Ortho

Question 1

What are the Salter-Harris fractures?

Answer 1

SALTER

Type I: Slipped, separated, straight across
Type II: Above the physis 
Type III: Lower (below the physis)
Type IV: TE - through everything
Type V: Rammed (physis is crushed)

Question 2

What is a Torus fracture?

Answer 2

Buckle fracture: compression of the bone, fracture on one side, does not go through the growth plate

Question 3

What is a greenstick fracture?

Answer 3

• Occurs at the diaphysis
• Occurs from bending of soft bone
• Looks like a partially broken stick with break only on one side

Question 4

What is Blount disease?

Answer 4

• Abnormal growth of the medial epiphysis of the proximal tibia
• More common in African Americans

Question 5

What is femoral anteversion?

Answer 5

• Too much internal rotation of the femur
• Not enough external rotation of the hip
• Patients sit in a W style
• Pathologic if it persists beyond 8 to 10 years of age

Question 6

What are the features of slipped capital femoral epiphysis?

Answer 6

• Salter Harris type I fracture at the growth plate
• Epiphysis slides off of the growth plate
• May present as referred knee pain
• Obtain AP frog-leg views of the hips
• Usually seen in obese adolescent male
• Treat with immobilization, avoidance of weight-bearing, possible surgery

Question 7

What are the features of Legg Calve Perthes Disease?

Answer 7

• Idiopathic avascular necrosis of the femoral head
• Lack of blood flow causes necrosis to the femoral head
• Occurs in children younger than eight years
• May present as painless limp
• Treat with casting or bracing

Question 8

What are the features of Osgood Schlatter disease?

Answer 8

• Presents in active children during adolescence or during a growth spurt
• Pain below the knee
• Due to traction at the tibial tubercle oh by the patellar tendon at the point of insertion
• Imaging: none or lateral x-ray

Question 9

What are the treatments for scoliosis?

Answer 9

• Curvature <25 degrees: observation
• Curvature >25 degrees: brace if the child is still growing
• Curvature >40 degrees: surgery

Question 10

What are the evaluation guidelines for those suspected of having developmental dysplasia of the hip?

Answer 10

• Get imaging after 2 weeks of age
• Hip ultrasound through 4 months of age, then radiographs
• Refer to ortho or image if:
  
  • • Ortalani/Barlow maneuver after 2wks of age
  • girls with breech presentation
  • boys with breech presentation
  • girls with h/o affected 1st degree relative