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Objectives: The best effective treatment strategy for limb length discrepancy (LLD) is still being debated. The goal of this study was to compare the efficacy and results of tension-band plating (TBP) and percutaneous epiphysiodesis using transphyseal screws (PETS) for LLD correction. Methods: From June 2008 to January 2019, children who had lower extremity epiphysiodesis with either TBP or PETS were reviewed retrospectively. At the conclusion of treatment, LLD, angular deformity, and complications were reviewed. The t-test or Wilcoxon rank sum test was used to compare continuous variables. Categorical variables were evaluated using Fisher's exact test or χ2 test. Results: A total of 32 epiphysiodeses with TBP (14 patients, 24 femur/tibias) or PETS (13 patients, 23 femur/tibias) were compared. TBPs were conducted while the patients were younger (11.0 vs. 13.1 years, p = 0.005). The treatment durations were similar in both groups (TBP: 23.5 months vs. PETS: 24 months, p = 0.132). PETS had significantly shorter operative time (p = 0.047), length of hospital stay (p = 0.014), and time to return to full activity (p = 0.043). LLD in the TBP group reduced from 2.64 to 1.38 cm (p = 0.005), while in the PETS group it decreased from 2.76 to 1.08 cm (p = 0.001). During treatment, the rate of LLD correction was 0.49 ± 0.9 cm/year for limbs treated with TBP and 1.0 ± 1.1 cm/year for limbs treated with PETS (p = 0.185). At the end of treatment, 8 TBP cases (47%) and 9 PETS cases (60%) had achieved LLD ≤ 2 cm (p = 0.502), and at the most recent follow-up, this had grown to 11 (65%) in the TBP group and 12 (80%) in the PETS group. There were no significant differences in the total number of complications between groups (p > 0.05). Revision surgery was required in 11 TBP and 3 PETS limbs due to persistent LLD or angular deformity (AD) (p = 0.016). Logistic regression did not reveal any significant association between TBP and the rate of complication or revision surgery. Conclusion: PETS and TBP are both effective methods for limb length equalization. PETS, on the other hand, was linked to a shorter operative time, a shorter hospital stay, a faster recovery to pre-operative function, and a lower complication rate. The rate of revision surgery due to persistent LLD or AD was higher in TBP. We advise surgeons against utilizing TBP to correct LLD. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the influence of socioeconomic status (SES), assessed by child opportunity index (COI) and insurance type, on access to orthopaedic care after pediatric ACL rupture. The secondary aim was to determine whether delays to care were associated with additional procedures at the time of ACL reconstruction (ACLR)., Methods: This IRB-approved retrospective study reviewed 238 patients aged 10 to 21 who underwent primary ACLR between 2013 and 2021 at a tertiary care center. Demographic and clinical data were obtained via chart review. The time intervals analyzed included the date of injury to the initial orthopaedic visit, the date of the initial visit to the MRI examination, and the date of the MRI examination to surgery. Patients were grouped by time intervals of ≤30 days versus >30 days. COI scores (total and 3 domains: education, SES, and health) were determined by ZIP code and assigned quintile-ranking scores (very low/low and moderate/high/very high). χ2 and Fisher exact tests were used to compare patients with prompt versus delayed orthopaedic care., Results: A total of 238 patients (mean age 16.51±1.73, 66.0% male, 63.1% public insurance, and 87.4% with very low or low total COI scores) were included in this study. There were no significant differences in insurance type or demographics between those with prompt or delayed care. No significant differences were found in total COI, education COI, socioeconomic COI, or health COI between patients with care within or after 30 days. Patients with delayed initial orthopaedic visits had a significantly higher prevalence of meniscus tears requiring repair (56.7% vs. 38.9%, P=0.004) or meniscectomy (24.7% vs. 22.9%, P=0.004)., Conclusions: Lower SES, as measured by COI and public insurance, did not impact time to orthopaedic care after pediatric ACL injury. Within a predominantly minority population with low COI, the effect of COI on access to care may be less pronounced than in white-majority settings. Community-based interventions may help recognize telltale signs of ACL injury, ensuring an orthopaedic visit within a month of injury and decreasing the incidence of meniscus tears., Level of Evidence: Level III-retrospective cohort study., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

With the increasing popularity of hoverboards in recent years, multiple centers have noted associated orthopaedic injuries of riders. We report the results of a multi-center study regarding hoverboard injuries in children and adolescents. who presented with extremity fractures while riding hoverboards to 12 paediatric orthopaedic centers during a 2-month period were included in the study. Circumstances of the injury, location, severity, associated injuries, and the required treatment were recorded and analysed using descriptive analysis to report the most common injuries. Between-group differences in injury location were examined using chi-squared statistics among (1) children versus adolescents and (2) males versus females. Seventy-eight patients (M/F ratio: 1.8) with average age of 11 ± 2.4 years were included in the study. Of the 78 documented injuries, upper extremity fractures were the most common (84.6%) and the most frequent fracture location overall was at the distal radius and ulna (52.6%), while ankle fractures comprised most of the lower extremity fractures (66.6%). Majority of the distal radius fractures (58.3%) and ankle fractures (62.5%) were treated with immobilization only. Seventeen displaced distal radius fractures and three displaced ankle fractures were treated with closed reduction in the majority of cases (94.1% versus 66.7%, respectively). The distal radius and ulna are the most common fracture location. Use of appropriate protective gear such as wrist guards, as well as adult supervision, may help mitigate the injuries associated with the use of this device; however, further studies are necessary to demonstrate the real effectiveness of these preventions.