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MSK > Paeds trauma > Flashcards

Paeds trauma Flashcards

1
Q

What is the most common cause of child death?

A

TRAUMA

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2
Q

What are the 4 principles of paeds trauma

A

1- usually incomplete, simple, easy to treat
2- Remodel well in plane of joint movement
3- A thick periosteal hinge is usually a friend
4- Fractures involving phases can result in progressive deformity

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3
Q

Why are child fracture quicker to heal?

A
  • metabolically active periosteum

- Cellular bone has increase collagen, porosity, cellularity, plasticity

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4
Q

Low energy and high energy forearm fractures

A

Low energy:

  • Buckle : occurs when bone buckles
  • Greenstick: partial thickness fracture where only the cortex and periosteum are interrupted on one side but remain uninterrupted on the other

High energy

  • OPEN- punctures through skin
  • Displace
  • Soft tissue
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5
Q

What end of the radius is most likely to be affected?

A

The distal end

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6
Q

Treatment

A

Closed

  • Analgesia
  • Cast well moulded over elbow
  • Change loose cast
  • Remove callus when evident

Open

  • External fixator
  • ORIF: open reduction fixator
  • Flex Nail
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7
Q

Types of bony knee injury

A
  • Physeal
  • Tibial spine
  • Tibial tubercle
  • Patellar
  • Sleeve fracture
  • Patellar dislocation
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8
Q

Physis injury where?

Aetiology?

A

More common in femur than tibia

Aetiology:

  • Hypertension- vascular disease
  • Varus: inward angulation - common peroneal nerve injury
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9
Q

Physis injury Management?

A

Management:

  • Cast immobilise
  • Percutaneous fix
  • ORIF articular displacement
  • ROM early
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10
Q

What is a Physis arrest

A

Interrupted growth plate from complications of physical fracture

  • Monitor
  • Can interrupt longitudinal growth which can lead to angular deformity and limb length deformity
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11
Q

How to manage Physis

A

Complete Epiphysiodesis: paediatric surgical procedure in which the epiphyseal bone is fused temporarily or permanently to delay growth of a long bone.

Contralateral Epiphysiodesis

Resect bar

Corrective osteotomy: surgical cutting of a bone to allow realignment

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12
Q

Tibial spine fracture types and management

A

I- Undisplaced
II- hinged
III- Displaced

Management:
I/II: Long leg cast
II/III: ORIF

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13
Q

Tibial tubercle fracture

A

–I Distal avulsion
–II To prox tibial physis (not joint)
–III To prox tibial physis (into joint)

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14
Q

Patella dislocation management

A
  • Cast
  • Mobilise
  • Vastus Medialis O esercises
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15
Q

What are common causes of anterior knee pain?

A
  • Diagnosis of exclusion.
  • R/O inflammatory, neoplasm
  • NB Osgood Schlatter disease, Sinding- Larsen- Johansson syndrome
  • DO NOT FORGET THE HIP
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16
Q

Patellar fracture management

A
  • Undisplaced – cylinder cast

* Displaced - ORIF

17
Q

Ankle fracture classification?

A

Anatomical: Salter Harris

Mechanistic

18
Q

Salter Harris classification of an ankle fracture

A

SH1 : fracture extends through the physis
SH2: fracture extends through the physis and exits through the metaphysis, forming a Thurston-Holland fragment
SH3: fracture extends through the physis and exits through the epiphysis
SH4: fracture involves the physis, metaphysis and epiphysis

19
Q

Assessment of ankle fractures and common pitfalls

A
  • History
  • Deformity
  • Soft tissues
  • AP & lateral radiographs – Follow OTTAWA RULE

Pitfalls

  • Miss oblique and mortise view
  • Miss ossification
  • Miss contralateral view
20
Q

Shaft injuries of the radius?

A

Galezzi
Monteggia
Colles/ Smiths/ Bartons

21
Q

Where is a gallezzi fracture located?

A

Distal radial SHAFT fracture with displacement of the distal radio-ulanr joint

22
Q

where is a monteggia fracture located?

A

Distal ULNAR SHAFT fracture with displacement of the radial head

23
Q

What is the presentation of a collet and a Smith’s fracture?

A

Colles: Extra- articular Fracture of distal radius with dorsal displacement of radius
- FORK
Smith’s : ( Opposite of Colles) Volar displacement of distal radial fracture

24
Q

What is the presentation of a Bartons fracture?

A

Intra-articular fracture of the dorsal aspect of the radius

MSK (40 decks)

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