Background: The purpose of this study was to explore the surgical treatment of intraspinal rib head dislocation (IRH) in children with dystrophic scoliosis secondary to type 1 neurofibromatosis (NF1-DS). Methods: From 2006 to 2019, 32 of 128 patients with NF1-DS were found to have IRH and enrolled in this study. There were 19 boys and 13 girls with an average age of 8.8±2.6 years. Patients were divided into 2 groups: group A (n=25) without IRH resection and group B (n=7) with IRH resection. The intraspinal rib proportion (IRP), apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift and thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were measured before and after the operation. Spinal injury was graded based on the American Spinal Injury Association (ASIA) Impairment Scale. Results: The study group had a total of 42 IRH. The mean follow-up duration was 46.1±28.7 months. The preoperative IRP in both groups was similar (35.5±14.3% vs. 31.2±15.3%, P =0.522). The postoperative IRP was lower in group B (18.5±11.2% vs. 0%, P =0.002). The IRP in group A decreased from preoperative (31.2±15.3%) to postoperative (18.5±11.2%) ( P <0.05). There was no significant difference in the apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift, thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis between the 2 groups before surgery and after surgery. Four patients with nerve injury caused by the IRH had full neurological recovery postoperatively. All patients were ASIA grade E at the last follow-up. Conclusions: The surgical treatment of IRH in children with NF1-DS should be determined on the basis of the presence of preoperative neurological symptoms. This study supports the practice of correcting spinal deformities only in patients with mild or no spinal cord injury. If there are obvious neurological symptoms, IRH resection is necessary to relieve spinal cord compression to recover nerve function. Level of Evidence: Level III.

Latent fingerprints are invisible impressions that need to be developed before being used for individual identification. To advance fingerprint powdering, which is the most common method of developing latent fingerprints on nonporous substrates, two types of green-light-excited carbon dots (CDs) were synthesized hydrothermally using rhodamine 6G (R6G) and rhodamine B (RB) as the precursors. Under the physical effects of capillary attraction and coffee-ring effect, they were dispersed into hierarchical porous micron-sized diatomite (DE) in a facile, cost-effective, and eco-friendly way. The evolution of fluorescence characteristics from water-dispersed CDs to solid CDs/DE composite powders is clarified from the perspectives of physical properties and microstructures of the CDs and diatomite matrix. Optimized green fluorescent R6G-CDs/DE and yellow fluorescent RB-CDs/DE can be excited by visible light (green region) and show very high performance in fingerprint development under the luminescence modes, which has low phototoxicity and helps to preserve chemical information in fingerprint residues. Furthermore, image enhancement protocols, called "digital filters", established based on qualitative and quantitative analyses of red, green, and blue (RGB) channel images of fluorescent fingerprints developed with the CDs/DE composite powders are very efficient in eliminating background interferences of challenging surfaces such as multicolored or patterned substrates. The as-prepared new materials for fingerprint development and the created methods for image enhancement show great promise in practical application scenarios.

Study Design. Questionnaire translation and validation. Objective. The aim of this study was to translate the Early-Onset Scoliosis 24-Item Questionnaire (EOSQ-24) into simplified Chinese and to evaluate the reliability and validity of this questionnaire in children with early-onset scoliosis (EOS) in mainland China. Summary of Background Data. The EOSQ-24 is a validated quality of life questionnaire in children with EOS and has been translated into multiple languages and used worldwide. However, there is currently no simplified Chinese version available for use in mainland China. Methods. The English version of the EOSQ-24 questionnaire was translated into simplified Chinese based on the recommendations of the International Quality of Life Assessment (IQoLA) group. The reliability of the scale was evaluated using test–retest reliability and internal consistency, and construct validity was examined through factor analysis. Hundred childrenwith EOS were enrolled in the study. To assess the test–retest reliability of the scale, the parents or caregivers of 38 of participants repeated the questionnaire after 2 weeks. Results. Test–retest reliability was excellent overall (intraclass correlation coefficient [ICC] = 0.935) and ranged from moderate to excellent for each domain (ICC = 0.681–0.945). The overall internal consistency was excellent (Cronbach α = 0.893) and had a variable range for each domain (Cronbach α = 0.560–0.889). Factor analysis was performed, and seven principal components were extracted that accounted for 70.1% of the variance. Conclusion. The simplified Chinese version of the EOSQ-24 scale has acceptable reliability and construct validity, and it can be used for the assessment of health-related quality of life (HRQL), caretaker burden, and satisfaction for children with EOS in mainland China. Level of Evidence: 3

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Background The objective of this study was to evaluate the medium-term and long-term surgical outcomes of the 1-stage posterior-only lumbosacral hemivertebra resection with shortsegment fusion in children. Methods: This retrospective chart review included 21 children with congenital scoliosis due to lumbosacral hemivertebra who received 1-stage posterior-only hemivertebra resection with short-segment fusion from 2012 to 2016 with at least 5 years of follow-up. Standing anteroposterior and lateral radiographs of the spine were compared preoperatively, postoperatively, and at last follow-up. Radiographic evaluation included measured changes in segmental scoliosis and lordosis, compensatory scoliosis, thoracic kyphosis, lumbar lordosis, trunk shift, and sagittal spinopelvic alignment. Results: There were 12 boys and 9 girls with a mean age of 6.5 ± 3.2 years. The mean follow-up period was 6.7 ± 1.3 years. The mean fusion level was 2.7 ± 0.9 segments. The mean segmental scoliosis was 29 ± 6 degrees preoperatively, 9 ± 3 degrees (correction rate of 71%) postoperatively (P < 0.05), and 7 ± 3 degrees (correction rate of 76%) at the latest follow-up. The compensatory curve of 26 ± 12 degrees was spontaneously corrected to 14 ± 8 degrees (correction rate of 47%) at last follow-up (P < 0.05). Trunk shift was significantly improved on both coronal (53%) and sagittal (56%) planes after surgery (P<0.05) and stable at follow-up. The sagittal spinopelvic alignment was balanced in all cases. There were no neurological or infectious complications. Conclusions: It is safe and effective to perform 1-stage posterioronly lumbosacral hemivertebra resection with short-segment fusion, which can significantly correct the segmental scoliosis, prevent the compensatory curve progress and improve the trunk shift. This strategy also can save motion segments and avoid long lumbar fusion. Medium-term and long-term follow-up outcomes are satisfactory. Level of Evidence: Level III.

Background The purpose of this study was to investigate the clinical and functional outcomes of early versus delayed treatment of pediatric lateral condylar fractures of the humerus with a displacement greater than 2 mm. Methods Sixty-seven children treated surgically at our hospital from March 2016 to September 2021 for lateral condylar fracture of the humerus with displacement > 2 mm were retrospectively analyzed. The children were divided into two groups where early surgery consisted of patients being operated on within 24-h post-injury (n = 36) and delayed surgery consisted of children operated after 24-h post-injury (n = 31). Clinical and functional results were compared between the two groups. Results There were no significant differences between the two groups in terms of operation time, blood loss and incidences of perioperative complications. However, mean length of incision was significantly greater (P < 0.0001) in the delayed treatment group (5.68 ± 1.08 cm) compared to the early treatment group (3.89 ± 0.82 cm). No differences were found in functional outcomes, consisting of the Baumann angle of the affected limb, the carrying angle, Mayo Elbow Performance Score, and Flynn’s criteria at final follow-up. Conclusions Delay in surgery for more than 24 h after injury does not influence the clinical and functional results for lateral condylar fracture of the humerus with displacement > 2 mm in children. However, delayed open reduction and pinning may increase the incision length possibly due to increased edema.

ObjectiveTo explore the application of the growing rod (GR) technique in the treatment of kyphotic early-onset scoliosis (KEOS) and analyze its surgical efficacy and safety.MethodsThe clinical data of 30 children with KEOS who received GR treatment at our department between January 2016 and December 2019 were analyzed retrospectively. There were 18 cases with normal kyphosis (normal kyphosis group) and 12 cases with excessive kyphosis (excessive kyphosis group). Both groups received GR treatment, and all patients received anteroposterior and lateral spine X-ray examinations before, after the initial surgery, and at the final follow-up. The surgical conditions and imaging parameters of the two groups were compared, and the complications were recorded.ResultsThere was no statistical difference in the Cobb angle of the major curve, apical vertebral translation (AVT), and trunk shift (TS) between the two groups before, after the first surgery, and at the final follow-up (P &gt; 0.05). The Cobb angle of the major curve, the AVT, and the TS in both groups after the first surgery were lower than before the first surgery (P &lt; 0.05), but there was no statistical difference between the two groups (P &gt; 0.05). At the final follow-up, there were increases in both the Cobb angle and the AVT (P &lt; 0.05), while the TS decreased in comparison with findings after the first surgery (P &lt; 0.05). Before and after the first surgery and at the final follow-up appointment, there was a statistical difference in the degree of thoracic kyphosis (TK) between the two groups (P &lt; 0.05), while there was no statistical difference in terms of lumbar lordosis (LL), the proximal junctional angle (PJA), and the distal junctional angle (DJA) (P &gt; 0.05). After the first surgery, TK and LL showed a significant moderate response in both groups (P &lt; 0.05), while there was no significant difference in TK, LL, PJA, and DJA compared with the results at the final follow-up (P &gt; 0.05).ConclusionsThe use of the GR technique can improve kyphosis in KEOS treatment.

Additional proximal fixation for growing rods in early-onset scoliosis (EOS) may offer a more effective and safer option for severe scoliosis patients with hyper-kyphosis. Here, we compared the outcomes of EOS patients treated with growing rods in which 6 proximal anchor points on 3 vertebrae were used vs. 4 proximal anchor points on 2 vertebrae. The records of patients with EOS treated surgically from January 2016 to December 2017 were retrospectively reviewed. In the Proximal 4 group, 2 vertebral bodies were anchored proximally with 4 anchor points; in the Proximal 6 group, 3 vertebral bodies were anchored proximally with 6 anchor points. Forty-two patients (mean age 5.11 ± 1.93 years) were included; 22 Proximal 4 group, 20 Proximal 6 group. Mean follow-up was 40.86 ± 13.49 months. The decrease in main curve Cobb angle postoperatively was significantly greater in the Proximal 6 group (33.22° vs. 19.08°) (P < 0.05). Cobb thoracic kyphosis (TK) was significantly decreased postoperatively in the Proximal 6 group (mean 20.70°); no significant decrease occurred in the Proximal 4 group. The main curve Cobb angle decrease at last follow-up was significantly greater in the Proximal 6 group (37.84° vs. 24.23°) (P < 0.05). Cobb TK was significantly decreased at last follow-up in the Proximal 6 group (mean 25.17°, P < 0.05); no significant decrease occurred in the Proximal 4 group. Instrument complications were lower in the Proximal 6 group (15.00% vs. 45.45%) (P < 0.05). No proximal junctional kyphosis was noted. Fixing 3 proximal vertebral bodies with 6 anchors improves radiographic outcomes of EOS treated with growing rods, and has a lower rate of screw pull-out.