Pediatric Orthopedics Sports

Question 1

Aerobic recommendations for youth

Answer 1

• Most of the 60 min or more a day should be moderate or vigorous intensity at least 3 days per week

Question 2

Muscle strengthening examples for youth

Answer 2

• Playground equipment
• Rope climbing
• Calisthenics
• Tug of war
• Weight training

Question 3

Bone strengthening examples for youth

Answer 3

• Basketball
• Jumping rope
• Hopscotch
• Running
• Weight training

Question 4

Training results in youth

Answer 4

• Pre-adolescents can increase strength 30-40% over 8-20 wks of training
• Gains rapidly lost after training ceases
• Gains are seen as increased & more efficient muscle recruitment verses muscle hypertrophy

Question 5

Common causes of youth injuries associated with sports

Answer 5

• Overuse
• Poor training regimen
• Poor form/technique
• Poor balance & coordination

Question 6

Signs of overuse

Answer 6

• Pain not tied to an acute injury
• Pain increases with activity
• Swelling
• Change in form or technique
• Decreased interest in practice

Question 7

Describe Osgood Schlatter Disease

Answer 7

• Rupture of the growth plate at the tibial tuberosity/attachment if the patellar tendon
• Seen ages 11-15 yrs, males more than females
• Occurs during periods of rapid growth combined w/stress from repeated quad contraction
• Results in sub-scute avulsion at the growth plate & inflammation

Question 8

Describe Severs Disease

Answer 8

• Inflammation of the growth plate at the Achilles tendon insertion on the calcaneus
• Presents at age 8-12 yrs as heel pain with weight bearing or calf contraction
• Caused by rapid growth & stress on heel cord from running & jumping (Possible link to obesity)

Question 9

Treatment for Severs Dsease

Answer 9

• Ice
• Heel cord stretch
• Strengthening
• Good footwear
• Arch support

Question 10

Describe slipped capital femoral epiphysis (SCFE)

Answer 10

• Backward slip of the femoral head at the growth plate; head stays in the socket & rest of femur shifts forward
• Seen ages 11-17 yrs in ratio of 3/1 males to females
• Cause is unknown but associated with child being overweight for height

Question 11

Presentation of SCFE

Answer 11

• Gradual onset of hip/knee pain with a limp
• Affected leg usually shortened & ER with loss of full hip flexion & IR

Question 12

SCFE usually requires a surgical fix ASAP to stabilize the femoral head, if not done in a timely fashion, risk of

Answer 12

• AVN
• DJD
• Loss of ROM

Question 13

Presentation of Legg-Calve Perthes Disease

Answer 13

• Pain in the hip that is made worse with activity
• Pain in the thigh or knee area
• Walks or runs with a limp; may be painless
• Pain goes away with rest

Question 14

Describe Legg-Calve Perthes Disease

Answer 14

• Unknown cause
• Usually b/w 4-10 y/o
• Boys 5x more likely than girls
• Usually very physically active & small for their age

Question 15

Treatment of Legg-Calve Perrthes Disease

Answer 15

• Rest
• Activity restriction
• Physical therapy ROM and strengthening of hip muscles

Question 16

MOI of a supracondylar fractures of distal humerus

Answer 16

• Fall on outstretched hand causing hyperextension of the elbow resulting in a posterior displacement of the distal humerus

Question 17

Describe little league shoulder

Answer 17

• Inflammation and widening of the growth plate at the
  proximal humerus
• Caused by repetitive stress of throwing or overhead tasks (racket sports)
• Presents as pain in shoulder with activity, tenderness and swelling in upper arm
• Treatment – rest for 8-12 weeks, strengthen shoulder (throwers 10), coach on form, follow guidelines on number, type of pitches and rest time

Question 18

Describe little league elbow

Answer 18

• Inflammation of growth plate at medial epicondyle of the elbow
• Caused by repetitive stress of throwing
• Presents as medial elbow pain during and after activity
• Treatment - rest 2-4 weeks minimum, strengthening, coaching on form, pitching guidelines

Question 19

What exercises are included in the Thrower’s 10 Program

Answer 19

• Prone Row, Extension, Abduction, Scaption and abduction with external rotation
• Sidelying external rotation
• Supine protraction
• Seated push ups
• Standing wall push ups, scaption to 90 degrees, abduction to 90 degrees
• Standing external rotation and internal rotation

Question 20

Predisposing factors for ACL injuries in females

Answer 20

• Genu valgus alignment
• Poor hamstring to quadriceps strength ratio
• Running & landing on an extended knee
• Quadriceps dominance
• Hip/core weakness

Question 21

Treatment progression for meniscus repair

Answer 21

• Full weight bearing at 6 wks for outer 1/3 repairs
• Usually delay progression of middle 1/3 repairs by 2 wks compared to outer 1/3
• Return to sport by 5-7 months

Question 22

Describe Spondylolysis

Answer 22

• Fracture of one or both pars
• Usually b/w 11-17 y/o
• Males more than females