Ortho - paeds

Question 1

when do growth plates close

Answer 1

13-15Y F
15-17Y M

Question 2

epiphyseal plate also called
made up of

Answer 2

also called physis
made up of hyaline cartilage

Question 3

growth plate fractures
- MOI
- present
- OE
- Ix

Answer 3

moi - twist or fall, less commonly repetitive injury
present - pain, unable to WB
OE - bruise, swelling, visible deformity
assess NV status
Ix - xr in at least 2 views, joints above and below
- poss CT/ MRI - pre-op planning

Question 4

classification of growth plate # called

Answer 4

salter-harris

Question 5

salter-harris classification

Answer 5

type I - staight across growth plate
type II - above and GP - 75%
type III - below and GP
type IV - through
type V - crushing

Question 6

mx GP #

Answer 6

A-E
secondary survey
?safeguarding
I and II - closed reduction, cast and post-reduction xr and review 7/7 post-injury in # clinic
if presenting >5/7 post-injury then do not manipulate and ?need op if poor alingment
III and IV - reduction, low threshold for ORIF (instability, high risk of early OA)
V - retrospective dx often, specialist

Question 7

complications

Answer 7

disruption or early closure of growth plate
impaired function
growth arrest
limb deformity