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Upper extremity squirm > Upper Extremity Peds Squirm > Flashcards

Upper Extremity Peds Squirm Flashcards

1
Q

Growth Plate Zones

A

Germinal zone.
Proliferative
Hypertrophi
Endochondral

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2
Q

Name of fragment in a type II salter harris

A

Thursday holland is metaphyseal fragment

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3
Q

Skipped Ogden

A

ok

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4
Q

Ossification of humeral head, greater and lesser tuberosity?

A

6 months
1-3 years
4 years

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5
Q

Classification of proximal humeral plate fracture

A 
Neer Harowitz
Grade 1 is less than 5 mm displaced
Grade II is less than 1/3 width
Grade III is displaced 1-2 thirds
Grade IV is greater than 2/3 width
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6
Q

Acceptable alignment for Proximal humerus fracture in kids. Complication?

A

1-4 years old: any angulation
5-12 years old: up to 45 degrees angulation and one half displaced (near III)
12 is 20 degrees of angulation and displacement of less than 30% (neer horowitz II)

Can do osteotomy if its a problem, Axillary nerve needs exploration if out after 4 months (1% incidence and usually neuropraxia)

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7
Q

whats the disease with no clavicle?

A

cleidocranial dyostosis

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8
Q

Classification of AC disruption

A

Dameron and Rockwood (two favs) 1-3 is noon
1 is sprain
2 is partial tear with widening
3 is periosteal split with 25-100% displaced
4 posterior displacement buttonholed through trap
5 more than 100% displaced
6 is infracoracoid and into the conjoined tendon

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9
Q

Ossification of scapula shit?

A

Coracoid 1 year for base, upper fourth are 10 years

Acromion fuses late, 20 year

stopped writing it

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10
Q

Stryker notch view is for what?

A

Coracoid fracture or hill sachs

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11
Q

Ideberg:

A

1a antioer, 1b posterior glenoid, 2 inferior exit 3 superior exit, 4 across the body, 5 is combo, six is comminuted

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12
Q

Acromion fracture

A

1 non displaced. 1 a is avulsion, 1b direct trauma

II is displaced without narrowing

III is subacromial narrowing

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13
Q

Shoulder suspensory complex

A

Clavicle AC, acromion, neck glneoid, coracoid and CC

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14
Q

What do you consider if luxatio?

A

Ehler’s dances syndrome

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15
Q

Reduction of elbow first move?

How do you splint anterior dislocation?

A

HYPERSUPINATION

Some extension

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16
Q

Bauman angle?

Humeral ulnar angle?

Metaphyseal diaphysial angle

A

11-20 degrees

5-15

40 degrees

17
Q

Most common displacement and how it happens in supracondy? What type puts risk to brachial after and median nerve?

A

Posteromedial is more common! and happens when pronated (makes sense, its how you catch yourself)

IT IS LUCKY because posteriolateral puts brachial after and nerve at risk

18
Q

Classification of supracondy’s

A

Gartland

19
Q

Milch lateral condyle?

What are stages? Tx?

Note: crepitus suggests unstable

A

Through trochleaocapitellar groove. Two is through trochlea

Jakob!
Stage 1 is intact articular surface, less than 2 mm displace
Stage 2 is 2-4 mm displaced and articular surface disrupted
Stage 3 is displaced fragment, rotated

Stage 1 usually treat in slab with forearm NEUTRAL!!!!

20
Q

Warning sign of medial condyle?

A

watch out for fat pad sign, because epicondyle is actually not in the capsule

21
Q

Medial condyle staging?

A

Kilfoyle?

22
Q

Transphyseal imaging finding?

Classification

A

Posteriomedial displacement but radial and ulnar relationship maintained

DeLee: Based on ossification Lateral condyle
1 is prior to it being there (salter 1, before 1 year old)
2 is age 1-3. Can be 1 or II SH
3 is age 3-7, WATCH For smooth outline of distal metaphysics

23
Q

T condylar fracture classification?

A

1 nondisplaced
2 Displaced but no metaphysical comminution
3 Displaced

Basically always need OR

24
Q

Radial head/neck classification?

A

Obrien is based on angulation
Type 1 is less than 30 degrees
2 is 30-60
6 is more

Wilkins is based on fracture
A SH1 or 2
B is SH3 or 4
C is metaphseal completely

25
Q

Treatment radial head?

A

Type 1 obrien (less than 30 degree is nonop)
Type 2 is isrealli or patterson method of reduction. Esmarch also
type 3 is OR or do OR for anything unstable

26
Q

Problem with ORIF radial head?

A

Osteonecrosis, PIN, shit like that

27
Q

Olecrenon fx tx?

A

In cast with 5-10 degrees flexion unless significantly displaced. THINK ABOUT OI

Unless shear, then hyper flex but worry about swelling

28
Q

Montagia equivalent classification?

A

1 is isolated radial head dislocation
2 is ulna and proximal radius fracture
3 isolated radial neck
4 is elbow dislocation

29
Q

Acceptable angulation in montagna?

A

10 degrees as long as radial head pops in

30
Q

Galleazi classification and positions for treating?

A

Type 1 is apex volar. IT IS A SUPINATION injury. So pronate it (remember thumb follows apex)

Type 2 is opposite. Apex dorsal so supinate it

31
Q

Distal radius physical injury acceptable range?

A

1 and 2 needs 50% apposition without rotational deformity.

SH III must be anatomic

IV and V need surgery if at all displaced (1 mm)

Also OR if carpal tunnel

32
Q

Acceptable deformity for radius fracture?

A

15 degrees if less than 9 for girls 11 for boys
10 degrees for 9-13 for girls
10 degrees for 11-13 for boys
none after that

33
Q

Scaphoid classification. Who gets surgery?

A

Type A is distal pol
a1 extraarticular. A2 intraartic
B is middle third (waist)
C is proximal pole

Displacement 1 mm or angulate more than 10 degrees

34
Q

Capitate and scaphoid fx without dislocation is what?

A

Naviculocapigtate syndrome

35
Q

Metacarpal classification

A

Type A epiphyseal/physeal
Type B metacarpal neck: 4th and 5th is peds version of peer fracture Acceptable angulation is 15 for 2nd and 3rd, 45 for 4th and 5th
C shaft and ten degrees for 2nd and 3rd and 20 for 4th and 5th

D is base. Unstable, usually operative

36
Q

Thumb metacarpal classification

A

NOTE physis is proximal

A is distal to physis and 30 degrees acceptable
B is Salter harris two metaphseal medial. APL pulls laterally and proximally, adductor medial. THUMB SPICA
C is SH II and metaphysical laterally. Tends to buttonhole and need ORIF
D intraarticular III or IV and bennet equivalent

37
Q

Gamekeeper classification

A

A sprain
B rupture of ligament
C avulsion (Salter harris 3)
D psuedogamekeeper: from SH 1 or II feracure

38
Q

Phalanx classifciation

A

A physeal
B is shaft and tend to be APEX VOLAR in P1 due to lateral band and central slip
C Neck USUALLY operative b/c shit gets stuck in it like volar plate
D condylar intraairticular and needs wires to hold it

39
Q

Phalanx fx operative when?

A

Unstable type C and D (neck and condyle)
Interposition of shit and won’t reduce

Type B (shaft) and alignment angulated 30 degrees or 2- degrees if ten

Upper extremity squirm (2 decks)

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