– Discussion: – epiphyseal artery – metaphyseal artery – nutrient artery – periosteal vessels – see tibia bone circulation – Pediatric Bone Circulation: – circulation in pediatric bone: – differs from adult circulation due to requirements of growth … Read more
– See: – Pediatric Distal Tibial Fracture – Pronation-External Rotation Frx – Supination – External Rotation Frx – Supination Inversion Frx – Supination Plantar Flexion – Tillaux Fracture – Triplane Fracture – Discussion: – most … Read more
– Post Fixation: – w/ BPB grafts, the sutures are passed thru the bone plug and then are passed around a screw over a washer; – w/ soft tissue grafts (such as tendinous edge of Achilles tendon graft), requires a Krackow stitch (whiped locking stitch) is required; – Spiked Washer Fixation: … Read more
(see: juvenile RA menu) Discussion definition: < 4 involved joints. most frequently encoutered subgroup, accouting for 30-40% of JRA; peak age is 2-4 years more common in girls (4x) differential dx Clinical Presentation> begins w/ incidious onset which can be painless swelling, warmth, and restriction of motion are common sx; knee, ankle, and elbow (& … Read more
– Discussion: – Pavlik harness is a dynamic flexion abduction orthosis used to treat DDH in infants up to 6 months of age; – harness usually leads to stability of reduced hip w/ in 4 wks, but its use should be continued until clinical exam & x-rays of hip are normal; … Read more
Pavlik harness: Position for Reduction & Safe Zone – Discussion: – stable zone: – ROM in which hip remains reduced w/o subluxation; – spica cast: – may be used when reduction has narrow stable zone … Read more
DDH Effusion – diff. dx Perthes Disease Sickle Cell Anemia Slipped Capital Femoral Epiphysis Coxa plana–the fate of the physis. Radiographic abnormalities of the iliac apophysis in adolescent athletes.
– See: – Pathologic Hip Frx – Metastatic Tumors to Bone – Discussion: – fractures which occur from low energy injuries which occur thru an area of bone weakness with a pre-existing abnormality; – injured area demonstrates distored archetecture and distored bone density; – Diff Dx: … Read more
– See: General Discussion – Hyperparathyroidism – incidence of hip frx is about 10%; – in younger pts with good bone stock, consider ORIF; – in elderly pts consider primary THR; – note, however, when when hyperparathyroidism occurs as a consequence of renal … Read more
– Discussion: – osteoarthritis represents a gradual processes of destruction & regeneration; – early in dz, articular cartilage loses its glistening appearance; – later on surface layers flake off while deeper layers develop longitudinal fissures, process termed fibrillation; – cartilage becomes thin and sometimes denuded; – … Read more