Orthopedics Flashcards
nursemaid’s elbow
subluxation of radial head
cause: upward pulling on arm
Sx: elbow flexed, no swelling, child not using arm
Tx: reduce by flexing elbow and supinating hand
atlantoaxial instability
unstable joint beetween occiput and first cervical vertebrae or first and second
- associated with down syndrome, skeletal dysplasias
Tx: fusion of C1 and C2
Complications: paralysis and death
klippel feil syndrome
failure of segmentation/ fusion of cervical lumbar or sacral
Assoc: congenital torticollis, GU anomalies, heart disease, hearing loss, sprengel’s deformity (scapula abnormality rotated laterally)
diskitis
infection or inflammation of intervertebral disk
Sx: tenderness over involved disk, sometimes fever
Dx: ESR elevated, MRI and bone scan can confirm
developmental dysplasia of the hip
Girls more than boys, left hip
RIsk factors: female, first born, breech presentation, family history, oligohydramnios
Dx: barlow or ortolani positive, abnormal galeazzi, asymmetric abduction of hip and asymmetric buttock folds
- use ultrasound until ossification 4-6 months of age
tx: pavlik harness or surgery
Complication: avascular necrosis of femoral head, limb length issues, painful abnormal gait, osteoarthritis
septic arthritis
bacterial infection of joint, ortho emergency
- hip affected in younger children
Cause: staph aureus and strep pyogenes
Sx: fever, limp, pain with movement, erythema swelling and asymmetry of folds
Dx: WBC, ESR, CRP
Tx: surgical decompression, IV abx
transient synovitis
postinfectious response of hip joint - preceded by URI or diarrhea
Sx: low grade fevr, limp, mild irritability, hip pain
Dx: WBC/ESR normal, r/o septic arthritis
Tx: NSAIDS, bed rest, observation
legg calve perthes
idiopathic avascular necrosis of femoral head
Age: 4-9 years, white and asians, boys, thin boys
Sx: painful limp, decreased internal rotation and abduction of hip
Dx: AP and lateral films show crescent sign
Tx: PT and rigorous exercise, surgery
Slipped capital femoral epiphysis
slipping of femoral head off neck
adolescence, boys, obese adolecent boy
Sx: painful limp with pain in the groin hip or knee, assoc with hypothyroidism
Dx: AP/lat film
Tx: pinning epiphysis
Complications: avascular necrosis, chondrolysis, limp length issues, osteoarthritis
osgood schlatter disease
inflammation of tibial tuberosity by overuse
- age 10-17, more common in boys
Sx: swelling of tibial tuberosity and knee pain with point tenderness over tibial tubercle
Tx: rest, stretching of quads and hamstrings
incomplete fracture
greenstick fracture
- one side of cortex fx with other side intact
comminuted fracture
fracture of multiple fragments
salter harris classification
SALT CRUSH
1 - same: fx within physis
2 - above: fx in physis and above metaphysis
3 - low: fx in physis and blow into epiphysis
4 - through and through: fx in physis through both meta and epiphysis
5 - crush: crushing of physis
supracondylar fx
emergency if fx displaced and angulated because of neurovasc injury risk and compartment syndrome
Sx: point tenderness, swelling, deformity of elbow, pain with passive extension of fingers
Dx: posterior fat pad sign
