MSK Flashcards
triplane ankle fx
what to know
fx exists in frontal/lateral/transverse planes
get a CT to determine displacement, XR not adequate
tx: closed reduction, do not attempt more than twice due to to risk of bleeding and physis damage. may need operative management if displaced
supracondylar fx
-what arteries and nerves to be aware of
brachial artery
median nerve
ulnar nerve
supracondylar fx
worst complication
compartment syndrome leading to volksman contraction
bivalve cast if significant edema
supracondylar fx
tx
- nondisplaced: splint elbow 90 degrees
- displaced: emergent ortho consult. if neurovascular compromise, may attempt reductionin ED
Bowing fracture
-how serious?
very serious. fx impedes supination and pronation of forearm
must be seen by ortho. they may reduce by breaking the bone to remove bowing
Radial neck fx
when to call ortho
Toddler: <10 degree neck angulation will correct naturally, >30 degree= closed reduction or percutaneous pin
Age >10:
>30 degree angulation or translocation >3mm=call ortho
unable to reduce angulation <45 degrees = call ortho, orif
unable to pronate/supinate >60 degrees = call ortho
pediatric elbow ossification centers:
CRITOE
capitellum, radial head, internal epicondyle, trochlea, olecranon, external epicondyle
1,3,5,7,9,11
olecranon fx
-how to tx
nondisplaced: cast in 30 degrees flexion
displaced >2mm: ortho emergency c/s for surgical repair
toddler fx:
tx
if child limps and you don’t see x, suspect toddler’s fx salter harris 1 and splint.
osgood schlatter
-tx, what to tell pt and family
no need for immobilization
pain decreased by age 14-16 when physis closes
Sever’s disease
what is it
who gets it, tx?
calcaneal apophysitis
boys 8, girls 6
mcc pediatric heel pain, b/l in 60% of cases
tx: nsaids, orthotic shoe inserts
