The Role of Obesity in Pediatric Orthopedics.

Pediatric obesity has become a worldwide epidemic and leads to notable effects on the developing skeleton that can have lifelong implications. Obesity in the pediatric population alters bone metabolism, increasing the risk for fracture. It can alter the presentation of common pediatric orthopaedic conditions such as scoliosis. Obesity also leads to changes in the patterns and severity of pediatric fractures as well as alters conservative fracture treatment due to increased displacement risk. Obese pediatric trauma patients place a high burden on the nationwide hospital system in a variety of ways including the increased risk of perioperative complications. Obesity is modifiable, and addressing the issue can improve the orthopaedic and overall health of children.

Update in adolescent orthopaedics: discussion of common hip conditions.

The study of the adolescent hip has seen major advances over the past decade, with important findings in the pathophysiology and management of adolescent hip conditions coming through the advent and use of improved surgical techniques to treat residual and complex hip deformities. Pediatricians are familiar with slipped capital femoral epiphysis and Legg-Calvé-Perthes disease, but they may not be as familiar with residual deformities related to those conditions that manifest themselves in the adolescent and young adult population. The recently described concept of femoroacetabular impingement has become one of significant interest, with advanced hip arthroscopy techniques developed to treat the condition through a minimally invasive approach. The adolescent hip continues to fascinate pediatric and young adult surgeons, and it is hoped that with long-term studies that the efforts taken today to save these hips from early joint replacement will ultimately keep young patients active with a good quality of life.