Flashcards in Ortho Deck (95)
How are kids bones dif. from adults?
metabolically more active
thicker and more durable
What is an occult fx?
fracture not initially evident on plain xrays
Salter Harris I fx?
transverse physeal fx w/ widening
Salter Harris II fx?
fx through metaphysis and physis
Salter Harris III fx?
fx through physis and epiphysis
Salter harris IV fx?
fx through metaphysis, physis, and epiphysis
Salter harris V fx?
physeal compression or crush fx
What is the MC pediatric elbow fx?
Presentation of supracondylar fx?
FOOSH injury from height, typically w/ hyperextension
swelling, pain +/- deformity
What x-ray view will you best see a supracondylar fracture?
Tx of distal humerus supracondylar fx?
Type I/II: posterior splint w/ light overwrap, Ibuprofen, elevation, refer to ortho
Type III or NV concerns: emergent ortho consult
presentation of lateral condylar fx?
soft tissue swelling concentrated to lateral aspect of elbow
ttp over lateral condyle
Management of lateral condylar fx of distal humerus?
emergent referral if displacement >2mm
splint, sling, NSAIDs
ortho: casting v. surg
What are some complications of lateral condylar fx of distal humerus?
cubitus valgus/varus deformities
Common causes of medial epicondylar fx
muscle attachement avulsion-throwing athletes
may be assoc. w/ elbow dislocation
Management of medial epicondylar fx?
emergenct if entrapped fragment
splint: wrist & sling
ortho: short term immobilization v. open fixation
comps of medial epicondylar fx?
ulnar nerve palsy
Common causes of radial neck fx?
FOOSH w/ valgus stress
elbow dislocations: during dislocation or relocation
Presentation of radial neck fx?
TTP over radial head/neck
pain w/ supination/pronation > flexion/extension
young children may complain of wrist pain
Management of radial neck fx?
immobilize (including wrist)
sling, NSAIDs, ortho
comps of radial neck fx?
premature physeal closure
loss of ROM
MC age range for nursemaid's elbow?
common cause is sudden pull of pronated arm
Presentation of nursemaid's elbow?
arm either fully extended or slightly flexed and pronated
overall refusal to use arm (may still use fingers)
mild pain over radial head, pain increase w/ attempts to supinate
What are the 2 ways that you can reduce a nursemaid's elbow?
1. hyperpronation w/ pressure over the radial head
2. supination, flexion w/ pressure over radial head
then lollipop test
epidemiology of capitellar osteochondrosis "panner disease"
dominant (throwing) arm
baseball, gymnastics, handball
Presentation of panner disease?
rapid onset of pain
deep, lateral pain
ROM: limited extension
no locking sensation
panner disease PE findings?
+/- swelling, TTP
pain/guarding w/ passive extension
lateral pain w/ valgus stress