Salter-Harris Fractures

Question 1

What is a Salter-Harris Fracture?

Answer 1

Fracture through the Epiphyseal Plate

• Mostly occurs from falls
• 1/3 of cases are sports related

Question 2

Describe: Salter-Harris Fracture Type I

Answer 2

Transverse fracture through hypertrophic zone of the Growth Plate

Question 3

What is the treatment for Salter-Harris Fracture Type I?

Answer 3

• No surgery

- Fracture boot for 6 weeks

Question 4

Describe: Salter-Harris Fracture Type II

Answer 4

Fracture through the Growth Plate and Metaphysis

• Causes minimal shortening
• Most common type (85% of cases)

Question 5

What is the treatment for a Salter-Harris Fracture Type II?

Answer 5

• No surgery

- Bone is reduced and casted for 6 weeks

Question 6

Describe: Salter-Harris Fracture Type III

Answer 6

Fracture through the Growth Plate and Epiphysis causing damage to the Growth Plate

• Extends into articular surface
• Chronic disability with significant deformity

Question 7

What is the treatment for a Salter-Harris Fracture Type III?

Answer 7

Open Reduction Internal Fixation surgery

Question 8

Describe: Salter-Harris Fracture Type IV

Answer 8

Fracture through the Growth Plate, Epiphysis, and Metaphysis

• Extends into articular surface
• Premature fusion causing shortening of the bone

Question 9

What is the treatment for a Salter-Harris Fracture Type IV?

Answer 9

Open Reduction Internal Fixation Surgery

Question 10

Describe: Salter-Harris Fracture Type V

Answer 10

Compression or crush injury of Growth Plate

-Severely affects growth

Question 11

What is the most common pediatric surgery?

Answer 11

Inguinal Herniorrhaphy

Question 12

What causes Pediatric Inguinal Hernias?

Answer 12

Congenital defect

-Fascial layers didn’t close properly during development

Question 13

Why is mesh not used during Pediatric Inguinal Hernia repairs?

Answer 13

Mesh is a permanent, fixed material

-Stays the same size as the patient grows

Question 14

Where is the incision made for a Pediatric Inguinal Hernia repair?

Answer 14

Inguinal crease (1-2 cm. long)

Question 15

What must you be aware of when doing a Pediatric Inguinal Hernia repair?

Answer 15

Ilioinguinal Nerve

Question 16

What suture is used to ligate the Hernia Sac during a Pediatric Inguinal Hernia repair?

Answer 16

4-0 Silk

Question 17

What is a Bassini Repair?

Answer 17

Technique to close Hernia without using a mesh

-Muscles are sutured downward toward inguinal ligament to create a tension free closure

Question 18

What muscles are associated with a Bassini Repair?

Answer 18

• Internal Oblique
• Transverse Abdominis
• Transversalis Fascia

Question 19

What suture is used during a Bassini Repair?

Answer 19

4-0 Silk

-Simple Interrupted Knots

Question 20

How soon can an Abdominal Wall defect be diagnosed?

Answer 20

Around 12 weeks of gestation via ultrasound

Question 21

What are the two main types of Pediatric Abdominal Wall Defects?

Answer 21

• Omphalocele

- Gastroschisis

Question 22

What is an Omphalocele Hernia?

Answer 22

Abdominal organs protrude through this opening along the umbilical cord
-Covered in same membrane that protects umbilical cord

Question 23

What is Gastroschisis?

Answer 23

Abdominal defect to the right of the Umbilicus

-Organs not covered by umbilical membrane

Question 24

What are the two options for Repair of a Gastroschisis Hernia?

Answer 24

• Primary Repair of Defect

- Stage Silo Repair

Question 25

What are the steps for a Staged Silo Repair?

Answer 25

• Intestine placed in sterile bags
• Bag slowly tightened from the top
• Fascia is closed after intestines have been replaced