OrthopaedicPrinciples.com

Integrating Principles and Evidence

Integrating Principles and Evidence

-Paediatric Trauma

Sports Shoulder- Injuries in Children

    Sports Shoulder Injuries in Children Epidemiology Common Sports Associated Football (especially defensive players) Wrestling Basketball (males) Softball, gymnastics, cross-country (females) Extreme sports: Skateboarding Skydiving Key Point Limited high-quality epidemiological data Need for: Registries and better tracking systems Common Injury Patterns 1. Medial Clavicle Epiphyseal Injury Population Adolescents Key Concept Often a physeal fracture, […]

Complications with Pediatric Femur Fractures

Courtesy: Martin Herman, MD   Pediatric femoral shaft fractures Common pediatric fracture. Excellent healing potential. Union is usually achieved without difficulty. Main concerns are limb length and alignment rather than fracture healing. Common complications Shortening (most common). Malunion. Delayed union (rare). AAOS Based Treatment Guidelines 0 to 6 months Pavlik harness. 6 months to 5 […]

Principles of Paediatric Trauma

Courtesy: Rakesh Mashru, MD. Cooper Medical School at Rowan University, Department of Orthopaedic Surgery. General Principles of Pediatric Trauma (Orthopaedic Focus) 1. Epidemiology Fracture Incidence By age 16: ~40% of males ~25% of females– sustain at least one fracture Most Common Fracture Sites Distal forearm (wrist) Clavicle 2. How Children Differ from Adults A. Bone […]

Paediatric Forearm, Wrist and Hand fractures

Courtesy: Dr. Walid K Yassir Children’s Hospital of Michigan Pediatric Emergency Department www.chmpem.com Epidemiology and Mechanism Pediatric forearm fractures Account for approximately 40 percent of pediatric long bone fractures. Most commonly occur after a fall on an outstretched hand. The ulna is subcutaneous and is prone to direct trauma, producing a nightstick injury. Increasing incidence […]

Paediatric Trauma- Panel Discussion

Courtesy: Saqib Rehman MD, Associate Professor, Director of Orthopaedic Trauma, Temple University, Philadephia, Pennsylvania, USA   Pediatric Trauma Panel Discussion Posterior Hip Dislocation in Adolescents Key points Commonly caused by high energy trauma such as sports injuries and road traffic accidents. Usually occurs in adolescents with open physes. Always assess for associated femoral head injury. […]

Pediatric Amputation Principles

Courtesy: Pieter Maré, M.B.Ch.B, FC Orth(SA), PhD, UCSF Orthopaedic Surgery  Pediatric Amputations – Key Principles  Concept Amputation in children = reconstructive procedure, not failure Goal: Pain-free stump Good prosthetic function Acceptable cosmesis Core Principles  Limb & Growth Preservation Preserve maximum limb length Preserve growth plates (physis) Prefer disarticulation over trans-osseous amputation  Joint Preservation Always try […]

Fractures of the #Wrist in Children

Corutesy: Dr Amr Abdelgawad, Texas tech University, El Paso, Texas, USA   Distal Radius Fractures in Children 1. Normal Wrist X-ray Anatomy Essential Views AP view Lateral view Key Bony Structures Radius – primary articular bone Ulna – smaller, less involved in articulation Physis (Growth Plate) Smooth, regular line Indicates skeletal immaturity Must not be […]

Fifth Metatarsal fracture

Courtesy: Prof Amr Abdelgawad, Associate Professor, Texas Tech University, USA Anatomy 5th metatarsal base: Insertion of Peroneus brevis tendon Common site of avulsion injuries (inversion) Blood supply Poor at metaphyseal–diaphyseal junction  Risk of delayed union / non-union Growth Plate vs Fracture (X-ray Differentiation) Feature Growth Plate (Apophysis) Fracture Direction Parallel to metatarsal Perpendicular / transverse […]