miscellaneous pediatric Flashcards
key difference between skeletally mature and immature bones ?
presence of physeal plates
when should non accidental injuries or child abuse be taken into consideration ?
1- Incoherent history
2- Bilateral fractures
3- Fractures in different stages of healing
4- Bruises and or burns in highly suggestive areas
5- Fractures in very young age
(below 18 months – pre ambulatory)
6- Spiral fracture pattern
what classification is used in paediatric fractures (distal bones ) ?
salter harris classification
what is the most common paediatric fracture ?
supracondylar humeral fracture
what is the mechanism of injury of supracondylar humerus fracture ?
fall on outstretched hand ( extension )
direct fall on elbow ( flexion )
what nerve is affected in supracondylar humerus fracture ?
anterior interosseous nerve
what does anterior interosseous nerve affection present with ?
inability to flex thumb and index finger
what is the management of supracondylar humerus fractures ?
non-displaced : conservative in a back splint with close follow up
displaced : closed vs open reduction and k wire fixation
what are the non operative management options for femoral shaft fracture ?
hip spica
what operative modality is not preferred in children above 49 kg suffering from femoral shaft fracture ?
elastic intramedullary nails - nancy nails
what are the treatment modalities of femoral shaft fracture for each age group ?
less than 6 months :
pavlik harness
hip sica
7 months to 5 years :
hip spica
external fixator
ORIF
flexible nails
6-11 years :
ORIF
external fixator
flexible nail
> 11 years :
ORIF
Flexible nail
IM nail
what is Talipus-Equino varus ?
congenital club foot
what other congenital abnormalities are associated with Talipus-Equino varus?
spina bifida
UT anomalies
GIT anomalies
what is the patho-anatomy of Talipus-Equino varus?
CAVE
cavus - contracture of plantar fascia
adductus - of forefoot
varus - of heel
equinus - achilles tendon shortening
what is the management of congenital club foot ?
serial casting - ponseti technique
soft tissue procedures
what is thee other name for flat foot ?
pees planus
what are the two forms of pes planus ?
flexible - most common
rigid
what is the difference between the rigid and flexible form of pes planus ?
flexible - arch reconstitutes with tip toeing , does not with rigid
but both show a decrease in the medial longitudinal arch
what are the causes of rigid flat foot ?
accessory navicular
tarsal coalition - abnormal connection of 2 or more bones in thee foot
congenital vertical talus
what are the two forms of tarsal coalition ?
calcaneo - navicular
talo-calcaneal
what is the presentation of pes planus ?
May have arch pain or pretibial pain
In flexible form – foot is flat on weight bearing only
In rigid form – foot is flat regardless of weight bearing
what is osggood-scchlatter ?
self-limited condition characterized by inflammation and stress-induced injury of the tibial tuberosity at the insertion point of the patellar tendon
what is the typical age of presentation ?
10-15 years old
what is the clinical picture of osgood schlatter ?
1- Anterior knee pain, often described as localized to the tibial tubercle
2- Pain often exacerbated by activities such as running, jumping, or kneeling, and relieved with rest
what is the salter harris classification ?
SALTER
Straight across growth plate - seperated growth plate
Above growth plate
lower growth plate
through or two growth plate
erasure of Growth plate
