Ortho Paeds Flashcards
what is an invisible fracture?
X ray does not show , immobilise as there may be cortical disruption -> treat as though fracture
ossification centres:
look black on Xray
cartilage –> will ossify
Types of fractures:
in children: why are they different?
thicker more active periosteum
Salter harris 3-4-5 why are they bad?
what is treatment ?
can cause shortening or angular defromity
need to treat with open reduction
types 3 and 4 : what are they most likely to cause
growth arrest + progressive deformity
Physeal arrest: what is this?
bone bridge across the epiphysis and the metaphysis which lead to length abnormalities
Pain/lipming child: What is 1st thing to exclude ?
hip infection
0-5 hip pain
Developmental dysplasia of the HIp:
10+ years
SUFE
Inflammatory
Most common orthopaedic abnormalitiy in newborns
DDH (not painful hip)
DDH risk factors
female first born oligohydramonios breech presentation family
3 causes for DDH:
ligament laxity
muscular underdevelopment
abnormal shallow slop acetabulum
indicative of hip infection
limp and hip pain +/- knee elevated temp WBC, CRP, ESR, US MRI
DDH:
<6 months
>6 months
<6 months US (as cannot see cartilage)
>6 months X ray
Management of hip infections?
Xray - may be subluxed due to present of the infections
DDH: What is clinical presentation of walking age ?
waddling (due to discloation) due to shortened leg
subluxation vs dislocation which is worst
dislocation worst
which hip is more commonly affected?
left hip
bilateral presentation of DHH
30% bilateral
diagnosis: DDH: Galezzi test
knees at unequal heights when hip and knees are flexed - dislocated side is lower
diagnosis: DDH: Galezzi test
what should you be wary of?
knees at unequal heights when hip and knees are flexed - dislocated side is lower
be wary of: both dislocation - they will be
complications of DDH
dislocation = leads to premature osteoarthritis
joint contractures
if hip is FULLY dislocated:
closed reduction + spica cast
may require open reduction if cannot get it in closed
