Bone Development and Pediatric Injury Patterns Flashcards
Endochondral ossification
Hyaline cartilage forms model
Perichondrium surrounds hyaline cartilage where osteoblasts infiltrate and covert into periosteum
Cartilage in center disintegrates as osteoblasts form primary center…ossification moves towards ends
Hylaine cartilage in epiphyses increases in length…osteoblasts penetrate and ofrm secondary…growht outward until epiphysis converted to spongry
NEED CONTACT BETWEEN JOINTS
DDH
Developmental dysplasia of the hip
Abnorma femoral ehad with acetbaulum contact causes acetabulum to delay in growht
Female, breech presentation, genetics, swaddling
Bone age
Can look at bones and see secondary ossification centers and how developed they are
Physis
Epiphysis
Apophysis
Phyis-s primary ossification center
Epi - secondary ossification center…lengthening\
Apo - secondary…contour
Pediatric bone
Bone weaker than ligament
Periosteum is osteogenic and metabolically active - thicker and stronger so get greenstick fractures
Bone is plastic…buckle fracture - longitudnal forces compress
Bowing deformity - microscopic fractures dissipae impact
Regions of physis
Germinal - resting state
Prolif - active growth creating bone length
Hypertropihc - most likely area of fracture with little ECM
Ednochrondal calcification - strongest ares
Salter-harris types of physis injruies
S - straight across, physis only
Above - physis and metaphysis
Lower - physis and epiphysis
Through - physis, metaphysis, epiphysis
ERasure - crush injury
SCFE
Type 1 - posteiro and inferior slippage of proximal femoral epiphy
Obese
Most are chronic
Decreased internal roatiation
Dull, in groin, thigh, knee
Type 2
Most common and rarely causes arrest
Type 3
Possible arrest
Need surgery to return to anatomic positon
type 4
Possible arrest
Need surgery
Type 5
Often missed and bone grwoth arrest univeral
Diagnosis made after arrest
OCD
Osteochondritis dissecans
Osteonecrosis of the epiphyseal subchondral bone (separation of carticalge and bone)
Microtrauma
Demineralization of bone
Failure of revasculaerization
OCD clinical
Most of lateral medial femoral condyle
Localized pain worse with activity
Swelling
Legg-Calve-perthes disease
Idiopathic avascular necrosis of the femoral epiphysis
Persistent hip or knee pain with limp
