What’s New in Pediatric Orthopaedics 2026

Key findings in pediatric orthopaedics are presented in the new JBJS Specialty Update What’s New in Pediatric Orthopaedics. Here, we highlight the 5 most compelling studies, as selected by coauthor Christina K. Hardesty, MD.

Trauma

The effect of skin tenting on the outcomes of adolescents with nonoperatively or operatively treated clavicular fractures was assessed in a multicenter retrospective review published in JBJS. A total of 88 patients were included. No differences in patient-reported outcome measures, complications, or time to return to sport were observed between the nonoperative and operative groups¹.

A prospective study published in JBJS compared functional bracing and spica casting for femoral diaphyseal fractures in 80 patients between 6 months and 5 years old. The groups had equivalent outcomes overall, including in shortening and varus angulation at 1 year of follow-up, although more superficial skin issues and procurvatum were observed in the bracing group. Patients treated with casting demonstrated more difficulty with moving independently and were less likely to fit in a car seat².

Infection

The prevalence of spinal involvement was investigated in 170 patients with chronic recurrent multifocal osteomyelitis. Forty-eight patients (28%) had spinal lesions, and of those, 27 had vertebral body lesions. Vertebral body height loss was demonstrated in 23 patients. The importance of early surveillance and timely treatment to mitigate progressive vertebral deformity was emphasized by the study authors³.

Neuromuscular

A retrospective study identified progressive hip displacement after triradiate cartilage (TRC) closure in 21% of ambulatory children with cerebral palsy (Gross Motor Function Classification System I to III). Patients with a migration percentage of ≥28% at TRC closure had the highest risk. The researchers concluded that annual hip surveillance following TRC closure should continue for at-risk patients, particularly those with bilateral involvement or epilepsy⁴.

Spine

Pulmonary function was assessed in 77 patients with idiopathic scoliosis 40 years after their diagnosis⁵. The study findings point to “persistent, heterogeneous reductions in lung capacity” in this population, “underscoring the need for long-term monitoring and consideration of pulmonary health in clinical management,” write Specialty Update authors Drs. Hardesty et al.

What’s New in Pediatric Orthopaedics is freely available at JBJS.org.

What’s New by Subspecialty

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.

Recent OrthoBuzz posts include: What’s New in Adult Reconstructive Knee Surgery, What’s New in Musculoskeletal Basic Science, and What’s New in Musculoskeletal Tumor Surgery.

References

1. Willimon SC, Wilson PL, Quinn M, Pang JH, Perkins CA, Ellis HB, Li Y, Nepple JJ, Pandya NK, Pennock AT, Spence DD, Bae DS, Busch MT, Edmonds EW, Kocher MS, Sabatini CS, Heyworth BE. Completely displaced midshaft clavicular fractures with skin tenting in adolescents: results from the FACTS multicenter prospective cohort study. J Bone Joint Surg Am. 2025 May 30;107(14):1553-60.
2. Andras LM, Sanders JS, Phan TN, Purtell SR, Gasca J, Wren TAL, Sim AT, Skaggs D, Kramer A, Chavez M, Kay R. A prospective, randomized comparison of functional bracing and spica casting for femoral fractures showed equivalent early outcomes. J Bone Joint Surg Am. 2025 Jun 26;107(16):1769-76.
3. Rogers ND, Trizno AA, Joyce CD, Roberts JL, Soep JB, Donaldson NJ. Spine involvement and vertebral deformity in patients diagnosed with chronic recurrent multifocal osteomyelitis. J Pediatr Orthop. 2024 Oct 1;44(9):561-6.
4. Lindgren AM, Asma A, Rogers KJ, Miller F, Shrader MW, Howard JJ. Hip displacement after triradiate closure in ambulatory cerebral palsy: who needs continued surveillance? J Pediatr Orthop. 2024 Nov-Dec 01;44(10):601-7.
5. Ragborg LC, Dragsted C, Ohrt-Nissen S, Mortensen J, Gehrchen M, Dahl B. Pulmonary function in patients with idiopathic scoliosis 40 years after diagnosis. Spine J. 2024 Nov;24(11):2135-42.