Pediatric Fractures and Tumors

Question 1

How are almost all clavicular fractures treated?

Answer 1

non-operatively

Question 2

Birth to 4 years of age. May have muffled creptitus. need an arthrogram and requires closed treatment with percutaneous pins

Answer 2

Transphyseal injuries of humerus

Question 3

Occur between 5 and 10 years of age. Milch type I and also a type II. On the type II, the fracture line follows the physis and exists the trochlear notch

Answer 3

Lateral Condylar Physis Fractures of humerus

Question 4

can have bad results with restricted motion, progressive cubitus varus, and avascular necrosis

Answer 4

Medial Condylar Physis Fractures of humerus

Question 5

Second most common pediatric fracture. Usually between 1-7 yrs of age. Most often extension type

Answer 5

Supracondylar Fractures of humerus

Question 6

loss of forearm rotation or motion regardless of final reduction, alignment, or method of treatment

Answer 6

radial neck fractures of the elbow

Question 7

Usually between ages 1-5. H/O of traction injury to arm. Child holds elbow in a position of flexion and pronation of the forearm

Answer 7

Nursemaid’s elbow

Question 8

Describe the reducation manuever used to fix nursemaid’s elbow

Answer 8

flexing elbow maximally and pronating and supinating with thumb over radial head

Question 9

most common fractures in children

Answer 9

radius and ulna

Question 10

fracture of the middle or proximal ulna with dislocation of the radial head

Answer 10

Monteggia

Question 11

When is remodeling potential greatest for femoral shaft fracture?

Answer 11

less than 10 yrs of age

Question 12

treatment of choice for skeletally immature children older than 6 years of age with a transverse fracture in the middle 60% of the femoral diaphysis

Answer 12

Flexible Intramedullary Nail Fixation

Question 13

Cause of tibial spine avulsion

Answer 13

ACL attachment

Question 14

Deformity that can occur with proximal tibial metaphyseal fractures regardless of what treatment takes place

Answer 14

valgus deformity

Question 15

most common lower extremity fractures in children.

Answer 15

tibial shaft fractures

Question 16

Salter-Harris type III fracture of the ankle

Answer 16

Tillaux

Question 17

What is the Salter-Harris classification of tri-plane ankle fractures?

Answer 17

type IV

Question 18

Clinical finding that is suggestive of bone tumor

Answer 18

Unexplained mass, especially in the thigh

Question 19

Second most common primary bone tumor. “star burst” periosteal reaction on xray. presents in 2nd decade often in knee

Answer 19

osteosarcoma

Question 20

Survival rates for Ewings with pre-op chemo

Answer 20

80 to 90%

Question 21

Most common cause of bone destruction in adult

Answer 21

breast, lung, prostate, kidney cancer

Question 22

Most common of benign primary bone tumors. Usually in knee/proximal humerus. Mostly cause mechanical problems/compression

Answer 22

osteochondroma

Question 23

When do osteochondromas stop growing?

Answer 23

skeletal maturity

Question 24

Benign tumor that’s bone forming. Presents as dull/sharp pain, worse at night, better with aspirin/NSAIDs. Usually in long bones of lower extremity or posterior lumbar spine

Answer 24

osteoid osteoma

Question 25

Central radiolucent lesion metaphyseal side of growth plate, long bones

Answer 25

unicameral bone cyst

Question 26

Treatment of unicameral bone cyst

Answer 26

needle aspiration and steroid injections at 2 mos intervals

Question 27

Occurs in metaphysis of long bones (knee). Oval elongated radiolucent, well marginated. Non-neoplastic

Answer 27

Fibrous cortical defect/non ossifying fibroma

Question 28

Ectopic bone in inflamed muscle following muscle injury/contusion. Firm painless mass when mature. Most slowly resorb

Answer 28

myositis ossificans

Question 29

Rare, striated muscle tumor. High grade malignancy, often metastatic

Answer 29

rhabdomyosarcoma