Childhood trauma Flashcards

1
Q

What are the risk factors for childhood trauma?

A

Previous fracture

Metabolic bone disease

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2
Q

What are the principles of childhood trauma?

A

Fractures often simple, incomplete and heal quickly
Remodel well in plane of joint movement
Thick periosteal hinge is good
Fractures involving physes cn result in progressive deformity

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3
Q

What are the types of forearm fracture?

A

Shaft
Galeazzi
Monteggia
Distal radius

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4
Q

What is a galeazzi fracture?

A

Impact to distal ulna causes fracture of radius

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5
Q

What is a monteggia fracture?

A

Impact to proximal radius causes ulnar fracture

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6
Q

What are the types of low energy forearm fracture?

A

Buckle

Greenstick

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7
Q

What are the types of high energy forearm fracture?

A

Open
Displaced
Soft tissue injury

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8
Q

How is a suspected broken limb assessed?

A

History
Deformity
Soft tissue exam- wounds, sensation, motor function, vascular status
Xray

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9
Q

What is the treatment of a fracture of the distal radius?

A
Buckle= Cast for 3-4 weeks
Greenstick= cast 4-6 weeks
Complete= Cast +/- pin 6 weeks
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10
Q

What are the complications of a limb fracture?

A
Compartment syndrome
Non union
Refracture
Posterior interosseus nerve injury
Superficial nerve injury, esp radial in radius fracture
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11
Q

What is the differential for knee trauma?

A
Infection
Inflammatory arthropathy
Neoplasm
Apophysitis
Hip injury
Foot injury
Sickle
Haemophilia
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12
Q

What ar the types of bony injury of the knee?

A
Physeal injury
Metaphyseal injury
Tibial spine
Tibial tubercle
Patellar fracture
Patellar dislocation
Sleeve fracture
Osteochrondral lesions
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13
Q

What are hyperextension physeal injuries associated with?

A

Vascular injury

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14
Q

What are fibular injuries associated with?

A

Common fibular nerve injuries

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15
Q

What is the treatment of physeal injuries?

A

Cast

Percutaneous fix

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16
Q

What is the risk with tibial spine injuries?

A

Overlaps with ACL

In children, ACL rarely snaps

17
Q

What is the treatment of a tibial spine injury?

A

Long leg cast

Open reduction and internal fixation

18
Q

What is the management of a patellar fracture?

A

Undisplaced- cylinder cast

Displaced- open reduction and internal fixation

19
Q

What are the risk factors for patellar dislocation?

A
Laxity of ligaments
Poor vastus medialus oblique
Q angle
Femoral anteversion
Tibial external rotation
20
Q

What is the management of a patellar dislocation?

A
Reduce
Brace for stability but keep mobile
Weightbear
Physio
Surgical
21
Q

When is surgical treatment required in patellar dislocation?

A

Recurrent

Repair ligaments

22
Q

What is often the plane of ankle fracture?

A

Physis

23
Q

How are ankle fractures assessed?

A

History
Deformity
Soft tissues- wounds, sensation, motor function, vascular status
Xray- AP and lateral

24
Q

What are the types of ankle fracture?

A

SH 1-4

Transitional

25
Q

What are transitional fractures?

A

Fractures in 13-14 year olds when growth plate closing

26
Q

What are the types of transitional fractures?

A

Tillaux

Triplane

27
Q

What is the treatment of SH1 and 2 ankle fractures?

A

Cast if undisplaced

Manipulation if displaced >3mm

28
Q

What is the treatment of SH3 ankle fractures?

A

Cast if undisplaced

Open reduction an internal fixation if displaced

29
Q

What is the treatment of SH4 ankle fractures?

A

Open reduction and internal fixation

Monitor for growth arrest

30
Q

What is the treatment of a tillaux ankle fracture?

A

Closed/open reduction

31
Q

What is the treatment of a triplane ankle fracture?

A

Open reduction and internal fixation

32
Q

What are the types of overuse injuries?

A

Osgood-Schlatter’s disease

Sever’s disease

33
Q

What are warnings for non accidental injuries?

A

Incongruent history
Bruising pattern
Burns
Multiple fractures in various stages of healing