Paediatric orthopaedics

Question 1

SCFE, Juvenile RA, osgood schlatter in MSK flashcard

Answer 1

:)

Question 2

Bone cancers - go through this in own time

Answer 2

Osteosarcoma, osteochondroma, erwigs sarcoma, giant cell tumour

Question 3

When do growth plates close

Answer 3

14-25

Question 4

Radiographic changes of growth plates when they close

Answer 4

Epiphyseal line - growth plate turns into thin epiphyseal line

Disappearance of growth plate

Question 5

Salter Harris classification system for growth plate injuries

Answer 5

Type I: Slip
*Fracture occurs through the growth plate only.
*Rarely visible on X-rays because it involves the cartilaginous portion of the growth plate

Type II: Above
*Fracture extends through the growth plate and metaphysis.
*Most common type of growth plate fracture.
*fracture line extending above the growth plate on X-rays.

Type III: Lower
*Fracture extends through the growth plate and epiphysis.
*X-rays.

Type IV: Through
*Fracture extends through the growth plate, metaphysis, and epiphysis
* X-rays.

Type V: Crush
*Compression injury to the growth plate
*Not visible on X-rays - MRI diagnosis

Question 6

Treatment for each type of growth plate injury

Answer 6

Type 1 - immobilisation

Type 2 - immobilisation and closed reduction if there is displacement, may need surgical intervention if significant displacement

Type 3 - high risk of growth disturbance - careful reduction to prevent this. Surgical intervention if severe displacement

Type 4 - high risk of growth disturbance - surgical management and long term follow up

Type 5 - high risk of growth disturbance - needs MRI diagnosis - close monitoring, surgery if severe