Common Orthopedic and Sports Related injuries developing child Flashcards

1
Q

Overuse injuries count as ____ % of sports related pediatric injuries

A

30-50%

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2
Q

Physical exam for overuse injuries

A

Faulty movement patterns
Length-strength imbalances
Bio-mechanical issues

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3
Q

is there adequate research for the young athlete and recovery?

A

minimal research
adult model of treatment is applied to this population
research is skewed to adult counterpart

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4
Q

What areas do have significant research for the young athlete

A

ACL reconstruction
Meniscal injury
Osteochondritis dissecans

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5
Q

When is the age for typical onset of adolescent back pain

A

13-14

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6
Q

What are common predictors of adolescent LBP

A

pain beliefs
mental health
presence of somatic complaints
anxiety/stress response
females>males

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7
Q

What factors did not predict LBP

A

scoliosis
posture
joint hypermobility/flexibility
back/core muscle strength or endurance
carrying a school bag

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8
Q

What are the three main interventions for adolescent LBP

A
  1. utilize CPG when applicable
  2. impairment based interventions
  3. educational strategies are most critical element of management
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9
Q

out of place
misaligned, rotated
your back/spine is weak
any story that creates additional anxiety, pathology, concern

A

not helpful language education strategies

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10
Q

structures of you back/spine is health
strategies for you to manage or control your pain
exercise and movement will help keep you and your spine healthy

A

helpful language

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11
Q

Apophysis

A

secondary centers of ossification, found where major tendons attach to bone

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12
Q

What do apophysis do

A

provide contour and shape to growing bones without adding length

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13
Q

these growth centers are the weakest links in the musculoskeletal chain at given age ranges

A

apophysitis

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14
Q

What are common misdiagnosis of apophysistis

A

tendonopathy/tendonitis
stress fracture
avulsion fracture

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15
Q

Tibial tuberosity

A
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16
Q

What is apophysitis

A

repetitive stress at growth center leading to inflammation due to mirco-trauma at bone cartilage junction

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17
Q

Tibial tuberosity apophysitis

A

patellar tendon attachment to tibial tuberosity

female 8-13
male 10-15

mimics: patellar tendonopathy
PFPS
Fat pad syndrome

18
Q

Examination of tibial tuberosity apophysitis

A

pain with resisted quad contraction
pain with passive quad stretching
point tender at tibial tuberosity

19
Q

Patellar apophysitis

A

inferior pole of patella
9-12 year old
mimics:
-infrapatellar fat pad syndrome
-patellar tendonopathy
-PFPS
-plica sydnrome

20
Q

Examination of patellar apophysitis

A

pain with resisted quadriceps contraction
pain with passive quad stretching
point tender at distal patella

21
Q

management of patellar and tibial tuberosity apophysitis

A

activity modification/rest

NO eccentrics NO heavy slow resistance
correct muscle imbalance

22
Q

Clacaneal apophysitis

A

calcaneal attachement of achilles tendon

8-13 year old
mimics: achilles tendonopathy
retrocalcaneal bursitis
plantar fasciitis

23
Q

diagnosis of calcaneal apophysitis

A

one leg heel standing
squeeze test
palpation
all 3 have 100% specificity

24
Q

what does imaging show with apophysitis

A

all of the patients and controls showed increased density of the apophysis
50 % of the pain free controls showed fragmentation versus almost all 90% of children with heal pain

25
Q

management of calcaneal apophysitis

A

modified activity
no eccentrics of heavy slow resistance

26
Q

Little leaguers elbow

A

most common medial epicondyle attachment of common flexor tendons
10-16 years of age
mimics:
medial epicondylitis
UCL complex injury

27
Q

Symptoms with little leaguers elbow

A

pain with resisted wrist flexion and gripping
may or may not be pain with valgus stress
point tender over bony portion of medial epicondyle

28
Q

what is the management of hip and pelvic apophysitis

A

depends on degree of pain but if painful walking and standing then start with weightbearing on crutches

29
Q

what are avulsion fractures

A

similar to apophysitis but often acute injury vs overuse

degree of displacement and location dictate need for surgical intervention or bracing
minimally displaced will be managed similar to apophysitis with more agressive rest

30
Q

What are some concerns associated with ACL surgery

A

growth plates/epiphyseal plate involvement
limb length discrepancy

31
Q

what are some risk of non operative ACL surgery

A

unable to return to sport
secondary injury
-meniscal injury
-chondral injury
-MCL

32
Q

What did the cohort study determine about acl surgery

A

increased risk of additional tissue injury along with inability to return to previous level of activity

33
Q

transphyseal ACLr

A

recommended to be reserved for those that are near skeletal maturity

34
Q

nontransphyseal

A

reserved for skeletally immature 8-12 years

35
Q

What is a tibial spine fracture

A

avulsion fracture of ACL attachment to intercondylar eminence in skeletally immature

36
Q

Physical examination of tibial spine fracture

A

often unable to achieve full extension may lack 20-30 degrees of extension due to avulsed bone falling within the joint

37
Q

Imaging need to be done before trying to gain full extension

A

true

38
Q

tibial spine fixation rehab

A

determined by fixation technique
may be initial weight bearing or ROM precautions

39
Q

Osteochondritis

A

inflammatory reaction

40
Q

osteochondritis dissecans etiology

A

controversial
ischemia
trauma

41
Q

most common areas/ages for osteochondritis

A

6-19
knee elbow

42
Q

goals for OCD

A

heal subchondral bone
preserve articular cartilage
prevent OA