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Longitudinal bone growth is mediated through several mechanisms including macro- and micronutrients, and endocrine and paracrine hormones. These mechanisms can be affected by childhood obesity as excess adiposity may affect signaling pathways, place undue stress on the body, and affect normal physiology. This review describes the physiology of the epiphyseal growth plate, its regulation under healthy weight and obesity parameters, and bone pathology following obesity. A literature review was performed utilizing PubMed, PMC, NIH, and the Cochrane Database of Systematic Reviews pertinent to hormonal and nutritional effects on bone development, child obesity, and pathologic bone development related to weight. The review indicates a complex network of nutrients, hormones, and multi-system interactions mediates long bone growth. As growth of long bones occurs during childhood and the pubertal growth spurt, pediatric bones require adequate levels of minerals, vitamins, amino acids, and a base caloric supply for energy. Recommendations should focus on a nutrient-dense dietary approach rather than restrictive caloric diets to maintain optimal health. In conclusion, childhood obesity has profound multifaceted effects on the developing musculoskeletal system, ultimately causing poor nutritional status during development. Weight loss, under medical supervision, with proper nutritional guidelines, can help counteract the ill effects of childhood obesity. [ABSTRACT FROM AUTHOR]

Ligamentous injuries of the hallux are rare, and when seen, they are most commonly treated conservatively. Surgical treatment of such injuries is also rare, making reports on the postoperative outcome and complications even less frequent. A case report of a hallux interphalangeal joint (IPJ) lateral collateral ligament tear in a 16-year-old gymnast is presented. Initially, she presented to the clinic with pain in her left hallux. She injured her toe while doing a gymnastic maneuver in which it got stuck and hyperextended. Physical examination revealed pain in her left great toe metatarsophalangeal and IPJs. Her medical history included the diagnosis of Ehlers-Danlos syndrome. She was managed conservatively with a controlled ankle motion boot for 4 weeks. When she returned for follow-up, her physical examination showed increased laxity to the great toe IPJ lateral collateral ligament compared with the other foot. A left foot MRI was done, which showed a complete rupture of the IPJ lateral collateral ligament origin (Figure 1). She underwent surgical intervention 6 weeks following her injury, in which the collateral ligament was repaired with suture anchors along with IP joint pinning to protect the repair (Figure 2). Following surgery, she returned to the clinic because of persistent drainage from a small hole near the incision site. During further incision and débridement, we discovered granulomatous tissue surrounding an embedded suture. The suture was removed, and the wound was irrigated. Following this procedure, the patient recovered fully in 3 weeks. She was provided a home exercise program and returned to gymnastics without limitations, toe pain, or instability. This case demonstrates an interesting complication following collateral ligament repair in the hallux., (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Background: Despite increasing diversity among medical students, pediatric orthopaedic surgery remains underrepresented regarding gender and ethnic diversity. Previous studies highlight notable underrepresentation of women and minorities in orthopaedic subspecialty fellowships., Methods: This study analyzed data from 2013 to 2023 on pediatric orthopaedic surgery fellows, collected through the Accreditation Council for Graduate Medical Education and Graduate Medical Education Consensus. Self-identified race and gender data were used to assess trends over the decade., Results: The analysis included 380 fellows, of whom 62.4% were male and 37.1% were female. Racial distribution showed 62.9% White, 9.2% Asian, 4.5% Hispanic/Latino/Spanish, 4.5% Black/African American, 0% American Indian/Alaskan Native, 0% Native Hawaiian/Pacific Islander, 0.53% multiple race/ethnicity, and 8.4% other. Notably, 37.1% of fellows were non-White., Conclusion: The study reveals persistent gender and racial disparities in pediatric orthopaedic surgery fellowships. Targeted recruitment and support for underrepresented groups, along with systemic changes to address barriers, are crucial for fostering a diverse and inclusive workforce. Enhanced diversity is essential for providing culturally competent care to the diverse patient population., (Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Sudden cardiac arrest (SCA) can be caused by inherited and acquired conditions and can lead to sudden cardiac death. There are many causes and risk factors for SCA such as QTc prolongation which can be inherited or acquired. Potential causes of acquired QTc prolongation include medications, electrolyte abnormalities, etc. Genetic causes are less common and look at channelopathies involved in the cardiac action potential that interferes with the repolarization, causing a prolonged ventricular contraction reflected in the QTc interval. Before determining that the cause of an SCA is due to a QTc prolonged interval, a full cardiac workup needs to be done to eliminate other anatomical causes of SCA. This case report elicits an interesting clinical scenario in which a previously healthy 20-year-old male experiences SCA while playing basketball. The patient was resuscitated at the scene. After defibrillation, intubation, various imaging studies, and a subcutaneous implantable cardioverter-defibrillator (ICD) placement, the patient was diagnosed with long QTc syndrome and underwent genetic testing which was later found to be negative. Hence, understanding the causes of SCA in young patients can be important in avoiding dreadful and life-threatening situations and providing information to the patient and family members., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Elias et al.)

Background: Pediatric orthopedic conditions present unique challenges due to ongoing skeletal growth and development. Managing these cases requires addressing both structural anomalies and functional deficits., Care Presentation: This case report discusses a 13-year-old male with recurrent left knee pain exacerbated by physical activity. The patient's history of a left knee infection at 1.5 years of age, possibly septic arthritis or osteomyelitis, underscores the long-term consequences of early pathology on skeletal growth and alignment. Imaging studies revealed a distal lateral femur physis bar and genu valgum, necessitating surgical intervention., Management and Outcomes: The surgery involved medial distal femur hemiepiphysiodesis and lateral distal femur bar excision to correct anatomical deformities and restore optimal limb alignment and function. Postoperative rehabilitation, including targeted exercises to improve quadriceps strength, was crucial for functional recovery and reducing the risk of complications such as medial patellofemoral pain., Conclusion: This case highlights the importance of a multidisciplinary approach in managing complex pediatric orthopedic cases., Competing Interests: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: N/A declare(s) Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.