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Conditions + definitions > MSK - paeds ortho/trauma > Flashcards

MSK - paeds ortho/trauma Flashcards

1
Q

What is the most common traumatic injury in children?

A

Broken forearm

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2
Q

What are the principles of childrens’ fractures?

A

Often simple, incomplete and heal quickly
They remodel well in plane of joint movement
A thick periosteal hinge helps recovery (usually)
Fractures involving physes can result in progressive deformity

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3
Q

What are the different types of facture?

A 
Transverse
oblique
spiral
Buckle
Impacted
Communicated
Greenstick
Intra/extra articular
Butterfly
Burst
Crash
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4
Q

What are the low energy fractures that occur in the forearm?

A

Buckle

Greenstick (buckle on ine side, snap on other)

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5
Q

What are the high energy fractures that occur in the forearm?

A

Open
Displaced
Often with soft tissue injury

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6
Q

What is the important consideration in forearm injuries?

A

Maintaining the supination/pronation range of movement

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7
Q

How do you assess a fracture?

A 
History - ask for mechanism of injury
Deformity
Look at soft tissue - whole limb
Wounds
Sensation, motor function
Vascular status

Document
Repeat post-intervention

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8
Q

What radiological investigations are needed into fractures?

A

X-rays in 2 planes
Must see above and below joint in both

PA, true lateral

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9
Q

What is the primary symptom of comparmtnet syndrome?

A

Pain ou of proportion

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10
Q

What are the complications of forearm fractures?

A 
Compartment syndrome (volkman's)
Non-union
Refracture
Radioulnar synstosis (abnormal fusion of bone)
Radial nerve injury
Radiocapitellat problems
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11
Q

What is radioulnar synstosis?

A

Abnormal fusion of radial and ulna bones
Happens more proximally
High energy, same level

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12
Q

How do you prevent radioulnar synstosis?

A

Single incicsion between two bones

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13
Q

How do you manage a buckle fracture of the forearm?

A

cast for 3-4 weeks

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14
Q

How do you manage a greenstick fracture of the forearm?

A

Cast for 4-6 weeks

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15
Q

How do you manage a complete fracture of the forearm?

A

Cast for 6 weeks

Sometimes K wires

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16
Q

What are the risks for remanipulation?

A

Complete fractures

Failed anatomic reduction

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17
Q

What are the differentials for knee trauma?

A 
Infection
Inflammatory arthropathy
Neoplasm
Apophysitis
Sickle cell, haemophilia
"Anterior knee pain"
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18
Q

What bony injuries occur in knee injuries?

A 
Physeal/metaphyseal
Tibial spine
Patellar fracture
Sleeve fracture
Patellar dislocation
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19
Q

What are the complications of a physeal injury?

A

Hyperextension - vascular injury

Varus - CPN injury

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20
Q

How do you treat a physeal injury?

A

Cast immbolise
Percutaneous fix
Earlly loss of range of movement

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21
Q

How do you monitor a physeal frature?

A

Look for Harus lines
Angulation
Length (growth arrest - resect if occurs)

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22
Q

What is a tibial spine injury?

A

ACL injury pulls off tibial spine

Only occurs in children as bone is weaker than tendon

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23
Q

What is a tibial spine injury?

A

Patella tendon rips off tibial spine

24
Q

How do you treat a patellar fracture?

A 
Undisplaced = cylinder cast
Displaced = ORIF (open reduction internal fixation)
25
Q

What are the risk factors for patella dislocation?

A 
Laxity of ligaments (collagen disorders)
Poor Vastus Medialis Obliqus
Q angle (angle between long line of tibia and that of femur)
Femoral anteversion
Tibial external rotation
Patella alta
26
Q

Who commonly gets osteochondral lesions?

A

Adolesccant population

27
Q

If there is a knee injury what other joint should you look at?

A

Hip

28
Q

What is the most common plane of fracture in the ankle?

A

The physis as it is weaker than ligaments

29
Q

What views should the film be taken in to prevent missed fractures?

A

Mortise

Oblique

30
Q

What are the different Slater-Harris classifications of fractures?

A

Type 1 - Fracture Line is within the Physis
Type 2 - Extends from the Physis into the Metaphysis
Type 3 - Fracture enters the Epiphysis from the Physis
Type 4 - Fracture extends across the Physis, from the Articular Surface to the Epiphysis
Type 5 - Fractures are Crush Injuries of the Physis

31
Q

What is the most common ankle fracture?

A

Slater-harris 2
Extending from physis into metaphysis
Often displaced

32
Q

What are the worries with a transitional fracture?

A

That the growth plate with close

33
Q

What are the types of transitional fracture?

A

Triplane

Tillaux

34
Q

What are the two types of overuse injuries you see in children?

A

Osgood-schlatter’s disease

Sever’s disease (football)

35
Q

What are the warnings for non-accidental injuries?

A

Incongruent history (doesn’t quite add up)
Bruising patterns
Burns
Multiple fractures at multiple stages of healing
Metapyseal fracture
Humeral shaft fracturesRib fractures
Non-ambulant fractures

36
Q

Who is most likely to get developmental dysplasia of the hip?

A

Easten Europe neonates (up to 3%)
Not just based on genetics, but also way they carry children

Girls 6:1
First born
Breech presentation
Oligohydramnios

37
Q

What are the clinical features of developmental dysplacia of hip?

A

Ortolani’s sign (will the hip dislocated)
Barlow’s sign (will joint relocated)
Piston motion sign (motion)

38
Q

How do you treat developmental dysplasia of the hip?

A

An abductive brace

39
Q

Who does Legg-calve-Perthes disease affect?

A

Mainly primary school children

Males 5:1

40
Q

What are the clinical features of Legg-Calve-Pertes (LCP)?

A 
Short stature
Limp
Knee-pain on exercise
Stiff hip joint
Systemically well
41
Q

What are the phases of LCP?

A

Avascular necrosis (femoral head)
Fragmentation - revascularisation - painful phrase
Reossification - bony healing
Residual deformity

42
Q

When do patients with LCP usually present?

A

Fragmentation phase

At which point it is too late to help

43
Q

What are the differentials of LCP (unilateral)?

A

Septic hip
JIA
SCFE
Lymphoma

44
Q

What are the differentials for bilateral LCP?

A

Hypothyroid
Sickle
Epiphyseal dysplasia

45
Q

How do you treat LCP?

A

Maintain hip motion
Analgesia
Restrict painful activities
Nothing active

46
Q

What is valgus?

A

Deviation away from midline

47
Q

What is varus?

A

Deviation toward midline

48
Q

What is SCFE?

A

Slipped capital femoral epiphysis

49
Q

Who is affected by SCFE?

A

Tenage boys more than girls

9-14yrs

50
Q

What is stable vs unstable SFE?

A

Stable is if you cna weight bear

51
Q

How does SCFE present?

A

Pain in hip OR knee!
Externally rotated posture and gait
Reduced internal rotation, especially in flexion

52
Q

What determines mild/moderate/severe SCFE?

A

Mild is less than 1/3 of femoral head slipping
Moderate up to half
Severe is more than half

Relative on AP film

53
Q

What is the pathology of SCFE?

A

Displasment through hypertrophic zone

Metaphysis moves anterior and proximally

54
Q

How do you treat SCFE?

A

Screw across the physis (surgery)

55
Q

What are teh complications of SCFE (surgery)?

A

AVN - avascular necrosis
Chondrolysis (screw too far)
Deformity
Early osteoarthritis

Conditions + definitions (68 decks)

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