Physical Exam of DDH
– See: Impediments to Reduction – Early DDH: – Barlow’s Test – Ortolani’s test – Hip Clicks: – common occurance on physical exam; – there is no published significance of hip clicks; – Late DDH: – tightness … Read more
Hip
Physical Exam and Evaluation of Colles Frx
– Neurological Exam: – be sure to examine the AIN, PIN, and median nerve at the wrist; – carpal tunnel syndrome; – evaluate the strength of the APB; – injury from contact with bone spicules; – … Read more
Phalangeal Injury
– Amputation of the Finger and Hand – Arthrodesis of the MP joint and Finger Joints – Boutonnere Injuries – Characteristics of Phalangeal and Metacarpal Fractures – Compression Screws – Condylar Frx – Crossed Finger Flap – Dislocations of PIP – Digit Reimplantation – Dislocations: … Read more
Pes Planus / Flat Foot
– Discussion: – loss of normal medial longitudinal arch leads to pes planus, which can be flexible or rigid; – may arise as a consequence of hyper-pronation or from increased eversion of the subtalar joint; – hence, the calcaneus lies in valgus and external rotation relative to the talus; – associated midfoot sag may be … Read more
Peroneal Nerve
– See: – Innerv. Musc. Lower Limb – Innervation of the Leg and Foot: – Anatomy: – common peroneal nerve is derived from (L4, L5, S1, S2) as a part of the sciatic nerve; – posterior component, supplies short head of biceps femoris in thigh, crosses posterior to lateral head of gastrocnemius, and becomes subQ behind … Read more
Percutaneous Fixation of Anterior Column Fx
– See: Classification and Column Theory – Percutaneous Screw Placement: – anterior column screws can be placed either antegrade (from cephalad to caudad) or retrograde (vice versa); – implant: 7.3 or 8.0 mm cannulated screws; – C-arm is placed perpendicular to the superior pubic ramus; … Read more
Pelvic Osteotomy for DDH
– See: DDH: – Indications for Treatment: – age: pelvic osteotomies are usually performed between ages 3-8 years; – in children > 3 years, open reduction, femoral shortening, & acetabular redirection will provide concentric reduction, will reduce AVN, & will achieve a functional range of motion; – some will even consider pelvic osteotomy in children as … Read more
Pediatric Radiology
– See: – Methods to Etimate Growth Potenital: – Growth Plate Anatomy – Appearance of Ossification Centers: – skeleton incompletely ossified at birth, & portions such as carpals, patella, navicular, cuneiforms, will radiographically appear entirely cartilaginous; – ossification centers will enlarge in all directions, until it becomes bounded on … Read more
Pediatric Femur Fractures
– See: – Distal Femoral Physeal Fractures – Hip Fractures in Children – IM Nailing of Pediatric Femoral Fractures – Discussion: – commonest site of fracture of the femoral shaft is in its middle third, where normal anterolateral bowing of the diaphysis is at its maximum; … Read more
Pediatric Discitis
– Discussion: – a benign, self-limiting inflammation or infection of an intervertebral disc space or a vertebral end-plate; – it may represent extension of subacute vertebral endplate osteomyelitis which does not produce a progressive vertebral osteomyelitis; – discitis presents in different ways at different ages; … Read more