Pediatric Orthopedics Flashcards
Define physis
growth plate
What does SALTER stand for
Separated growth plate
Above growth plate
BeLow growth plate
Through gorwth plate
ERasure of growth plate
What is the treatment of Salter harris Type I and II fractures
closed reduction, cast immobilization
heals well
what is the treatment of Salter-harris type III and IV
ORIF and to prevent growth arrest
what is the treatment of type 5 salter-harris
no specific treatment, high incidence of growth arrest
what is another name for a buckle fracture
torus fracture
impaction of the bone
what is the treatment of a buckle fracture
casting
What is the MOI of greenstick fracture
bending
m/c FOOSH
what are fracture patterns that are suggestive of abuse
- transverse femur fracture in child < 1
- transverse humerus fx in child < 3
- spiral long bone fractures (torsion)
- bucket handle fx
- rib fractures
what do most states require in regards to mandated reporting of concerns for child abuse
immediate verbal report
written report within 24-48 hours
What is a subluxation of the radial head
Nursemaids elbow
m/c in kids 6mo - 6 years
what is the presentation of nursemaids elbow
often hear a snap
initial pain subsides quickly
forearm resting in pronation and slightly flexed
child refuses to use arm
who are high risk newborns forDDH
first born
breech
+family hx
oligohydramnios
macrosomia
what is the mainstay diagnostic test of DDH
Barlow and Ortolani maneuvers
what is Barlow
dislocated a dislocatable hip; ‘click’ on exit -> out
What is Ortolani
reduces a dislocated hip; ‘clunk’ on entry -> in
What is the treatment of DDH
< 4 months and reducible: Pavlik harness first line
spica casting
older than 18mo or failure of spica: open reduction with spica
older than 2yo: open reduction wiht osteotomy
what is the diagnostic cobb angle
> 10 degrees
what is an idiopathic avascular necrosis of the proximal femoral epiphysis
Leg-Calve-Perthes-Disease (LCPD)
What are risk factors for LCPD
low SES
(+) FH
low birth weight
abnormal birth presentation
second-hand smoke
What is the presentation of LCPD
classically painless limp with insidious onset
may have intermittent hip or knee pain
reducted hip ROM on PE
what is a common adolescent hip disorder seenin overweight/obese males
SCFE
(SLipped capital femoral epiphysis)
m/c in left hip
what is the presentation of SCFE
hip pain (groin and thigh) m/c
usually associated with lip or ER of leg
can often present with knee pain
What is the treatment of SCFE
if unstable, NWB, contact ortho immediately
most - perc pinning, ORIF if severe
What is apophysitis
stress injury of a tendon that is attached to the physis
(tendonitis)
what is apophysitis of the tibial tubercle
Osgood Schlatter’s Disease
what is little leage elbow
medial apophysitis
overuse injury from repetitive throwing
pain over medial epicondyle
what is the gold standard treatment for clubfoot
ponseti casting (serial casting)
tenotomy - bracing
Genu varum
bow legged
genu valgum
knock kneed
what is an autoimmune, aseptic and inflammatory joint disease
juvenile idiopathic arthritis
how is juvenile idiopathic arthritis diagnosed
diagnosis of exclusion
6+wks of arthritis symptoms in a child under the age of 16
VAS score can help with dx
what are the subtypes of juvenile idiopathic arthritis
Oligoarthritis
plolyarthritis
sysetmic
enthesitis-related
Psoriatic
Undifferentiated
