Paediatric Othopaedics Emergencies Flashcards
What can fractures involving physes result in?
Progressive deformity
What is a Galeazzi fracture?
Shaft fracture of radius
What is a Monteggia fracture?
Fracture of shaft of ulna
Complications of fractures out arm
Nonunion, Refracture, Radioulnar synostosis, PIN injury (posterior interosseous nerve), Superficial radial nerve injury, DDRUJ/ radiocapitellar problems
What is a buckle, torus distal radius fracture?
Failure of 1 cortex in compression
What is a greenstick fracture?
Failure of 1 cortex in compression other cortex in extension
bone bends and breaks
Management of buckle fracture?
Cast 3-4 weeks
Management of greenstick fracture?
Cast 4-6 weeks
Management of a complete fracture?
Cast 6 weeks
Treatment for physical injury of knee
Cast to immobilise,
Percutaneous fix,
ORIF (open reduction and internal fixation) articular displacement
Treatment of physeal arrest
Respect bar,
Complete epiphysiodesis,
Contralateral epiphysiodesis,
Corrective osteotomy
Tibial spine fracture Meyers and McKeever classification?
1-undisplaced,
II-hinged
III- displaced
How to treat I and II tibial spine fracture
Long leg cast
How to treat tibial spine fracture II/III
Open reduction and internal roatation,
AxIF
Tibial tubercle classification Ogden
I- distal avulsion
II- to proximal tibial physis (not joint)
III- to proximal tibial physis (into joint)
Patella dislocation risk factors
Laxity, Poor Vastus Medialis Oblique, Q angle, Femoral anteversion, Tibial external rotation,
Patellar dislocation treatment
Cast 2/52 ligament,
Mobilise,
VMO exercises
Treatment for type 1 osteochondral lesions
Immobilise
Treatment for type 2 and 3 osteochondral lesions?
Drilling/ fix
Difference between type 1,2,3 osteochondral lesions?
Type 1- cartilage intact,
Type 2- flap,
Type 3- fragment
What rules do you follow before getting an AP and lateral radiographs of ankle?
Ottawa rules
What are the Ottawa rules?
Pain in malleolar zone,
Bone tenderness at posterior edge of lateral malleouls on medial/ lateral view or base of 5th metatarsal or navicular,
Inability to bear weight
What is an ankle transitional fracture?
Growth plate closing at age 13-14 years
What is a Tillaux fracture
Fracture of the anterolateral aspect of the distal tibial epiphysis,
Type SH3,
Caused by external rotation
Ankle fracture classification
Via Salter–Harris type classification
Describe SH3 fracture
Supination inversion,
Epiphyseal medial
Triplane fracture
Caused by external rotation,
SH3 on AP and SH2 on lateral
Examples of overuse injuries in orthopaedics
Osgood-Schlatter’s Disease,
Sever’s disease (growth plate inflammation of he calcaneus)
Warnings on non-accidental injury
Incongruent history,
Bruising,
Burns,
Multiple fractures at multiple stages of healing
What is a Salter-Harris fracture?
fracture that involves the epiphyseal plate or growth plate of a bone
Define a SH1 fracture
Fracture straight across the epiphyseal plate
Define a SH2 fracture
Above the epiphyseal growth plate
Define a SH3 fracture
Lower than epiphyseal growth plate
Define a SH4 fracture
Fracture through everything
