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Pediatric Orthopedics > Ankle Pediatric Fractures Osteochondrities > Flashcards

Ankle Pediatric Fractures Osteochondrities Flashcards

1
Q

What is chronic recurrent multifocal osteomyelitis (CRMO)

A

Autoinflammatory disorder of children and young adults that is characterized by nonbacterial osteomyelitis

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2
Q

Is CRMO bacterial or nonbacterial osteomyelitis

A

Nonbacterial osteomyelitis

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3
Q

What are the typical imaging findings of CRMO

A

Lyric and sclerotic lesions in the metaphyses of long bones

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4
Q

What is Diaz Disease

A

Aseptic Necrosis of the Taurus
- Rare and associated with trauma
- Self limiting
- Walking cast to protect the talus, returns to shape

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5
Q

What are symptoms of Juvenile RA (Still’s Disease)

A
  • antalgic gait
  • skin rash - salmon pink macuole increasing in size
  • Rheumatologist referral due to long term treatment
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6
Q

Describe Rheumatic Fever

A
  • starts as upper respiratory tract infection
  • Transient swelling with pain of the joints
  • successive pattern
  • subsides in one appears in another
  • early treatment to avoid valvular damage (group A beta-hemolytic strep)
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7
Q

What is Osteomyelitis

A
  • pyogenic
  • hematogenous or inoculation by puncture wound
  • symptoms: swelling, erythema, tenderness, calor of joint with throbbing pain
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8
Q

Which bone is most commonly affected by hematogenous osteomyelitis

A

Calcaneus

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9
Q

Describe osteomyelitis in infants and children

A
  • in infants: epiphyseal
  • in children - metaphysis
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10
Q

What are the radiographic findings of osteomyelitis

A
  • early: swelling
  • lytic areas, periosteal changes
  • Brodie’s abscess
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11
Q

What medical condition can result from osteomyelitis

A

Tuberculosis: due to hematogenous spread in metaphyseal of long bones

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12
Q

What is one common differential diagnosis for osteomyelitis

A

Ewing’s sarcoma

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13
Q

What are the problems associated with ball and socket joint of the ankle

A
  • allows for sagittal plane motion but also transverse and frontal
  • results in instability
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14
Q

How do you treat ball and socket joint of the ankle

A
  • if chronic ankle problems occur, fusion is the surgical procedure
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15
Q

Describe ankle valgus and how it is acquired

A
  • congenitally short fibula
  • acquired from fibular fracture, unequal growth with tibia
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16
Q

What to the treatment for ankle valgus

A

Tib-fib fusion or bone graft to produce stability

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17
Q

Describe epiphyseal fractures

A
  • can occur from significantly different consequences from adult fractures
  • unique fracture patterns
  • premature epiphyseal arrest
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18
Q

When does the primary centers of ossification in long bones start forming

A

7th week intrauterine

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19
Q

When does the femur ossify

A

Early 7th week

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20
Q

When does the tibia ossify

A

Later in 7th week

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21
Q

When does the fibula ossify

A

8th week

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22
Q

What are pressure epiphyses

A

Articular, end of long bone, transmit pressure through joints, provide longitudinal growth of bone

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23
Q

What are traction epiphysis

A

Sites of muscle attachments, tremendous pressure, provide shape and contour of bone

24
Q

Describe the anatomy of the physis

A

Radiolucent cartilaginous plate between meta and epiphysis

25
Q

In epiphyseal fractures, where does injury actually occur

A

In the physis, not the epiphysis

26
Q

What occurs in the in the cartilaginous zone of the epiphyseal

A

Growth due to dividing cells
Maturation —> calcification
Transformation —> ossification

27
Q

What happens in the metaphysis of the epiphyseal region

A
  • assist in bone formation and remodeling
28
Q

What happens in Ranvier and LaCroix of the epiphyseal region

A

Fibrous components

29
Q

What is Type 1 Salter Harris

A

Epiphysis separated from the metaphysis without boney fracture

30
Q

What is Type II Salter Harris

A

Thurston Holland fracture though the epiphysis transversely going through metaphysis (triangle)

31
Q

What is Type III Salter Harris

A

Intra articular fracture from joint surface through the epiphysis, then extending along the plate to its periphery

32
Q

What is Type IV Salter Harris

A

Intra articular from the joint surface through the epiphysis across the physeal plate and through a portion of the metaphysis (oblique fracture)

33
Q

What is Type V Salter Harris

A

Severe crushing injury and compression force of the physeal plate

34
Q

What is the treatment and prognosis for Type I Salter Harris

A

NWB Cast 3-4 weeks
Peds heal in 1/2 the time it would take an adult
Prognosis - excellent

35
Q

Hat is the most common physeal plate injury

A

Salter Harris Type II

36
Q

What is the treat for nondisplaced salter Harris Type II

A

WB cast 4 weeks

37
Q

What is the treatment for displaced Salter Harris Type II

A

Reduce —> NWB 4 weeks above knee —> 2 weeks in BK walking cast

38
Q

What is the prognosis for Salter Harris Type II

A

Excellent - growing cells stay within the cartilage

39
Q

What is the treatment for nondisplaced Type III Salter Harris

A

BK cast 4-6 weeks with 3-4 weeks NWB

40
Q

What is the treatment for displaced Type III Salter Harris

A

if ORIF, okay to use smooth k wires prependicular to growth plate,
Remove k wires in four weeks
DO NOT COMPRESS - NO SCREWS

41
Q

What is he prognosis for Type III Salter Harris

A

Good - if blood supply intact

42
Q

Treatment for Nondisplaced Type IV Salter Harris

A

AK Cast for 4 weeks —> BK cast for 2 weeks
WB for both

43
Q

Treatment for displaced Type IV Salter Harris

A

ORIF

44
Q

What is the prognosis for Type IV Salter Harris

A

Poor
High incidence of premature closure with angulation deformity

45
Q

What is the treatment for Type V Salter Harris injury

A

NWB cast for 3 weeks
- uncommon crushing force injury
- no physeal fracture or displacement

46
Q

What id the prognosis for Type V Salter Harris

A

Poor

47
Q

What is osteochondrosis

A
  • non inflammatory disturbance affecting the epiphysis
  • unknown etiology
48
Q

What are the stages seen on x ray findings of osteochondrosis

A
  • necrotic sage - sclerotic appearance of bone
  • regenerative - increased fragmentation
  • remodeling - boney replacement of necrotic cortex and marrow
49
Q

What is osteochondrosis of the talus

A

Diaz disease

50
Q

What is oseochondrosis of the cuneiforms

A

Bushke’s disease

51
Q

What is osteochondrosis of the 5th MT base

A

Iselin’s disase

52
Q

What is osteochondrosis of the sesamoids

A

Treve’s disease

53
Q

What is osteochondrosis of the accessory tarsal navicular

A

Haglund disease

54
Q

What is osteochondrosis of the navicular

A

Kohler’s disease

55
Q

What is osteochondrosis of the 2nd MT head

A

Frieberg’s disease

56
Q

What is osteochondrosis of the calcaneal apophysis

A

Sever’s disease

Pediatric Orthopedics (18 decks)

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