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The A B C’s of Playground Bone and Joint Injuries

A comprehensive guide by Dr. Brett Cascio covering fractures, casts, Little League injuries, concussions, dislocations, and emergencies. Learn how to recognize, treat, and prevent common playground bone and joint injuries.

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The A B C’s of Playground Bone and Joint Injuries

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  1. The A B C’s of Playground Bone and Joint Injuries Brett Cascio, MD LTC, US Army Reserve Medical Director, Memorial Sports Medicine LSUHSC and McNeese St. Clinical faculty

  2. Topics Emergencies Fractures Casts Little League/overuse injuries Concussions

  3. Emergencies Dislocations Open fractures Supracondylar elbow fracture SCFE Septic joint Compartment Syndrome - cast

  4. Dislocation Should you reduce?

  5. Open Fracture

  6. Supracondylar elbow fracture 3 types Type 3 can be a vascular emergency

  7. SCFE Slipped Capitol Femoral Epiphysis Can worsen rapidly Can cause necrosis of femoral head Forced ext rot w/ flex

  8. Septic Joint Hip and knee Limping or will not bear weight Fever, effusion Sexually active teens http://www.rch.org.au/fracture-education/growth_plate_injuries/Physeal_growth_plate_injuries/

  9. Compartment syndrome Swollen, tight compartment Usually with trauma but can be exercise induced Tight cast Can lead to kidney failure and permanent disability

  10. Fractures Open (compound) or closed Displaced or nondisplaced

  11. Buckle or Greenstick FRACTURE

  12. Growth Plate Fracture Bones grow longer and wider Growth plates on ends of bones from femur to finger Periosteum – can get entrapped

  13. SALTER HARRIS

  14. SALTER HARRIS I

  15. SCFE – Slipped Capital Femoral Epiphysis

  16. SALTER HARRIS II

  17. SALTER HARRIS III

  18. SALTER HARRIS IV

  19. SALTER HARRIS V Very bad – growth arrest

  20. Triplane Happens because way growth plate fuses

  21. ACL avulsion Swollen painful stiff knee

  22. Tibial tubercle avulsion Patella tendon tears bone Its like Osgood Schlatter’s Disease on steroids Swollen painful stiff knee

  23. Ankle Sprain vs fracture Often it is hard for orthopaedic docs to decifer

  24. Toe/finger injuries Don’t underestimate

  25. 5th Metatarsal Fracture Jone’s Fracture?

  26. Back Stress Fracture? Herniated disc

  27. SUSPICIOUS FRACTURES • Recurrent injuries lethal in 10% • First born, step, premature, learning disabled • Over half of fxs in first year • No predominant abuse pattern • Chip fracture of distal femur metaphysis • Multiple fractures of different stages of healing • Femur fxs in pre-ambulatory children • Skull rib scapula fxs • Ulna nightstick fractures

  28. Splint vs Cast Splint safer Cast stronger Don’t get wet Don’t put anything in cast to scratch

  29. Splint vs Cast

  30. STOP Sports InjuriesSports Trauma and Overuse Prevention Overuse injuries Epidemic “Little league” elbows and shoulders Coaches and PE teachers and PARENTS http://www.stopsportsinjuries.org/

  31. Little League Elbow, Shoulder Tommy John Salter 1 fract vs UCL tear Risk factors http://www.cincinnatichildrens.org/health/l/little-league-shoulder/?sa=X&ved=0ahUK EwjpwJib7KLLAhVHNSYKHVcfBo4Q9QEIGTAA

  32. Sever’s Disease osteochondritis

  33. Head bone - Concussions Huge increase in public awareness Memorial Sports Program IMPACT testing Find resources in your area

  34. Hip Bone Hip labrum tears Dancers, kickers, Fastest growing type of injury Repair vs. debride Psoas tendon Impingement

  35. Thank you Emergencies Fractures Dislocations Casts Little League/overuse injuries Concussions www.casciosportsmed.com

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