Background: Vitamin D is an essential component in calcium metabolism. Seasonality, advanced age, sex, dark skin pigmentation, and limited exposure to sunlight were reported as causes of vitamin D deficiency. This study aims to determine whether children with lower levels of vitamin D suffer more fractures than those with sufficient levels. Materials and Methods: Our institution underwent a prospective case–control randomized cross-sectional single-blinded study that included 688 children. They were split into two groups: the study group and the control group. The study group received supplements of vitamin D and calcium for 6 months. Another reference cohort was observed, which comprised 889 patients in the pediatric ward for different respiratory or gastroenterological conditions without a history of fractures. This group was used for age–sex matching tests. Results: Logistic regression showed that with every one unit increase of vitamin D level, the chance of having a middle third fracture in both bones of the forearm decreased by 7% (OR 1.07); distal third fracture incidence decreased by 1.03 times; middle third radius fracture incidence decreased by 1.03 times; distal third radius fracture incidence decreased by 1.06 times. The risk of having a distal third both-bone forearm fracture increased by 1.06 times with every year of age. Comparing the healing process, we noticed an improvement in bony callus formation for patients in the study group. Conclusions: Dosing the serum level of 25-OH-vitamin D should be taken into consideration for pediatric low-energy trauma fractures. Supplementing with vitamin D and calcium throughout childhood can be a solution for healthy bones. Our preliminary results show that the normal level of vitamin D in children should start at 40 ng/mL.

Developmental dysplasia of the hip (DDH) is a progressive condition that lacks clear diagnostic and management protocols, due to insufficient data. While some advocate for universal screening, others recommend using risk factors as landmarks. In this study, we aimed to assess the risk factors associated with DDH incidence among a large population. We conducted a retrospective single-center multifactorial study between January 2019 and March 2022, including 3720 children who were investigated anamnestically, clinically, and through an ultrasound scan. We classified them into two groups: the control group with 3300 healthy children and the study group with 420 newborns diagnosed with DDH. Our analysis identified several risk factors associated with DDH, including gender, prematurity, non-vertex birth presentation, oligohydramnios, gestational diabetes, maternal hypertension, family history, associated deformities, and swaddling. We found that every DDH patient had at least two risk factors. Based on our findings, we recommend that children who present two or more risk factors for DDH be mandatorily evaluated sonographically, as well as children with clinical signs. DDH screening is recommended for each newborn for the long-term benefits of early detection and treatment.

Background and objective: Adolescent idiopathic scoliosis (A.I.S.) is a disorder with a significant impact on health and self-image. This spinal deformity can affect between 2% and 4% of the adolescent population and may alter one’s quality of life. This study aims to assess the patient outcome, satisfaction, and quality of life following surgical treatment using the SRS-30 questionnaire. Materials and Methods: A number of 49 children and adolescent patients diagnosed with idiopathic scoliosis that had surgery were included in this study. They thoroughly completed the SRS-30 questionnaire before and after the surgery, based on which data analysis was carried on. Correlations between the test results and imagistic data (pre- and postoperative Cobb angle, correction rate of Cobb angle, number of instrumented spinal segments, and number of pedicle screws/laminar hooks used in the surgery) were performed. Results: Our results showed that 87.76% of the patients were girls, and the mean age at surgery was 14.83 years. Postoperatively, the Cobb angle improved significantly (p < 0.0001). The questionnaire domain “Satisfaction with management” improved dramatically after surgery, averaging 13.65 points (91% out of the maximum score). The average postoperative test score was 125.1 points. Statistically significant correlations were found between the correction rate and SRS-30 score improvement (p < 0.001), in total as well as per each domain of the survey, respectively. Comparing the questionnaire domains, “Self-image” was positively correlated with “Satisfaction with management” (p < 0.0001). Conclusions: Better correction rate led to higher values of SRS-30 score. Additionally, the younger the age at surgery is, the higher the score. The number of instrumented spinal segments does not alter the quality of life. Overall, the most crucial factor influencing patient satisfaction after surgical treatment is self-image.

Idiopathic scoliosis affects a severe number of children. Their quality of life and development are also disturbed. Some therapeutic strategies have been developed to control illness progression and to optimize the quality of life. In this perspective, randomized, case-control, interventional study, the impact of using melatonin, calcium, and vitamin D, respectively, on idiopathic scoliosis patients was analyzed. Our preliminary results showed that these drugs positively affected the illness progression quantified by the spine curvature. Patients with idiopathic scoliosis may benefit from a novel treatment by supplementation with vitamin D, calcium, and melatonin.

Introduction: Elastic stable intramedullary nailing is widely recognized for treating pediatric forearm fractures due to its stable fixation and minimal impact on soft tissue. Traditionally, casting has followed elastic stable intramedullary nailing; however, recent studies question its necessity. This study evaluates the outcomes of omitting casts post-elastic stable intramedullary nailing, examining healing speed and quality of life compared to cases where casting was applied. Materials and Methods: A prospective study was conducted from 2022 to 2024 in an urban hospital, where children with both-bone midshaft forearm fracture were randomized to receive or not receive casting after elastic stable intramedullary nailing. Age- and sex-matched patients were selected to allow for accurate comparison. The study included patients aged 5 to 14 years. Outcomes were measured using radiographic scores and quality-of-life assessments. Results: From a total of 355 patients, 136 cases were included in the assessment. Analysis indicated faster healing in patients without postoperative casting, as evidenced by higher REBORNE scores at 3 weeks and 2 months. Quality of life, measured by the Pediatric Quality of Life Inventory, was also significantly improved in the no-cast group at 6 weeks. Discussion: Our findings suggest that elastic stable intramedullary nailing provides sufficient stability for both-bone midshaft forearm fracture, making additional casting unnecessary. Early mobilization led to better functional outcomes without increasing complications. Although some minor early discomfort was reported, the cast-free approach proved effective and safe. Conclusion: Elastic stable intramedullary nailing remains the gold standard for treating pediatric forearm fractures. Our preliminary results indicate that for both-bone midshaft forearm fracture, elastic stable intramedullary nailing can be safely performed without postoperative casting, promoting faster healing and better patient satisfaction.

Background/Objectives: This study aimed to evaluate the effect of preoperative halo-gravity traction (HGT) on surgical outcomes in adolescents with severe idiopathic scoliosis (AIS), comparing posterior spinal fusion (PSF) performed with versus without traction in terms of curve correction, complication rates, and overall surgical efficacy. Methods: A retrospective cohort study was conducted on 46 adolescents (mean age 14.6 ± 1.9 years) with severe AIS (Cobb > 65°) treated at a single tertiary center between 2011 and 2024. Sixteen patients underwent primary PSF, and 30 received preoperative HGT followed by PSF. Radiographic parameters—including Cobb angle and Risser grade—were analyzed pre- and postoperatively. Statistical tests (t-test, Mann–Whitney U, and multivariable linear regression) assessed differences in correction and predictors of outcome, with p < 0.05 considered significant. Results: Baseline characteristics were comparable between groups (mean preoperative Cobb: 83.6° ± 11.2° vs. 83.1° ± 15.6°, p = 0.91). The traction cohort achieved significantly smaller postoperative Cobb angles (30.9° ± 7.8° vs. 42.7° ± 18.9°, p = 0.027), greater absolute correction (52.7° ± 7.4° vs. 40.4° ± 10.5°, p < 0.001), and higher percentage correction (63.3% ± 6.7% vs. 50.0% ± 14.0%, p = 0.002). Regression analysis confirmed HGT as an independent predictor of improved correction (+14.6%, 95% CI +6.9–22.3%, p = 0.00047). No neurological or major complications occurred, and most correction was achieved within the first three weeks of traction. Conclusions: Preoperative halo-gravity traction significantly enhances deformity correction and surgical safety in severe AIS without added morbidity. Most benefit occurs within 21 days, supporting shorter, standardized traction protocols. HGT remains a valuable adjunct for optimizing outcomes in rigid scoliosis prior to posterior spinal fusion.