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common pediatric orthopedic injuries

Objectives. What are Growth Plates and Why do I care?Osgood-Schlater DiseaseSlipped Capital Femoral EpiphysisRadial Head SubluxationToddler's Fracture. What's a Growth Plate?. Growth Plate (epiphyseal plate)EpiphysisApophysis (tendon insertion). . . . Why Do I Care?. Kids are TRICKY!. Objectives.

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common pediatric orthopedic injuries

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    1. Common Pediatric Orthopedic Injuries Anthony Beutler, MD Department of Family Medicine USUHS

    2. Objectives What are Growth Plates and Why do I care? Osgood-Schlater Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    3. What’s a Growth Plate? Growth Plate (epiphyseal plate) Epiphysis Apophysis (tendon insertion)

    4. Why Do I Care?

    5. Objectives What are Growth Plates and Why do I care? Osgood-Schlatter Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    6. Osgood Schlatter: Presentation Who? Young Athlete Growing FAST Open Growth Plates What c/o? Pain with activity Limp Stops playing

    7. Osgood-Schlatter: Diagnosis Exam TTP tibial tuberosity Tight quads You KNOW when: Everything fits No pain at rest Xrays?

    8. Osgood Schlater: Final Thoughts Treatment: Rest Stretch Quads Strengthen Quads Watch Out for: Same symptoms in heel? Pain at rest Night pain

    9. Objectives What are Growth Plates and Why do I care? Osgood-Schlatter Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    10. Slipped Capital Femoral Epiphysis: Presentation Who? 7 – 14 yo Growing FAST (or about to) Obese or active more likely

    11. Slipped Capital Femoral Epiphysis: Diagnosis Exam Limited/painful IR Hip Obligate IR with flexion You KNOW when: Klein’s line Radiologist frantic page What Next?

    12. Treatment: Non-weight Bearing! Ortho Consult within 72 hours This can be bad! Watch Out for: Legg-Calve-Perthes Septic/Toxic Synovitis Slipped Capital Femoral Epiphysis: Final Thoughts

    13. Objectives What are Growth Plates and Why do I care? Osgood-Schlatter Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    14. Young Kids Are Messy

    15. Radial Head Subluxation: Presentation Who? 2 – 7 year old Pulled by the arm What c/o? Crying Won’t use arm

    16. Radial Head Subluxation: Diagnosis Exam Typical posture “My Arm” Maybe some swelling You KNOW when: You reduce AND Child begins to use arm Xrays?

    17. Radial Head Subluxation: Final Thoughts Treatment: Reduction Psychotherapy for mom Watch Out for: Supracondylar Fractures Compartment Syndrome

    18. Objectives What are Growth Plates and Why do I care? Osgood-Schlatter Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    19. Toddler’s Fracture: Presentation Who? 1 – 5 year old Minimal trauma What c/o? Won’t walk Antalgic gait

    20. Toddler’s Fracture: Diagnosis Exam TTP tibia (good luck!) Trouble running back to mom You KNOW when: Xray --- maybe

    21. Toddler’s Fracture: Final Thoughts Treatment: Casting 3-4 weeks LLC Heal VERY fast Watch Out for: Fractures of Abuse

    22. Objectives What are Growth Plates and Why do I care? Osgood-Schlatter Disease Slipped Capital Femoral Epiphysis Radial Head Subluxation Toddler’s Fracture

    23. Review Question 11 yo soccer player complains of knee pain whenever she plays 2 games in 1 day. Exam shows no joint swelling, no erythema, but TTP over tibial tuberosity. The preferred treatment for this athlete is: MRI and orthopedic referral X-ray of affected knee, NSAIDs, rest until pain subsides, and then return to sports Rest from aggravating activities, quadriceps stretching and strengthening program, then return to sports Knee brace, NSAIDs, return to play in 2 weeks

    24. Review Question 13 yo boy complains of medial right knee pain worse with going up and down stairs or when running in P.E. class. Motrin helps the pain a little. On exam his knee appears completely normal. The next step in treatment for this patient is: MRI and orthopedic referral X-ray of affected knee, NSAIDs, rest until pain subsides, and then return to sports Rest from aggravating activities, quadriceps stretching and strengthening program, then return to sports Examination of the hip

    25. Final Review Question:

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