Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Kin 2236 Athletic Injuries > Lecture 4: The Young Athlete > Flashcards

Lecture 4: The Young Athlete Flashcards

1
Q

Where does long bone grow?

A

Long bone growth occurs at each end around the epiphyseal (growth) plates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Apophysis

A

traction epiphysis

where tendons attach to bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epiphyseal plate

A

where long bone growth occurs (at ends of long bone)

  • 2-5x weaker than surrounding bone
  • 15-30% of all childhood fractures are growth plate fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Major differences between the bones of growing children and adults

A
  • increased vulnerability of the epiphyseal plate
  • tendon/ligament attachment sites (apophyses) are weak cartilaginous plates that are predisposed to avulsion injuries
  • metaphysis/diaphysis in children is more resilient when compared to mature bones
  • during rapid growth phases, bone lengthens before muscles and tendons are able to stretch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Increased vulnerability of epiphyseal plate

A

Junction btwn growth plate and metaphysis

  • typically due to shear/rotation force and compression. Most resistant to tension
  • physis is 2-5x weaker than adjacent capsule or ligament (more common injury at bone than tendon/ligament)
  • periosteum is a major support
  • injury can be acute or from repeated force
  • common acute fracture: distal radius, humerus, distal tib, fib, femur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Salter-Harris Fracture

A

Fracture at epiphyseal plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type I Salter-Harris

A

Complete separation of epiphysis from metaphysis WITHOUT any bone fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Type II Salter-Harris

A

MOST COMMON - TRIANGLULAR shaped metaphyseal fragment

line of separation extends along growth plate then through portion of metaphysis

does not go thru jt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Type III Salter-Harris

A

INTRA-articular and extends from jt. surface to growth plate and extends along plate to its periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Type IV Salter-Harris

A

Fracture extends from jt. through epiphysis, across whole growth plate and through part of metaphysics

COMPLETE split

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Type V Salter-Harris

A

COMPRESSION

Relatively uncommon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Salter Harris Classifications

A

S- Straight Across
A - Above
L - Lower or beLow
T - Two or Through
ER - ERasure of growth place or cRush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Little League Shoulder

A

Stress fracture of proximal epiphyseal plate of humerus (11-16 year olds)

  • lower tolerance for rotational stress at epiphyseal plate

Pain in dominant shoulder of athlete (baseball, tennis, volleyball)
- during and after throwing
- decreased speed and control
- recent increase in FITT

  • Treatment: abstinence from activity fo 4-6 weeks
  • healing occurs uniformly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Slipped Capital Epiphysis

A

Pressure epiphysis

  • Femoral head stays in place and femoral neck slips up
  • Occurs in children btwn 12-15 years (overweight males, late maturers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical Clues for Slipped Capital Epiphysis

A
  • decreased hip abduction and internal rotation
  • shortening and external rotation of leg
  • surgical emergency (pin placement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Apophyses as weak cartilaginous plates

A

Predisposes to avulsion injuries

  • repetitive submaximal forces
  • increase FITT
  • growth patterns (more muscle-tendon tightness during growth spurts)

We typically injure 2-jt. muscles (ex. rectus femoris, sartorius)

17
Q

Common sites of avulsion around pelvis

A

Ischial Tuberosity > AIIS > ASIS

Ischial tuberosity: hamstrings attach
AIIS: rectus femoris attaches
ASIS: sartorius attaches

18
Q

Mode of Injury of avulsions around the pelvis

A

Running
Kicking
Slip

19
Q

Clinical clues for avulsion around pelvis

A
  • athlete usually reports “pop” or tearing followed by pain at site (or poorly localized groin pain for AIIS)
  • pain on palpation over site (ASIS displaces inferiorly over AIIS)
  • pain with passive stretch and resisted flexion of muscles
20
Q

Management of avulsion around pelvis

A

Immediate
- ice
- support w/ protected gait (crutches)
- refer for imaging

early rehab
- early core stability (transversus abdominus)
- static balance
- maintain cardio - UBE (upper body ergometer)
- progressive ROM and strengthening

late rehab
- progress functional strength and power

21
Q

Total time of recovery for avulsion around pelvis

A

Ischial Tuberosity: 3-4 months
ASIS and AIIS: 6-8 weeks

22
Q

Resilience of metaphysis/diaphysis in children

A

Metaphysis/diaphysis in children is more resilient when compared to mature bones

  • withstands greater deflection w/o fracture

Children have Greenstick type fractures
- incomplete fracture (like trying to break green tree branch)
- usually the fracture is on the side OPPOSITE to bending force
- common WRIST injury but can be anywherw

23
Q

Clincal clues for Greenstick fractures

A
  • may not have “typical” pain
  • tender on palpation mid shaft
  • swelling or may have “bump” due to bend in bone
  • may have decreased ROM or pain w/ weight bearing
24
Q

Management of Greenstick fractures

A
  • refer for X-ray
  • standard immobilization
  • heals quickly 3-4 weeks

Rehab following:
- regain ROM and strength

25
Q

Apophysitis

A
  • injury to apophysis (aka traction epiphysis)
  • due to bone lengthening before muscles and tendons can stretch
  • this is an over-use injury due to repetitive motion during rapid growth

minimal muscle-tendon injuries in this age group

26
Q

Little League Elbow

A

Apophysitis of medial epicondyle

  • due to forces during cocking and early acceleration (may also cause avulsion injury)
27
Q

Clinical Clues for Little League Elbow

A
  • medial elbow pain and decreased velocity and control
  • tenderness over medial epicondyle
  • pain w/ resisted wrist flexion and pronation (b/c wrist flexors attach at medial epicondyle)
  • valgus stress of elbow is PAINFUL
  • may have tenderness on lateral side (compression on lateral side)
28
Q

Managament of Little League Elbow

A

Immediate
- ice
- support w/ protected brace or splint
- refer for imaging

early rehab
- complete local rest for min of 4-6 weeks
- maintain lower extremity and core

late rehab
- throwing program starts 6-8 weeks
- start long toss then non-competitive pitches w/ emphasis on form
- stop for 2-3 days w/ any pain

29
Q

Osgood-Schlatter/Sinding-Larsen-Johansson

A
  • continuous contraction or stretch of quadriceps may cause softening or partial avulsion of apophysis
  • most common during growth spurts and w/ high level of activity (running and jumping)
30
Q

Osgood-Schlatter

A

at tibial tubersoity

31
Q

Sinding-Larsen-Johansson

A

at inferior pole of patella

32
Q

Clinical Clues of Osgood-Schlatter/Sinding-Larsen-Johansson

A

Slow onset tenderness
- tibial tuberosity in OS (girls 8-13 and boys 10-15)
- inferior patella in SLJ (children 10-15)

Tightness of surrounding muscles (quadriceps, hamstrings)

Excessive pronation

33
Q

Management of Osgood-Schlatter/Sinding-Larsen-Johansson

A
  • self limiting conditions
  • settles w/ bony fusion
  • OS may be left w/ a prominence of tibial tubercle
  • Activity modification (no need to rest completely)
  • cryotherapy
  • address imbalances (stretch/strengthen) - quads and hamstrings
34
Q

Sever’s Disease

A

Calcaneal Apophysitis is a traction apophysitis of the insertion of Achilles

  • usually seen in boys between 8 and 12 years of age
  • 2nd most common site of apophysitis (secondary to OS)
  • usually w/ increase in activity or during growth spurt
  • seen in children w/ shortened gastrocnemius-soleus muscle complex
35
Q

Clinical Clues of Sever’s Disease

A
  • tenderness over the posterior aspect of the heel
  • decreased dorsiflexion ROM (plantar flexors are tight)
  • over pronation
36
Q

Management of Sever’s Disease

A

Early rehab
- insert heel raise to decrease pain in early rehab
- stretch of plantar flexors

Progress to
- strengthens plantar flexors and dynamic stablizers when pain free
- correct/manage over-pronation
- condition settle in 6-12 months (max 2 years)

37
Q

Traumatic Plate Injuries

A
  • will have appropriate mechanism of injury
  • pain on palpation of growth plate
  • replication of stress causes increase in plate pain
  • requires immediate medical attention
38
Q

Chronic Growth Injuries

A
  • pain w/ activity (especially after increase in FITT)
  • pain subsides w/ rest
  • deformity
  • swelling
  • pain on palpation

Kin 2236 Athletic Injuries (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions