Peds Ortho Flashcards
T/f - child get sprains commonly
false
what is the most vulnerable in kids: bones, growth plates, ligaments
growth plates
Salter Harris I
Fracture occurs transversely through physis, separating epiphysis from metaphysis
Salter Harris 2
Fracture through a portion of the physis that extends through the metaphysis
Salter Harris 3
Fracture through a portion of the physis that extends through the epiphysis and into the joint
Salter Harris 4
Fracture across the metaphysis, physis, and epiphysis
Salter Harris 5
Crush injury to the physis
fracture of clavicle and proximal humerus most imp differential dx
septic arthritis
shoulder dislocation
Legg-CalvÉ-Perthes Disease
Idiopathic osteonecrosis of femoral head in children 2-12 years*
Legg-CalvÉ-Perthes Disease s/sxs
Limping 3-6 weeks
Activity increases pain
Aching in groin or thigh
Slipped Capital Femoral epiphysis
Displacement of femoral head through an immature physis
typically during adolescent growth spurt*
Microscopic fractures and gradual or acute slip
Slips posterior and medial
Slipped Capital Femoral epiphysis presentation
Pain increased with activity
Proximal anterior thigh or groin pain
Some patients have pain referred to distal thigh or lower
Screen all adolescents with lower ext pain
osteogenesis imperfecta vs child abuse
osteogenesis imperfecta:
Connective tissue disorder
“brittle bone disease”
Multiple fractures with minimal or no trauma
Child abuse:
Exam: Full exam - consider the child!
Include funduscopic!
Retinal hemorrhages
Suspicious soft tissue injuries
Previous injuries
Bruises at different stages of healing
Sexual assault
calcaneal Apophysitis aka
severs dz
severs dz
Inflammation of the calcaneal physis
Pain associated with increased with activity
Stress and microtrauma (tension Apophysitis)
Patellar apophysitis aka
Osgood-Schlatter Disease
Osgood-Schlatter Disease
Traction apophysitis of the proximal tibial tubercle at the insertion of the patellar tendon
Overuse injury
presentation
Pain and swelling at tibial tubercle
Ages 9 – 14 typically have undergone rapid growth spurt
Typically occur in 13 – 14 yo males and 11 – 12 yo female
More common in Adolescents active in sports
Bilateral 25 – 50% of cases
Developmental Dysplasia of the Hip (DDH)
Acetabulum does not fully cover the femoral head
Increased risk of dislocation
what tests do you do for Developmental Dysplasia of the Hip
Barlows
Ortolani
Legg-CalvÉ-Perthes Disease tx
Nothing influences rate of bone remodeling and healing
