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Med Surg: Ortho - PEDS
Winter Semester - 2011
38
Medical
Graduate
02/08/2011

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Cards

Term
What are the TWO main differences in Pediatric bone?
Definition
periosteum and growth plates.
Term
In kids, which is stronger, ligaments or bone? Why is this important?
Definition
Ligaments are stronger. Sprains are not as likely as fractures
Term
What term is described as thick, fibrous tissue that conducts nutrients to the growing bone?
Definition
Periosteum
Term
How does the difference in a Pediatric's periosteum from an adult's affect fractures and their healing?
Definition
Contributes greatly to stability and aids in reduction/fracture control
Nutrient supply leads to rapid callous formation and low nonunion rate
Term
What classification system is used to grade injuries at or through the growth plate?
Definition
SALTER-Harris Clasification
Term
What is important to note about growth plate ossification? Why is this important?
Definition
Individual growth plates ossify at different ages BUT always in the same order!
Why Important? If a growth plate appears open out of order, suspect fracture!
Term
In a child with joint pain, but a normal x-ray, what should you suspect?
Definition
SH Type 1 until proven otherwise
Term
Which SH fracture is described as seperation of epi and meta plates?
Definition
Type 1
Term
Which SH fracture is described as fracture through plate and exit meta?
Definition
Type 2
Term
Which SH fracture is described as fracture through plate and exits epi?
Definition
Type 3
Term
Which SH fracture is described as fracture though epi and meta plates?
Definition
Type 4
Term
Which type of SH fracture is described as Compression of plate?
Definition
Type 5
Term
Which type of SH fracture is Most serious due to its propensity to lead to growth arrest?
Definition
Type 5
Term
Which type of SH may NOT show on an x-ray?
Definition
Type 1 and Type 5
Term
Which type of ped fracture is described as a compression fracture?
Definition
Torus/Buckle
Term
Which type of fracture is described as one intact cortex?
Definition
Greenstick
Term
Whch type of ped fracture is described as a slight force, causing no fracture but can lead to problems with supination and pronation if not fixed?
Definition
Bowing
Term
Which type of ped fracture is described as ligaments being stronger than bone and causes a fracture?
Definition
Avulsion
Term
If a pt presents with pain in hip, limping with weight bearing (or refusal to walk), a history of URI or other viral arthritis, but on joint aspiration the fluid show NO WBC increase and neg cultures, what condition should you suspect?
Definition
Transient Synovitis
Term
What condition should you r/o before a dx of Transient Synovitis is made? What are the key differences?
Definition
Must r/o septic arthritis
Transient Synovitis will have none of the septic symptoms - fever, pallor, etc (Look normal, but cannot bear weight)
Term
What is the treatment for Transient Senovitis?
Definition
Usually self-limiting, 3 - 7 days
Term
Which ped condition is described as Idiopathic osteonecrosis of capital femoral epiphysis?
Definition
Legg-Calve-Perthes
Term
What complication can arise from Legg-Calve-Perthes?
Definition
Leads to misshapen femoral head
Term
In which types of pts would you see Legg-Calve-Perthes?
Definition
Males (4 - 10y/o) who are often small for their age
Term
What are the tx options for Legg-Calve-Perthes?
Definition
Casting (ABduction position -for 6, 8 or 12 weeks)
Surgery
Term
What condition is described as Displacement of the femoral head?
Definition
SCFE - Slipped Capital Femoral Head
Term
What is the "classic" picture of SCFE?
Definition
AA obese female between the age of 11 - 13 (presents unilateral initially with other side occurring later)
Term
What is the treatment for a SCFE?
Definition
Surgical Repair - Fixation
Term
What is the MC complaint with a SCFE?
Definition
Knee Pain
Term
Which condition is described as Fragmentation of tibial tubercle that Leads to prominence and painful bursa?
Definition
Osgood-Schlatter
Term
What are the treatments for Osgood-Schlatter?
Definition
1st Line - RICE and NSAIDs
2nd Line - Removal of the bursa
Term
If a pt presents with knee pain with forceful extension (going up steps, jumping etc.) and has point tenderness under the patella, but has no change in their ROM, what condition should you suspect?
Definition
Osgood-Schlatters
Term
What is the main complaint on presentation with Nursemaids elbow?
Definition
Not using their arm
Term
Does Nursemaid's elbow show on the x-ray?
Definition
No
Term
How should Nursemaid's elbow be reduced?
Definition
Reduced by flex/sup of elbow
Term
What is the "classic" sign of a pediatric ACL tear? What imaging is best for this diagnosis?
Definition
Tibial Eminence Fracture; Lateral x-ray best, PA view may not show anything
Term
What should you suspect with long bone fractures? Which type of fracture is most suspect?
Definition
SUSPECT ABUSE, until proven otherwise
Transverse Type of fracture
Term
What are some signs of abuse?
Definition
Multiple Fractures in various stages of healing
Multiple Bruises in various stages of healing
Stories that DON'T Match
Multiple Reoccurring Injuries
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