AAP and POSNA: New Orthopedic Practice Considerations

The American Academy of Pediatrics (AAP)-Section on Orthopedics and the Pediatric Orthopedic Society of North America (POSNA) have released a list of practices that physicians should avoid in certain pediatric patient populations.

The list, titled “Five Things Physicians and Patients Should Question,” was issued as part of the Choosing Wisely campaign. It includes the following statements:

• A screening hip ultrasound should not be ordered to rule out developmental hip dysplasia or developmental hip dislocation in babies with no risk factors and with a clinically stable hip examination.
• For children younger than age 8 years with simple in-toeing gait, radiographs should not be ordered and bracing or surgery should not be advised.
• Custom orthotics and shoe inserts should not be ordered for children with minimally symptomatic or asymptomatic flat feet.
• Advanced imaging studies should not be ordered for most musculoskeletal conditions in children until all appropriate clinical, laboratory, and plain radiographic examinations have been performed.
• If buckle (or torus) fractures are no longer tender or painful, follow-up X-rays should not be ordered.

To read the full version of the list, click here.

—Christina Vogt