Physical abuse, Ortho Flashcards
What type of fractures are pathognomonic of abuse?
- classic metaphyseal lesion (CML)
* corner fracture, chip fracture, bucket handle fracture
Most rib fractures from abuse are located where?
-posterior near the vertebrae or lateral
What is a serious consequence of shaken baby syndrome?
- subdural hematoma
Retinal hemorrhages are commonly seen in this condition.
- shaken baby syndrome
What % of kids grade 6-12 report to have been bullied at school?
10%
Which of the Salter-Harris fracture types is a clinical diagnosis?
- Type 1
* not able to be seen on XR films
Dysplasia of the hip is much more common in which gender?
- Girls 6x greater
What are the 2 newborn exams for DDH? What are you trying to elicit with each test?
- Barlow’s = dislocation
- Ortolani’s = relocation
If you pick up any abnormality in the DDH exam for how long should you continue observation before treating?
- for 1 month
What is the first treatment option for DDH?
- Pavlik harness
* check alignment by XR in 1-2 weeks
What is the treatment option for DDH if it is picked up after 6 months of age?
- closed reduction surgery
What is the treatment option for DDH if it is picked up after 2 years?
- open reduction + femoral or pelvic osteotomy
What is the most common cause of an acquired painful hip?
transient synovitis of the hip
What is the hallmark sign of transient (toxic) synovitis of the hip?
- spasm with hip internal rotation
What drug therapy can result in dramatic improvement for transient synovitis of the hip?
- NSAIDs
What is the proposed cause of Legg-Calve-Perthes Disease (LCPD)?
- joint effusion disrupting blood flow to femoral head during critical development stage leading to necrosis of proximal femoral head
What is a common biologic risk factor for slipped capital femoral epiphysis (SCFE)?
- obesity
What % of SCFE incidents are bilateral?
- 25-35%
If a patient presents with a mildly painful limb that was not acute onset what are you concerned for?
Legg-Calve-Perthes Disease (LCPD)
slipped capital femoral epiphysis (SCFE) is more common in which 2 populations?
- Male
- African Americans
What degree of varum is common until 18 months?
Up to 20 degrees is normal
Rickets is a risk factor for what?
- pathologic genu varum
Night bracing for genu valgum is necessary if exceeds how much degrees?
> 20 degrees
Surgery for genu valgum is indicated in what instance?
> 15 degrees at 10 yo
What is a common sign of osgood-schlatter disease?
- prominence of tibial tubercle
What is the cause of Osgood-schlatter disease?
- skeletally immature athlete with open tibial growth plate
* associated with rapid growth spurt
