Miscellaneous Pediatric Orthopedic Conditions19.1+ Pediatric Hip Conditions 19.2 Flashcards
What is the treatment modality for a child <6 m with femoral shaft fracture?
Pavlik harness or
Hip spica
Treatment of child 7m - 5 yrs femoral shaft fracture
Hip spica or
ORIF with plate and screws
External fixator
Flexible nail
Treatment of child 6 - 11 yrs with femoral shaft fracture
ORIF with plate and screws
Flexible nails
External fixator
Treatment of child >11 yrs with femoral shaft fracture
ORIF with olate and screws
Flexible nail
Intramedullary nail
What is the management of Talipes equinovarus
Serial casting (ponseti technique) Soft tiasue procedures (tenotomies, tendon transfer)
According to Salter Harris classification of fractures of distal ends of long bones;
Describe Type 1 fracture
Through growth plate (growth plate is intact)
Describe type 2 salter harris class of fracture
Through growth plate and metaphysis (growth plate intact)
Desribe type 3 fracture of salter harris classification
Through growth plate and epiphysis (growth plate cut)
Describe Type 4 fracture in salter harris classification of fractures
Through all 3 elements (epiphysis, growth plate cut, metaphysis)
Describe type 5 fracture in slater harris classification of fractures
Growth plate crushed
What is the most common pediatric fracture
Supracondylar humerus fracture
Management of supracondylar humerus fracture
• Non-displaced fractures • Conservative in a back splint with close follow up • Displaced fractures • Emergency closed vs open reduction and k.wire fixation
What is osgood schlatter disease?
Inflammatory apophysitis of the tibial tubercle due to repetitive microtensile trauma (beynot keter)
Management of osgood schlatter disease
- Reassurance
- NSAIDs
- Ice
- Withhold sport activities until condition subsides
- Patellar tendon strap
In Developmental dysplasia of the hip(DDH) what is the primary modality of imaging from birth to 4 m age
Ultrasound
What is the primary imaging modality in developmental dysplasia of the hip in age >4 m of age?
XRay
Management of developmental dysplasia of the hip
• Non operative
• Pavlik harness ( <6 months )
• Closed reduction + hip spica (6-18 months)
• Operative
• Open reduction + hip spica (> 18 months )
• Open reduction + femoral osteotomy
or pelvic osteotomy or both
What is the sign in xray of SUFE (slipped upper femoral epiphysis?
Melting ice cream cone sign
Management of SUFE (slipped upper femoral epiphysis)
No role for operation but Percutaneous in-situ fixation might be done
• Contralateral prophylactic fixation
What is the pathology of Developmental dysplasia of the hip
Defective shallow acetabulum (dysplasia)
• Coxa valga (wide angle)
• Soft tissue interposition in acetabulum (pulvinar
Management of irritable hip (sinovitis)
Must exclude septic arthritis then Reassurance • Close observation • NSAID’s • Activity modification / rest • Treat the cause
