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Pediatrics > Pediatric Orthopedics > Flashcards

Pediatric Orthopedics Flashcards

1
Q

What percentage of children will experience a fracture during childhood?

Are fractures more common in boys or girls?

A

50%

Boys

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2
Q

What are the types of Salter Harris fractures?

What is the most common type of salter harris fracture?

A

Type 1: Seperated, seperated metaphysis and epiphysis
Type 2: Above, fracture is above epiphysis in the metaphysis
Type 3: Below the growth plate
Type 4: Through the growth plate
Type 5: Rammed or crushed growth plate

Type II, above the growth plate

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3
Q

What is the imaging modality of choice in kids with a suspected fracture?

When should an MRI be considered?

A

X-ray

If there is still a high suspicion but can’t identify on x-ray

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4
Q

Should conscious sedation be used when reducing a pediatric fracture?

A

Yes

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5
Q

MOST reductions in kids don’t need to be perfect as they do in adults due to remodeling, what are the exceptions to this?

A
  • Spiral fractures
  • Intra-articular fractures
  • Fractures that cross the physis
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6
Q

What is the mechanism of injury for a buckle fracture?

Where is the typical location of a buckle fracture?

A

Compression

Usually the metaphyseal/diaphyseal junction

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7
Q

What is the treatment for a buckle fracture?

A

Don’t usually require reduction, just casting

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8
Q

What is the most common mechanism of injury for a greenstick fracture?

A

Most common MOI is a FOOSH, bending

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9
Q

In the upper extremity, what is a common area prone to fracture?

What is the most common MOI?

A

Supracondyler fractures (elbow)

FOOSH –> hyperextension, fall onto the elbow

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10
Q

What is the treatment for a supracondyler fracture in kids?

A

Reduction if needed
Splint –> cast

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11
Q

What fracture patterns may be suggestive of child abuse?

A
  • Transverse femur fracture in child < 1 yr
  • Transverse humerus fracture in child < 3 yr
  • Spiral long bone fractures
  • Bucket handle fractures
  • Rib fractures
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12
Q

A report of abuse must be made within how many hours of becoming aware/raising suspicion?

A

Written report within 24-48 hours depending on the state

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13
Q

What is the injury in a nursemaids elbow?

What is the most common MOI?

A

Subluxation of the radial head

Longitudinal traction to extended elbow - swinging child by hands/wrist

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14
Q

What is the treatment of nursemaids elbow?

A

Closed reduction

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15
Q

What is the most common orthopedic disorder in newborns?

What are the risk factors?

A

Developmental Dysplasia of the Hip (DDH)

Female, some ethnicities due to swaddling (Native American’s), 1st born

+ family history, oligohydramnios, macrosomia

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16
Q

What is the diangosis for DDH?

A
  • Barlow and Ortolani
  • Positive exam in birth to 4 months = US
  • Imaging after 4-6 months = x-ray
17
Q

What is the treatment for DDH in an infant less than 4 months?

A

Pavlik harness first line
*need to wear 23 hours per day, minimum 6 weeks of treatment

18
Q

What is the treatment of DDH if an infant fails treatment with Pavlik harness or 6-18 months of age?

A

Spica Casting

19
Q

What is the treatment of DDH older than 2 years with persistent dysplasia?

A

Open reduction with osteotomy

20
Q

How is scoliosis classified?

A

Patient age
*Infantile: birth to 2 years
Juvenile: 3-9 years
Adolescents: 10-17 years
Adult: 18+

21
Q

What is Legg-Calve-Perthes-Disease (LCPD)?

What is the classic presentation?

A

Idiopathic avascular necrosis of the proximal femoral epiphysis (femoral head)

Painless limp, insidious onset, intermittent hip/knee pain, reduced ROM

22
Q

What is the treatment for LCPD?

What are some supportive treatments?

A

If less than 8 years old: self-limited so observe
If over 8 years old: surgical intervention

Activity restriction, PT, NSAIDs, Bracing/traction

23
Q

What is the presentation of a SCFE?

A
  • Hip pain m/c
  • Usually associated limp or external rotation of hip
  • Not uncommon to present as knee pain
24
Q

Is Genu Varum normal in kids under 2-years?

A

Yes, it is physiologic until age 2

25
Q

How long must symptoms be present to clasify as juvenile idiopathic arthritis?

What are common symptoms?

A

6+ weeks

Pain, swelling, erythemia, and stiffness

26
Q

What sub-type of juvenile idiopathic arthritis is more common in boys?

A

Enthesitis-related

27
Q
A

Pediatrics (16 decks)

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