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37 Cards in this Set
- Front
- Back
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What are the four components of pediatric hip fracture classification?
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Transepiphyseal (with or without dislocation)
Transcervical Cervicotrochanteric Intertrochanteric |
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What is the rate of AVN with transepiphyseal fractures? How are they treated?
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Nearly 100% develop AVN
ORIF is the preferred treatment |
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What is the rate of AVN with transcervical and ceivicotrochanteric fractures? In what two ways are they treated?
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25% AVN
ORIF Closed reduction and percutaneous pinning with postoperative spica |
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How are pediatric intertrochanteric fractures most commonly treated?
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Spica cast
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An acetabular fracture ORIF in a patient under 10 years of cartilage age may result in what complication?
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Premature closure of triradiate cartilage
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What is the consequence of early triradiate cartilage closure?
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Shallow acetabulum
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How are femoral shaft fractures generally treated in patients <6 years of age?
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Spica cast
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. . . . in patients 6 to 13 years of age?
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Flexible intramedullary nails
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. . . in patients over the age of 13 years?
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Rigid intramedulla1y(IM) nail
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How much shortening is acceptable?
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2.5 cm
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What is the biggest disadvantage of using external fixation for treatment?
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Increased risk of refracture
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What are two possible complications of pediatric femoral shaft fracture?
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Patients under 10 years: femoral overgrowth
Tibial tubercle growth arrest with resulting recurvatum deformity |
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Pediatric distal femur fractures tend to fall into what direction?
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Varus
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These fractures are usually a Salter- Harris ___?
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ll
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What key complication must one closely observe for?
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Physeal growth arrest
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Physeal bridges: consider resection in patients with what two characteristics?
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>2 cm remaining growth
<50% physeal involvement |
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lf >50% physis involved, what are the two surgical procedures?
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Ipsilateral completion
Contralateral epiphysiodesis |
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What two populations are especially at risk for pediatric knee dislocation?
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Down syndrome
Arthrogryposis |
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What two structures may be trapped and block reduction of a tibial eminence fracture?
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Anterior horn of meniscus
Transverse meniscal ligament |
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What two injuries are potentially associated with these high-energy fractures?
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Popliteal artery injury
Compartment syndrome |
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Proximal tibial physis fractures are analogous what problem in adults?
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Knee dislocation
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lf the physeal fracture goes into malalignment, in what direction does it usually fall?
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Varus
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ln what direction does a proximal tibial metaphyseal fracture usually fall?
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Valgus
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How can malalignment be prevented?
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Long leg cast in extension
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What is the prognosis if malalignment does occur?
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Usually remodels
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With a pediatric tibial shaft fracture is reaming acceptable?
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Not if physes are open
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In which order do the three distal tibial physes close?
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Central
Medial Lateral |
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What fracture tends to affect a younger age group: triplane or Tillaux?
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Triplane occurs earlier
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What is the radiographic appearance of a triplane fracture on AP film?
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Looks like Salter-Harris III
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What is the radiographic appearance of a triplane fracture on lateral view?
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Looks like a Salter-Harris ll
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But it IS actually which Salter-Harris classification?
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Salter-Harris IV
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How are distal tibial physeal fractures treated?
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ORIF
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What part of physis has already closed with a Tillaux fracture?
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Medial
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What part of physis is injured?
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Lateral
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What is the Salter-Harris stage of a Tillaux fracture?
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III
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How are Tillaux fractures treated?
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ORIF
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What is the surgical approach?
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Anteriorly
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