The system has the potential to improve surgical processes. However, it also requires a commitment of time and resources. Any surgeon using the robotic guidance system should have extensive experience with spinal fusion surgery to assure patient safety.

ACL regeneration: Promising two-year results of first-in-human trial

In an article in the Orthopaedic Journal of Sports Medicine, orthopedic surgeon Martha Murray, MD, reports two-year results of the first-in-human trial of Bridge-Enhanced® ACL Repair (BEAR®). This phase I study was the culmination of 15 years of laboratory work developing a safe and effective scaffold. The procedure could serve as the basis for less invasive, more effective procedures for patients with torn ACLs and other musculoskeletal injuries.

Modern instrumentation for cervical stabilization in pediatric patients

Orthopedic surgeon, Daniel Hedequist, MD, and Neurosurgeon-in-Chief, Mark Proctor, MD, have extensive experience using modern implants to stabilize the spines of children with unusual diagnoses. In an article published in the Journal of Pediatric Orthopaedics, they reviewed the use of C2 translaminar screw fixation in children. Although this technique is often safer than other methods of screw fixation, it is currently underutilized in pediatric patients.

A new approach to transferring radial nerve triceps fascicles to the axillary nerve

Orthopedic Surgeon Andrea Bauer, MD, published a paper in The Journal of Hand Surgery detailing the success of the anterior approach to nerve transfer. She and her team successfully operated on a five-month-old girl with bilateral brachial plexus birth injury, who concurrently received two other types of nerve transfers.

Increasing operating room capacity through a dedicated Satellite Trauma Orthopedic Program

Orthopedic surgeon-in-chief Peter M. Waters, MD, published a study detailing the success of a program to utilize the operating room (OR) capacity of a satellite campus in order to decrease stress on the ORs in our pediatric tertiary care center.

Reducing cast-saw injuries through simple simulation

Orthopedic surgeon Donald Bae, MD, and colleagues examine the clinical efficacy and cost-effectiveness of training residents on cast removal through a novel task trainer that mimics the surface temperature of a patient’s skin.

Spinal fusion in children with cerebral palsy

Rachel DiFazio, PhD, RN, PPCNP-BC, FAAN, and colleagues assessed changes in caregivers’ perceptions of health-related quality of life and caregiver burden following surgical correction of scoliosis in CP patients.