OrthopaedicPrinciples.com

Integrating Principles and Evidence

Integrating Principles and Evidence

-Paediatric Trauma

Traumatic Neonatal Distal Femoral Physeal Injury

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA   Neonatal distal femoral physeal injury Definition A rare birth injury involving: Separation of the distal femoral physis Equivalent to: Salter-Harris classification Type I injury Epidemiology Rare in neonates Comparison with Other Physeal Injuries More common sites: Distal humerus Less common: Distal femur Etiology Primary Cause: […]

Acute Lateral condyle fractures in Children

Lateral condyle of humerus fracture Classification of the Lateral Condyle Fracture Milch – morphology Weiss – displacement Song – displacement and stability Milch Type 1 • Fracture exits LATERAL to trochlear groove Stable Milch Type 2 • Fracture exits MEDIALLY into trochlear groove • Unstable Milch – modified • Uses the capitello-trochlear sulcus as landmark […]

Physeal Injuries in Children

EPIDEMIOLOGY Physeal injuries account for approximately 21 percent of all paediatric fractures (average of six large series). Distribution by Location Phalanges: 37 percent Distal radius: 18 percent Distal tibia: 11 percent Distal fibula: 7 percent Metacarpals: 6 percent Distal femur: uncommon but high risk for growth arrest WHY PHYSEAL INJURIES OCCUR Key contributing factors include: […]

Ankle fractures in Children

Courtesy: Kaye Wilkins, Lynn Staheli , www.global-help.org  Pediatric Ankle Fractures (Distal Tibia & Fibula) Key Concept In children  physis is weaker than ligaments So  injuries occur through growth plate (physeal fractures) rather than ligament tears Hence: better called “Fractures around the ankle in the skeletally immature”  Classification  Not very useful: Salter-Harris classification (limited value for […]

Fractures of the Femur neck in children

Courtesy: Kaye Wilkins MD, Prof Lynn Staheli MD, www.global-help.org   Pediatric Hip Fractures (Proximal Femur Fractures) Overview Rare injuries in children, accounting for less than 1% of pediatric fractures Usually caused by high-energy trauma Associated with significant complications, especially avascular necrosis (AVN) Pediatric vs Adult Femoral Neck Fractures Feature Pediatric Adult Incidence Rare Common Mechanism […]

Fractures of the Femoral Shaft in Children

Courtesy: Kaye Wilkins MD, Prof Lynn Staheli MD   1. Deforming Forces Proximal Fragment Flexion + external rotation Due to iliopsoas muscle Abduction (varus tendency) Due to hip abductors Distal Fragment Shortening Due to: Hamstrings Quadriceps Key Concept Both muscle groups are biarticular – strong deforming forces 2. Age-Wise Incidence Peak 1: 2–5 Years Mechanism: […]

Sports Injuries of the Elbow in children

  1. Common Pediatric Elbow Injuries Supracondylar fracture of humerus (most common) Lateral condyle fracture of humerus Medial epicondyle fracture Elbow dislocation Radial neck fracture Olecranon fracture 2. Supracondylar Fracture Mechanism Fall on outstretched hand Hyperextension injury Distal fragment displaced posteriorly Classification (Gartland) Type I: Undisplaced Type II: Displaced with intact posterior cortex Type III: […]