Banner adolescent knee disorders

Question 1

What are the four phases of growth and development of the child?

Answer 1

prepubescence (6-10 boys, 5-9 girls)
early pubescence
midpubescence
late pubescence

Question 2

Which tanner stages are prepubescence?

Answer 2

Tanner 1-11 (age 6-10 boys, 5-9 girls)

Question 3

Which tanner stage is early pubescence?

Answer 3

Tanner III, secondary sex characteristics

Question 4

What is happening during midpubescence?

Answer 4

rapid growth

Question 5

What is happening furing late pubescence?

Answer 5

growth rate declines, physiologic epiphysiodesis

Question 6

Which 2 tanner stages are important for growth?

Answer 6

stage 3 and 4

Question 7

What are these:
Muscle-tendon imbalance, changes in strength and flexibilty
Anatomic malalignment: fem anteversion, external tibial torsion, genu valgum, pronation
Footwear and playing surfaces
Nutritional and hormonal factors: inadequate caloric intake, amenorrhea
Cultural deconditioning: increased numbers of sedentary and obese children
Growth, physes and apophyses

Answer 7

risk factors for injury

Question 8

What is this:
single application of traumatic force
Includes fractures, dislocations, ligament and meniscal tears

Answer 8

macrotrauma

Question 9

What is this:
repetitive, overuse injuries
Includes tendonitis, apophysitis, bursitis, stress fracture, patellofemoral pain syndrome

Answer 9

microtrauma

Question 10

(blank) is a painful swelling of the anterior tibial tubercle.

Answer 10

Osgood-Schlatter disease

Question 11

How do you get osgood schlatter disease?

Answer 11

secondary to repetitive microtrauma

Question 12

How do you treat osgood schlatter disease?

Answer 12

traction, ice, rest, NSAIDS (use of infrapatellar strap during activity)

Question 13

What is a type 1 salter harris classification?

Answer 13

overuse injury or fall with microcracks (pretty good outcome)
A transverse fracture through the growth plate (also referred to as the “physis”):[3] 6% incidence

Question 14

What is a type 2 salter harris classification?

Answer 14

A fracture through the growth plate and the metaphysis, sparing the epiphysis:[4] 75% incidence, takes approximately 2–3 weeks to heal.

Question 15

What is a type III salter harris classification?

Answer 15

A fracture through growth plate and epiphysis, sparing the metaphysis:[5] 8% incidence

Question 16

What is a type IV salter harris classification?

Answer 16

A fracture through all three elements of the bone, the growth plate, metaphysis, and epiphysis:[6] 10% incidence

Question 17

What is a type V salter harris classification?

Answer 17

A compression fracture of the growth plate (resulting in a decrease in the perceived space between the epiphysis and diaphysis on x-ray):[7] 1% incidence

Question 18

WHich two salter classifications can heal pretty well just with a leg cast?

Answer 18

Salter I and II (nondisplaced)

Question 19

How do you treat a displaced salter II fracture?

Answer 19

closed or open reduction with smooth pin trans physeal fixation. Screw fixation through metaphyseal fragment

Question 20

How do you treat salter III and IV?

Answer 20

open anatomic reduction, epiphyseal fixation

Question 21

Who are most likely to get tibial tubercle fractuers?

Answer 21

boys 12-17 (due to rapid contraction of the quad in jumping or rapid flexion)

Question 22

If a child is at tanner stage I and II, how should you treat them for an injury?

Answer 22

physeal sparing technique using soft tissue graft

Question 23

If a child is at tanner stage III and IV, how do you treat them for an injury?

Answer 23

transphyseal, soft tissue graft, metaphyseal fixation

Question 24

If a child is at tanner stage V, how do you treat them?

Answer 24

adult style reconstruction, BTB or hamstring autograft

Question 25

(blank) tears are most commonly associated with ligamentous instability. How do you fix it and why do you think it happens?

Answer 25

meniscal
meniscal repair
congenital defect in meniscus

Question 26

Is knee pain always a knee problem?

Answer 26

no, it can be associated with hip problems (ovarian cysts, spine and problems around the hip too) which will refer pain to knee

Question 27

If a child cannot internally rotate with hip flexion, what do they have?

Answer 27

SCFE