Background: 25-hydroxyvitamin D [25(OH)D] deficiency is a global health concern, particularly in pediatric populations, with implications for musculoskeletal health and overall well-being. This study aimed to evaluate serum 25(OH)D levels in a pediatric population and assess the prevalence of deficiency and insufficiency. Methods: A retrospective analysis was conducted on data from 741 pediatric patients (2–17 years old) who visited an urban hospital for children for acute respiratory and gastrointestinal conditions in the span of 2 years. Serum 25(OH)D levels were measured using chemiluminescent microparticle immunoassay. Statistical analyses were performed to assess the prevalence of deficiency and insufficiency, seasonal variations, and correlations with age and daylight exposure. Results: Of the 739 pediatric patients analyzed, a substantial proportion exhibited insufficient (31.80%) or deficient (36.54%) serum 25(OH)D levels. While younger age groups generally had higher mean 25(OH)D levels, a negative correlation was observed between 25(OH)D levels and age. Sunlight exposure variations did not significantly impact serum 25(OH)D levels. Despite diverse daylight exposure patterns, there were no significant differences between longer and shorter daylight periods. Conclusions: This study highlights the high prevalence of 25(OH)D deficiency and insufficiency in the pediatric population, emphasizing the need for public health monitoring and targeted supplementation strategies. Findings underscore the importance of regular consultations with healthcare providers to ensure optimal 25(OH)D levels in children, with potential implications for revising current sufficiency thresholds. Addressing 25(OH)D deficiency is crucial for promoting musculoskeletal health and overall well-being in children.

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.

Background: Pediatric osteoarticular tuberculosis (TB) remains a significant global health challenge, particularly in resource-limited settings, where delayed diagnosis and treatment frequently lead to severe long-term complications. Despite advancements in TB control, skeletal TB in children is often misdiagnosed due to its non-specific clinical presentation, contributing to poor outcomes such as joint deformities, growth disturbances, and chronic pain. The complexity of diagnosing osteoarticular TB is further exacerbated by the limited sensitivity of conventional diagnostic tools and the overlap with other musculoskeletal conditions. This study seeks to evaluate the impact of early detection and multidisciplinary management on treatment outcomes in pediatric patients with osteoarticular TB. Methods: A retrospective review was conducted at the Pediatric Orthopedics Department of the “Grigore Alexandrescu” Children’s Hospital in Romania from 2009 to 2023. Case data included clinical, imaging, and microbiological findings, and treatment outcomes in children aged 0–18 years diagnosed with tuberculous osteomyelitis. Results: The study identified varied clinical presentations, with delayed diagnosis often linked to misinterpretation of symptoms as non-TB infections. Multimodal diagnostic approaches combining imaging, microbiological testing, and histopathology improved diagnostic accuracy. Early surgical intervention alongside anti-TB therapy proved effective in reducing long-term complications. Conclusions: Timely, accurate diagnosis and multidisciplinary treatment are critical to improving outcomes in pediatric osteoarticular TB. Vaccination status and comprehensive diagnostic tools significantly influence disease progression and treatment success. The study underscores the need for enhanced screening and diagnostic methods to prevent delays in treatment.

Background/Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity often requiring surgical correction in severe cases. Halo-gravity traction (HGT) is commonly employed preoperatively to enhance spinal flexibility and reduce curve severity. This study aimed to evaluate the effectiveness of HGT in reducing Cobb angles in AIS and to assess how patient age, skeletal maturity (Risser score), and curve type (Lenke classification) influence treatment response. Methods: We conducted a retrospective cohort study of 28 AIS patients with Cobb angles > 65° who underwent preoperative HGT followed by posterior spinal fusion. Traction was applied for a mean of 24.64 days, reaching 40–50% of each patient’s body weight. Radiographic measurements were collected pre-traction, post-traction, and postoperatively. Statistical analyses included paired t-tests, Pearson correlations, Kruskal–Wallis tests, and linear regression. Results: Mean primary Cobb angle was reduced from 82.46° pre-traction to 61.00° post-traction (26.09% reduction) and further to 29.54° postoperatively (64.58% total reduction). Similar reductions were observed in secondary curves. No statistically significant correlations were found between age or Risser score and the magnitude of correction. Lenke type 3 showed the highest traction response, while type 5 had the greatest surgical gain. Curve type and skeletal maturity did not significantly affect final outcomes. Conclusions: Halo-gravity traction is a safe and effective adjunct in the surgical treatment of severe AIS, achieving substantial Cobb angle reduction. The degree of correction was not significantly influenced by age, Risser score, or curve type, supporting the broad applicability of HGT across adolescent patients.

Background: Flexible flatfoot is a common pediatric condition. Surgical intervention is indicated for symptomatic cases unresponsive to conservative treatment. This study evaluates the outcomes of two established procedures, Grice extraarticular subtalar arthrodesis and subtalar arthroereisis, in children treated for symptomatic flatfoot. Methods: A retrospective analysis was conducted on 158 patients (286 feet) treated between 2013 and 2024. Among them, 34 underwent Grice arthrodesis and 124 underwent arthroereisis. Demographic and procedural data were collected, including age, sex, neurological impairment (cerebral palsy), laterality, and concurrent Achilles tendon lengthening. Radiographic parameters assessed pre- and postoperatively included Meary’s, Pitch, and Kite’s angles (frontal and sagittal view), uncovering of the talus, and Cyma line. Only patients with both pre- and postoperative measurements were included in paired analysis. Statistical tests included paired t-tests within groups and Welch’s t-tests for between-group comparisons. Results: Grice patients were younger (mean age 9.0 ± 3.1 years) and included all cerebral palsy cases (18/34; 52.9%), while arthroereisis patients were older (10.8 ± 2.6 years) and typically neurologically normal. Achilles tendon lengthening was performed in 100% of Grice and 48% of arthroereisis cases. Both groups showed significant radiographic improvement across all measured parameters (all p < 0.05). Grice arthrodesis produced greater reductions in Meary’s angle (right Δ = −19.8° ± 9.2 vs. −13.1° ± 7.5; p = 0.024), while arthroereisis yielded larger increases in Pitch angle (left Δ = +9.2° ± 7.2 vs. +5.5° ± 6.2; p = 0.055). Other angular improvements (Kite’s, uncovering, and Cyma line) were statistically significant within both groups but not between groups. Conclusions: Symptomatic flat-valgus foot in children remains a relevant public health issue. Treatment should be individualized, while cases secondary to unrecognized or untreated congenital conditions often require surgery to restore normal foot biomechanics.