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46 Cards in this Set
- Front
- Back
What is the treatment for a physeal fracture <10 days old?
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Closed reduction
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What is the treatment if irreducible?
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Leave alone
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How much deformity is acceptable in patients over 12 years of age?
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<40 degrees
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What is the radiographic appearance of nursemaid’s elbow?
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Normal
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What nerve is at risk with an extension type supracondylar fracture?
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AIN (anterior interosseus nerve)
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What nerve is at risk with an extension type and posteromedial displacement?
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Radial nerve
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What two nerves are at risk with an extension type and posterolateral displacement?
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Median nerve
Brachial artery |
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What nerve is at risk with flexiotype?
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Ulnar nerve
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What two complications are associated with casting the elbow in hyperflexion?
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Compartment syndrome
Volkmann’s contracture |
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ln what compartment are the highest pressures present (same as in adult)?
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Deep volar compartment
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Compare resistance to varus and valgus stress: lateral pins only versus medial and lateral pins?
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Equivalent
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What construct provides better resistance to axial load?
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Medial and lateral pins better
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How can the strength of lateral-only fixation be improved?
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Cast also
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What are the three long-term complications of varus malunion?
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Poor cosmesis
Ulnar neuropathy Posterolateral rotatory instability |
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What is the usual age of injury?
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6 years
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How much displacement is acceptable?
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2 mm
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What is the treatment if less than 2 mm displacement?
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Cast
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What is critical about nonoperative lateral condylar fracture treatment?
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Must follow very closely
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Like a supracondylar fracture, what is fracture stability dependent on?
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Integrity of cartilaginous hinge
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What is the treatment for lateral condylar fracture with 2 to 5 mm of displacement?
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Closed reduction and percutaneous pinning
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How long after surgery should the pins be removed?
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4 weeks
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At what time point is radiographic evidence of healing first seen?
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6 weeks
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What is the treatment for lateral condylar fracture with over 5-mm displacement?
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ORIF
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What is a key caveat?
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Avoid posterior dissection to preserve blood supply
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How is a nonunion with <1 cm displacement best treated?
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Leave alone
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What is the preferred treatment for a nonunion with 21 cm displacement?
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ORIF
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What are the two key caveats?
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No soft tissue stripping
Anatomic reduction unnecessary |
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What is the usual age of medial epicondylar fracture?
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9 to 14 years
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How much displacement is considered acceptable?
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10 mm
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How is late-presenting Monteggia fracture with chronic radial head dislocation treated?
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ORIF
May require ulnar osteotomy |
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How are radial head fractures with to <40 degrees of angulation treated?
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Nonoperative
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How are radial head fractures with to 60 degrees of angulation?
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Closed reduction and percutaneous pinning
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How are radial head fractures with over 60 degrees of angulation?
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ORIF
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What should be tried before ORIF?
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Closed reduction (with Kirschner [K] wire hinge, for example) to improve angulation
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What are the three recently reported risk factors for wrist and forearm fractures in children?
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Decreased bone density
Poor balance Increased body mass index |
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What two steps are proven to protect against wrist and forearm fractures in sports?
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Wrist guards
Decreased ball size |
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How much rotation is acceptable in both-bone forearm (BBF) fractures in
patients <1O years of age? |
45 degrees
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What bone is at greater risk of developing growth disturbance:radius or ulna?
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Ulna
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What is the likely diagnosis for a child with healed BBF and inability tendons within the fracture callus to extend the fourth and fifth distal iriterphalangeals (DlPs)?
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Tethering of the fourth and fifth FDP
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What is the advantage to pinning a pediatric distal radius fracture?
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Decreased rate of loss of reduction
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How do outcomes of pinning and nonoperative treatment compare?
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Equivalent
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lf median nerve symptoms are present, how does this affect treatment?
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Should be pinned
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What are the two treatment options for phalangeal neck fracture?
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Closed reduction percutaneous pinning
ORIF |
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What structures must be identified and protected in surgery?
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Preserve collateral ligaments
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What is Seymour’s fracture?
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Distal phalanx fracture with associated nail-bed laceration Incarceration of germinal matrix in physis
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How is it treated?
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Requires exploration, nail-bed repair, fracture reduction
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