Courtesy: Prof Shital Parikh, Professor, Cincinatti Childrens Hospital, Cincinatti, Ohio, USA Pediatric ACL Tears & Tibial Spine Fractures – High-Yield Notes Pediatric ACL Tear Natural History (IMPORTANT) Non-operative – poor outcomes instability meniscal tears return to sports Delay > 12 weeks – irreparable meniscus injury Conclusion: Early surgical management preferred Assessment of Skeletal Maturity Methods: […]
-Paediatric Trauma
Ankle Fractures In Children
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Growth Arrest Risk Incidence after distal tibial physeal injury: Up to 50% Higher Risk In Displaced fractures Intra-articular injuries Medial malleolar injuries Salter-Harris classification (Ankle) Type I & II Treatment Closed reduction + casting Key Point Surgery does not reduce the risk of growth arrest Type […]
Femoral Shaft Fractures in Children
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Pediatric Femoral Shaft Fractures Overview Pediatric femoral shaft fractures One of the most common causes of pediatric orthopedic hospitalization. Management depends on age, fracture pattern, fracture location, and the child’s weight. Age Based Treatment Algorithm Less than 6 months Pavlik harness. 6 months to 5 years […]
Torus Fractures (Buckle fractures)
Courtesy: Amr Abdelgawad, Maimonaides Medical Centre, Brooklyn, NY, USA
Distal Tibia and Transitional Fractures in Children
Courtesy: Prof Antonio Andreacchio, President, European Paediatric Orthopaedic Society (2021-22), Chair, Paediatric Orthopaedic Department, Vittore Buzzi Children’s Hospital, Milan, Italy Distal Tibial Transitional Fractures (Pediatric Ankle) Overview Occur during physeal closure (transitional phase) Important pediatric ankle fractures Types Triplane fracture Tillaux fracture Anatomical Basis (Key Concept) Asymmetric Physeal Closure of Distal Tibia Closure sequence: […]
Principles of Paediatric PolyTrauma
Courtesy: Nirav Pandya, Associate Prof, UCSF, California, USA Epidemiology Trauma Accounts for approximately 60 percent of pediatric deaths. One in four children experiences trauma. About 76 percent of polytrauma patients have associated orthopedic injuries. High velocity injuries and adult type trauma patterns are becoming more common. Most Important Injury Neurologic injury Traumatic brain injury is […]
ACL Injuries in Children
Courtesy: Nirav Pandya MD, Associate Professor, Chief of Paediatric Orthopaedics, University of California at San Francisco(UCSF), USA Pediatric Anterior Cruciate Ligament Injury Introduction Previously considered rare in children Reason: Ligaments stronger than bone — injuries occurred at physis or tibial spine Current Trend Rapidly increasing incidence Why Increasing? Early sports specialization (age 6–10) High training […]
Paediatric Forearm and Hand fractures
Courtesy: Amr ABdelgawad, Maimonaides Medical Centre, Brooklyn, NYC, USA Pediatric Forearm and Hand Fractures Distal Radius Fracture Types Greenstick fracture with angulation and one cortex broken. Torus (buckle) fracture with compression and intact cortex. Complete fracture. Metaphyseal fracture. Physeal fracture (Salter Harris types). Acceptable alignment Up to 20 degrees of dorsal angulation (apex volar). […]
Radial Head & Neck Fractures In Children
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Radial Head and Neck Fractures in Children Overview Uncommon pediatric elbow injury. Peak incidence around 9 years of age. Usually caused by a valgus force following a fall on an outstretched hand. Types of Fractures Non displaced fractures. Displaced fractures. Angulated (tilted) fractures. Translocated fractures. Location […]
Paediatric Upper extremity Trauma
Courtesy: Amr Abdelgawad, Maimonaides Medical Centre, NY, USA Pediatric Upper Extremity Trauma 1. Medial Epicondyle Fracture (Children) Key Anatomy Last ossification center to fuse in elbow Fusion age: Boys: 16–19 years Girls: 13–16 years Attachments Medial collateral ligament (MCL) Mechanism Valgus stress – avulsion injury Commonly associated with elbow dislocation Treatment Non-operative (Most Cases) […]
Overview of Paediatric Upper Extremity Trauma
Courtesy: Amr Abdelgawad, Maimonaides Medical Centre, NY, USA Pediatric Upper Extremity Trauma Clavicle Fracture Key anatomy First bone to ossify during fetal development. Medial clavicular epiphysis is the last epiphysis to fuse at 20 to 25 years. Management Children younger than 12 years are treated nonoperatively in almost all cases. Adolescents 15 years and […]
Overview of Paediatric Lower Extremity Trauma
Courtesy: Amr Abdelgawad, Maimonaides Medical Centre, NY, USA Apophyseal and Avulsion Injuries Apophysis Secondary ossification center located outside the joint where tendons attach. Common apophyseal attachments Calcaneus: Achilles tendon. Tibial tubercle: Patellar tendon. Anterior inferior iliac spine (AIIS): Rectus femoris. Anterior superior iliac spine (ASIS): Sartorius. Ischial tuberosity: Hamstrings. Iliac crest: Abdominal muscles. Treatment Rest. […]
Femoral shaft fractures in Children
Courtesy: Amr Abdelgawad, Consultant, Maimonaides Medical Centre, Brooklyn, New York, USA Pediatric Femur Fractures Epidemiology Pediatric femur fractures Third most common long bone fracture after the forearm and tibia. Incidence is approximately 30 per 100,000 children per year. More common in males older than 3 years. Mechanism of injury Infants and toddlers: Falls. Always […]
Medial Epicondyle Fracture Fixation in the Lateral Decubitus Position
Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA Medial Epicondyle Fracture Fixation (Pediatric) – Stepwise Approach 1. Indications for Surgery Absolute / Strong Indications Fragment incarcerated in the joint Associated elbow dislocation Ulnar nerve symptoms Relative Indications Displacement >5 mm (controversial threshold) Elbow instability (valgus instability) High-demand patients: Throwing athletes Weight-bearing upper […]
Paediatric fractures that maybe Missed!
Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA Pediatric Elbow X-ray Interpretation – Stepwise Approach Why This Topic Is Important Many pediatric elbow fractures are occult and may not be obvious on initial X-rays A normal-looking X-ray does not exclude fracture Missed injuries can result in: Malunion Deformity Loss of motion Long-term disability […]