PC_peds

Question 1

NAT fractures

Answer 1

"-- Spiral humerus fx
-- Transverse femur fxs
– Corner Fx
– Distal Humeral Transphyseal Fx
– Posterior Rib Fx
– Fractures in various stages of healing"

Question 2

Salter harris fractures typically occur in _________ (zone)

Answer 2

Zone of provisional calcificatoin within the zone of hypertrophy

Question 3

Treatment of physeal fx

Answer 3

“Closed reduciton and casting

• • avoid multiple reductions
• • avoid late (10-14d) reductions”

Question 4

Treatment of physeal arrest

Answer 4

"• Bar resection
         – >2cm growth remaining
         – <50% physeal involvement
• Completion epiphysiodesis
• Contralateral epiphysiodesis"

Question 5

Blocks to reductoin of proximal humeral physeal fx

Answer 5

“Biceps tendon
Deltoid
Periosteum”

Question 6

Acceptable reduction of proximal humerus physeal fx

Answer 6

“– <5 yo: 70° and 100% displacement
– 5-12 yo: Up to 40° to 70°
– >12 yo: 40° and 50% displacement”

Question 7

______ nere injury with extension type SCH fx

Answer 7

AIN

Question 8

______ nere injury with flexion type SCH fx

Answer 8

Ulnar

Question 9

Most common complicatoin of SCH fx

Answer 9

maluion — cubitus varus/extension

Question 10

Treatment of pink-pulseless SCH fx

Answer 10

“Perfused –> CRPP

Monitor as inpatient for 24-48 hrs”

Question 11

Treatment of white-pulseless SCH fx

Answer 11

“Not perfused –> CRPP
If pinks up after reduction, monitor for 24-48 hrs
If steill not pink, open and explore

** no need for arteriogram **”

Question 12

Complication of lateral condyle fx

Answer 12

”– nonunion — longer immobilization

• • Cubitus valgus –> tardy ulnar nerve palsy
• • AVN (excessive posterior dissection)
• • physeal growth arrest”

Question 13

Indications to fix medial epicondyle fx

Answer 13

Incarcarated fragment

Question 14

Complications of transphysela distal humerus fx

Answer 14

“– Cubitus Varus

– Medial Condyle AVN”

Question 15

Treatment of monteggia

Answer 15

If can reduce — LAC; otherwise IMN vs ORIF

Question 16

Indication for treatment of radial head/neck fx

Answer 16

> 30-45 degrees angulation

Question 17

Complications of ORIF radial head/neck fx

Answer 17

“Loss of ROM
AVN
Synostosis”

Question 18

Acceptable reduction criteria of radius fx in <9 yo

Answer 18

“• 15° angulation

• 45° rotation”

Question 19

Acceptable reduction criteria of radius fx in >9 yo

Answer 19

“• 10° angulation proximal
• 15° angulation distal
• 30° rotation if distal”

Question 20

Torus fx

Answer 20

Splint

Question 21

Treatment of native hip dislocation

Answer 21

“Gentle reduction

Post MRI to eval to cartilaginous fragment”

Question 22

Treatement of transphyseal proximal femur fx

Answer 22

“50% AVN risk — need to reduce

Closed vs open reduction and pin fixation

Stability more important than physis”

Question 23

Length of treatment for spica ast

Answer 23

Age + 3 weeks

Question 24

Comlications of ex-fix for peds femur fx

Answer 24

“Refracture

Knee stiffness”

Question 25

Complicaitons of plate fixation for peds femur fx

Answer 25

“Difficulty with removal

Genu valgum”

Question 26

Rate of premature physeal closure in SH distla femur fx

Answer 26

60%

Question 27

Treatment of tibial spine fx

Answer 27

“• Types I and II
– Reduce in extension and LLC

• Types III and IV
– Ax vs. ORIF
– Suture construct
– Screw Fixation
– Entrapped meniscus"

Question 28

Complications of tibial spine fx

Answer 28

“– Stiffness

– Late anterior instability (60%)”

Question 29

Block to reduction in tibial spine fx

Answer 29

intermeniscal ligament