-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. […]

Toddler Fracture

Courtesy: Dr Amr Abdelgawad University of Texas, USA

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 […]

Supracondylar Fracture Humerus & Circulation

Courtesy: Prof Nabil Ebraheim,University of Toledo, Ohio, USA Supracondylar Fracture of the Humerus: Circulatory Assessment and Management Initial Principles Perform a thorough neurovascular examination before and after reduction. Avoid elbow hyperflexion beyond 90 degrees during casting because it may compress the brachial artery. Closed reduction and percutaneous pinning (CRPP) is the preferred treatment. The most […]

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 […]

Supracondylar Humeral fracture set up and Technique

Courtesy: Michael Taunton MD Mayo Clinic USA Supracondylar Fracture of the Humerus: Operative Technique (Closed Reduction and Percutaneous Pinning) Preoperative Setup Position the patient near the edge of the operating table. Position the C arm below the table. Place the fluoroscopy monitor directly opposite the surgeon. Use the C arm surface as the working platform. […]

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 […]

Supracondylar Fractures in Children

Courtesy: Prof Nabile Ebrahiem, University of Toledo, Ohio, USA Supracondylar Fracture of the Humerus in Children Introduction Most common elbow fracture in children, accounting for approximately 50 percent of pediatric elbow fractures. Occurs through the supracondylar region, the weakest part of the distal humerus. Types of Fracture Extension type Accounts for approximately 95 percent of […]