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Children
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Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care
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Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Orthopedics & Sports Medicine".

Deadline for manuscript submissions: closed (1 January 2026) | Viewed by 13883

Special Issue Editors

Dr. Sergio De Salvatore

E-Mail Website
Guest Editor
1. Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Rome, Italy
2. Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, 00050 Rome, Italy
Interests: orthopedic; spine; pediatric orthopedics; scoliosis; flatfoot; low back pain; spondylolisthesis; robotic spine; augmented reality; shoulder; hip; knee; navigation
Special Issues, Collections and Topics in MDPI journals
Dr. Fabrizio Donati

E-Mail Website
Guest Editor
Department of Orthopedics, Children’s Hospital Bambino Gesù, Palidoro, 00165 Rome, Italy
Interests: pediatric patients with cerebral palsy; orthopedic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The field of pediatric orthopedics is undergoing a significant transformation through the integration of emerging technologies, leading to improved diagnostic accuracy and therapeutic outcomes for children with musculoskeletal conditions. Innovations such as 3D printing, robotic-assisted surgery, artificial intelligence, and augmented reality are increasingly being adopted to address the pediatric population's complex orthopedic challenges. This Special Issue aims at compiling cutting-edge research and clinical studies that explore the application and impact of these technologies in pediatric orthopedic practice. We invite submissions that investigate the development and implementation of advanced imaging modalities, minimally invasive surgical techniques, personalized prosthetics, and rehabilitation strategies enhanced by technological advancements. Additionally, contributions that discuss the ethical considerations, cost-effectiveness, and long-term outcomes associated with these innovations are highly encouraged. By bringing together diverse perspectives and expertise, this Special Issue seeks to provide a comprehensive overview of how emerging technologies are reshaping pediatric orthopedic care, ultimately aiming at improving the quality of life for young patients. Researchers, clinicians, and healthcare professionals are invited to submit original articles, reviews, and case reports that contribute to this evolving discourse.

Dr. Sergio De Salvatore
Dr. Fabrizio Donati
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • novel technologies
  • pediatric orthopedics
  • flatfoot
  • genu valgum
  • hip dysplasia
  • pediatric trauma
  • virtual reality
  • clubfoot
  • early-onset scoliosis
  • Scheuermann disease
  • Perthes
  • epiphysiolysis
  • scoliosis
  • pediatric spine
  • neurological disorder

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Related Special Issue

Published Papers (7 papers)

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Research

Jump to: Review, Other

9 pages, 592 KB  
Article
Unique Challenges of Hebrew Translation and Cross-Cultural Adaptation of LIMB-Q Kids for Children with Lower Limb Differences
by Sharon Eylon, Michal Lieberman, Gilad Brandes, Patrice L. Weiss, Vladimir Goldman, Anthony P. Cooper and Harpreet Chhina
Children 2025, 12(10), 1318; https://doi.org/10.3390/children12101318 - 1 Oct 2025
Viewed by 749
Abstract
Background/Objectives. Patient-Reported Outcome Measures (PROMs) capture patients’ perspectives about their health status, quality of life, and medical care outcomes. LIMB-Q Kids is a validated PROM designed to assess health-related quality of life (HRQL) in children with lower limb differences. It evaluates physical, social, [...] Read more.
Background/Objectives. Patient-Reported Outcome Measures (PROMs) capture patients’ perspectives about their health status, quality of life, and medical care outcomes. LIMB-Q Kids is a validated PROM designed to assess health-related quality of life (HRQL) in children with lower limb differences. It evaluates physical, social, and psychological function; symptoms related to the leg, hip, knee, foot and ankle; leg-related distress, appearance, and school-related concerns. It has now been translated and culturally adapted from English to other languages. The aim of this study was to translate and culturally adapt LIMB-Q Kids to Hebrew. Methods. Following international guidelines, two independent forward translations from English to Hebrew were produced and reconciled into a single version. A backward translation was then compared with the original to identify discrepancies. This draft underwent cognitive debriefing interviews (CDIs) with 11 children (ages 8–15) having lower limb differences to assess comprehension and cultural relevance. Results. CDIs revealed general issues including lengthy or unclear text, high-level language, cultural unfamiliarity and duplication of descriptors. Specific to Hebrew, issues included gender inflections and the need for vowel diacritics to support younger, less proficient readers. Revisions to 14 items were made. Conclusions. A translation and cultural adaption (TCA) process led to a linguistically validated and culturally adapted Hebrew version of LIMB-Q Kids. It can now be used for the clinical follow-up of children with lower limb differences including pre- and post-operatively, and as an aid to decision-making for surgery. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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16 pages, 284 KB  
Article
Final Fusion Strategies in Early-Onset Scoliosis: Does Implant Density Make a Difference After Magnetically Controlled Growing Rod Treatment?
by Paolo Brigato, Leonardo Oggiano, Sergio De Salvatore, Davide Palombi, Sergio Sessa, Umile Giuseppe Longo, Andrea Vescio and Pier Francesco Costici
Children 2025, 12(6), 731; https://doi.org/10.3390/children12060731 - 31 May 2025
Cited by 2 | Viewed by 1401
Abstract
Background/Objectives: Early-onset scoliosis (EOS) frequently requires growth-friendly interventions, such as magnetically controlled growing rods (MCGRs), followed by definitive spinal fusion upon skeletal maturity. The optimal implant density (ID) for final posterior spinal fusion in these patients remains controversial. This study aimed to compare [...] Read more.
Background/Objectives: Early-onset scoliosis (EOS) frequently requires growth-friendly interventions, such as magnetically controlled growing rods (MCGRs), followed by definitive spinal fusion upon skeletal maturity. The optimal implant density (ID) for final posterior spinal fusion in these patients remains controversial. This study aimed to compare the radiographic, surgical, and economic outcomes associated with high-density (HD) versus low-density (LD) screw constructs in EOS patients previously treated with MCGRs undergoing definitive fusion. Methods: This retrospective study included 27 EOS patients who underwent definitive posterior spinal fusion between January 2017 and September 2022. Participants were categorized into two groups: HD (n = 13) and LD (n = 14). Primary outcomes included coronal and sagittal radiographic parameters assessed at early postoperative and final follow-up visits (minimum of 2 years). The secondary outcomes analyzed were major postoperative complications (grade ≥ IIIB according to Clavien–Dindo–Sink Classification [CDSC]), operative time, blood loss, hospital stay length, and total implant costs. Results: Baseline characteristics between the HD and LD groups were comparable. Early postoperative radiographic assessment demonstrated significantly greater thoracic kyphosis (16.3 ± 7.6° vs. 10.9 ± 14.4°, p = 0.021) and T1-S1 spinal height (43.3 ± 6.7 mm vs. 39.1 ± 4.3 mm, p = 0.039) in the HD group. At final follow-up, only T1-S1 spinal height remained significantly higher in the HD group (45.4 ± 7 mm vs. 39.7 ± 5.1 mm, p = 0.021). Implant costs were significantly higher in the HD group (EUR 6046.5 ± 1146.9 vs. EUR 4376.4 ± 999.4, p < 0.001), while operative time, blood loss, and hospital stay length showed no significant differences. HD constructs had three major complications requiring surgical revision, whereas LD constructs reported no perioperative complications but experienced three late-onset complications also necessitating revision surgery. Conclusions: LD constructs provided comparable long-term radiographic and clinical outcomes to HD constructs, with significantly lower implant-related costs. Despite initial superior kyphosis correction in HD constructs, this benefit diminished by the final follow-up. These findings support a selective, lower-density screw placement strategy to minimize costs and surgical complexity without compromising patient outcomes in EOS undergoing definitive spinal fusion. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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10 pages, 806 KB  
Article
Child Opportunity Index Predicts Outcomes in Pediatric Spine Trauma: A Novel Application of Social Determinants of Health
by Gabriel Urreola, Omar Ortuno, Michael Juma and Jose Castillo
Children 2025, 12(3), 380; https://doi.org/10.3390/children12030380 - 19 Mar 2025
Cited by 1 | Viewed by 1203
Abstract
Objectives: Social factors play a crucial role in health outcomes for pediatric patients, yet in the neurosurgery pediatric literature, these factors are rarely reported. To develop a deeper understanding of pediatric spine trauma outcomes, we investigate demographic and social factors measured by the [...] Read more.
Objectives: Social factors play a crucial role in health outcomes for pediatric patients, yet in the neurosurgery pediatric literature, these factors are rarely reported. To develop a deeper understanding of pediatric spine trauma outcomes, we investigate demographic and social factors measured by the Child Opportunity Index (COI) and Social Deprivation Index (SDI). We hypothesize that social factors predict clinical presentation, injury severity, and clinical outcomes. Methods: We conducted a retrospective cohort study of pediatric patients treated for spinal trauma at a Level 1 trauma center in Sacramento, California. We collected patient clinical data such as mechanisms of injury (MOIs), length of stay (LOS), treatment type, hospital disposition, polytrauma incidence, and follow-up attendance. Each patient’s social environment was characterized using COI and SDI metrics. Statistical comparisons were performed to assess associations between social factors and clinical outcomes. Results: Patients with worse childhood opportunity (lower COI and higher SDI) were more likely to be insured through Medi-Cal, identify as Hispanic, and experience violent MOI. Female patients were more likely to sustain polytrauma and had a higher likelihood of requiring surgical intervention. Additionally, patients from underserved communities demonstrated longer hospital stays and poorer follow-up adherence, with COI and SDI scores correlating with these disparities. Conclusion: Social disparities are associated with worse outcomes in pediatric spine trauma. We found COI and SDI to be valuable clinical metrics, motivating further research to be carried out at the state and national levels. These findings highlight health disparities in pediatric spine trauma. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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9 pages, 2757 KB  
Article
The Efficacy of a Novel Hybrid Brace in the Treatment of Adolescent Idiopathic Scoliosis: A Prospective Case-Series Study
by Hyoungmin Kim, Sam Yeol Chang, Bong Soon Chang, Jun Yeop Lee, Seonpyo Jang and Sung Taeck Kim
Children 2025, 12(3), 328; https://doi.org/10.3390/children12030328 - 5 Mar 2025
Viewed by 5173
Abstract
Background/Objectives: Bracing is an effective treatment for preventing curve progression in skeletally immature adolescent idiopathic scoliosis (AIS) patients. A novel hybrid brace has been developed to overcome the limitations of conventional rigid and soft braces. This study aimed to evaluate the clinical [...] Read more.
Background/Objectives: Bracing is an effective treatment for preventing curve progression in skeletally immature adolescent idiopathic scoliosis (AIS) patients. A novel hybrid brace has been developed to overcome the limitations of conventional rigid and soft braces. This study aimed to evaluate the clinical efficacy of the novel hybrid brace. Methods: We enrolled AIS patients who were candidates for brace treatment: aged 10–18 years, with a coronal Cobb angle of 20–45° and a Risser stage of 0–2. The primary outcome was the rate of successful brace treatment, defined as meeting all three criteria: (1) less than 5° of progression in the Cobb angle during follow-up, (2) less than 45° of Cobb angle at the final follow-up, and (3) avoidance of surgical treatment. Results: A total of 24 patients (1 male, 23 female) with a mean age of 12.2 ± 1.2 years were included in this study. At the initiation of bracing, the major curve had a mean Cobb angle of 34.5 ± 6.3° and an in-brace correction (IBC) rate of 41.5 ± 16.0%. The hybrid brace demonstrated a success rate of 91.7% (22/24) during a mean follow-up period of 22.1 ± 6.4 months. After brace treatment, seven (29.2%) patients showed an improvement of more than 5° in their Cobb angle. When compared to a matched control from a retrospective cohort, the hybrid brace demonstrated a greater success rate (91.7% vs. 83.3%) and a higher proportion of patients with an improved curve (29.2% vs. 12.5%), although statistically insignificant. Conclusions: A novel hybrid brace was effective in preventing curve progression in skeletally immature patients with AIS. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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Review

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10 pages, 241 KB  
Review
Biodegradable (PLGA) Implants in Pediatric Trauma: A Brief Review
by Herman Nudelman, Tibor Molnár and Gergő Józsa
Children 2026, 13(1), 19; https://doi.org/10.3390/children13010019 - 22 Dec 2025
Cited by 1 | Viewed by 1147
Abstract
Background/Objectives: Biodegradable implants have emerged as a promising alternative to traditional metallic fixation devices in pediatric orthopedic surgery. Avoiding implant removal is especially advantageous in children, who would otherwise require a second operation with additional anesthetic and surgical risks. This study reviews the [...] Read more.
Background/Objectives: Biodegradable implants have emerged as a promising alternative to traditional metallic fixation devices in pediatric orthopedic surgery. Avoiding implant removal is especially advantageous in children, who would otherwise require a second operation with additional anesthetic and surgical risks. This study reviews the current use of poly(lactic-co-glycolic acid) (PLGA) implants in pediatric fracture fixation and evaluates how they address limitations associated with traditional hardware. Methods: A narrative review was conducted summarizing current evidence, clinical experience, and case examples involving PLGA-based devices used in pediatric trauma. Special emphasis was placed on the degradation mechanism of PLGA, its controlled hydrolysis profile, and the capacity of the material to provide temporary mechanical stability during bone healing before complete resorption. The review included studies of PLGA use in forearm, distal radius, ankle, and elbow fractures, comparing outcomes to those obtained with metallic implants. Results: Across multiple clinical reports and case series, PLGA implants demonstrated effective fracture healing, stable fixation, and complication rates comparable to traditional metallic devices. Patients treated with resorbable implants benefited from reduced postoperative morbidity, no requirement for implant removal, and improved imaging compatibility. Conclusions: PLGA-based bioabsorbable implants represent a safe and effective alternative to conventional metal fixation in children. Their favorable degradation kinetics and clinical performance support their growing use in pediatric trauma surgery, while ongoing advances in polymer design and bioresorbable alloys continue to expand future applications. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
19 pages, 510 KB  
Review
Skeletal Maturity Assessment in Pediatric ACL-Reconstruction
by Umile Giuseppe Longo, Mariajose Villa Corta, Federica Valente, Laura Ruzzini, Pieter D’hooghe, Kristian Samuelsson, Frank A. Cordasco and Alexander S. Nicholls
Children 2025, 12(9), 1186; https://doi.org/10.3390/children12091186 - 5 Sep 2025
Viewed by 1947
Abstract
Anterior cruciate ligament (ACL) injuries in skeletally immature patients pose unique clinical and surgical challenges due to the presence of open physes and ongoing growth. In recent years, multiple surgical strategies have been developed to restore knee stability while minimizing the risk of [...] Read more.
Anterior cruciate ligament (ACL) injuries in skeletally immature patients pose unique clinical and surgical challenges due to the presence of open physes and ongoing growth. In recent years, multiple surgical strategies have been developed to restore knee stability while minimizing the risk of growth disturbances. However, clinical decision-making remains complex due to the lack of consensus regarding the optimal timing, technique, and graft selection for this population. This narrative review outlines the current clinical and radiological tools used to assess skeletal maturity and explores how maturity status informs surgical approach, with particular emphasis on physeal-sparing, hybrid, and transphyseal techniques. We summarize postoperative complications—including growth disturbances and graft failure—while highlighting current guideline recommendations and ongoing controversies. Lastly, we propose a multimodal model for skeletal maturity assessment to support individualized treatment strategies and emphasize the need for standardized protocols and high-quality research to improve long-term outcomes in pediatric ACL reconstruction. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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Other

Jump to: Research, Review

12 pages, 7025 KB  
Case Report
Complex Surgical Management of Permanent Patellar Dislocation in an Adolescent: An Eight-Year Follow-Up Case Report
by Janina Wurster, Elias Ammann, Erich Rutz, Victor Valderrabano and Carlo Camathias
Children 2025, 12(12), 1594; https://doi.org/10.3390/children12121594 - 24 Nov 2025
Cited by 1 | Viewed by 1042
Abstract
Introduction: This case report presents the multifactorial surgical management and long-term outcome of a permanent patellar dislocation in a 16-year-old female patient. Case presentation: A 16-year-old female with permanent patellar dislocation of the left knee complained of progressive pain and functional limitations. Physical [...] Read more.
Introduction: This case report presents the multifactorial surgical management and long-term outcome of a permanent patellar dislocation in a 16-year-old female patient. Case presentation: A 16-year-old female with permanent patellar dislocation of the left knee complained of progressive pain and functional limitations. Physical examination revealed a 20-degree passive flexion contracture, significant muscle weakness in knee extension, and a permanently laterally dislocated patella that could not be manually repositioned. Imaging studies revealed a complex knee deformity characterised by femoral valgus, tibial varus, posterior tibial slope, and trochlear dysplasia. The patient underwent a comprehensive surgical approach addressing all deformities, including femoral and tibial osteotomies, trochleoplasty, medial patellofemoral ligament (MPFL) plasty, and quadriceps muscle balancing. Results: At the eight-year follow-up, the patient demonstrated a full range of motion and adequate stability, and experienced mild pain only rarely. Outcomes improved significantly: the International Knee Documentation Committee (IKDC) score increased from 10.3% to 75.9%, the Lysholm score rose from 24 to 72, the Kujala score improved from 22 to 67, and the BPII score increased from 14.9 to 55.4. Conclusions: Comprehensive surgical correction of all predisposing factors achieved sustained functional improvement over eight years, demonstrating that systematic treatment of anatomical and functional abnormalities is essential for the successful management of permanent patellar dislocation. Level of evidence: V. Full article
(This article belongs to the Special Issue Advancements in Pediatric Orthopedics: Integrating Emerging Technologies for Enhanced Care)
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