Ortho 3

llbgurl's version from 2015-10-02 17:56

Section 1

Question Answer
microtrauma in the deep fibers or the patellar tendon at its insertion into the tibial tuboersity Osgood Schlatter Disease
adolescents after going through rapid growth spurtOsgood Schlatter Disease
males > girls 7:1Osgood Schlatter Disease
pain reproduced by extending the knee under resistanceOsgood Schlatter Disease
focal swelling and point tenderness over tibial tuberosityOsgood Schlatter Disease
self limiting, ice/cold rx, quadriceps stretching once acute sx subsideOsgood Schlatter Disease

Section 2

Question Answer
22% of girls 39% of boys per seasonsports injuries
incident rates increase with level of competition, frequency of participation and age with older children/adolescents having the greatest rates and severity of injurysports injuries
highest risk: football, gymnastics, ice hockey, wrestling, skateboardingoveruse injuries
knee injuries most COMMON pediatric sports injury
sprainsstretch or tear in the ligaments or other connective tissues
strainsa stretch or tear in a muscle or tendon
highest incidence of occurrence over contusions and fractures sprains/strains
minimal tearing, pain or edmagrade 1
stable joint, local tenderness, full ROMgrade 1
little or no change in muscle massgrade 1
positive weight bearing, little or no discolorationgrade 1
some tearing, pain, edema, discolorationgrade 2
palpable defect in muscle mass, limited mobility, moderate pain, edema and moderate joint instabilitygrade 2
complete tear, without joint instability and severe paingrade 3
marked joint laxity, large palpable defect with significant edemagrade 3
marked discoloration, possible numbness, tingling or weakness distant to injurygrade 3
mechanism to injury or repetitive activitysprains/strains
point tendernessthink fracture!
popping or snapping, radiation of pain, treatment since injurysprains/strains
symmetry of muscle groups, ROM, edema, discoloration, fluid, strenght, peripheral vascular status, neurosprains strain
24-72 hoursRICE
isometric exercises after 1-2 days restsprain strain
grade 3refer to ortho
large swelling immediatley after injuryget x-ray
no history of trauma when r/o fracture thinkinfection
salter-harrisfractures of the epiphyseal plate
no disruption to growth plate, usually from a fall. NO growth disturbanceSalter-Harris I-II
blood supply to growth plate is partially maintained; cells may be damagedSalter-Harris III-IV
greatest potential for growth disturbance; cells in growth plate are crushedSalter-Harris V
lateral and anterior/posterior views should be obtainedx-rays
salter 1 fracturesoften do not show up on x-ray; may need to repeate in 10-14 days s/p trauma
diagnosis is often made on the basis of clinical picture: tenderness over the area of the growth plateSalter I fracture
open fracture, skull fracture, change in sensationhas to go to the ER
fracture treatmentcontrol swelling with application of ice/elevation immoblization and refer
examine corresponding joint/area on the other extremityoveruse injury
joints above and below injuryoveruse
peripheral vascular statuscolor, temperature, pulses
neurological functioningDTRs, sensation, gait
rest, NSAID, strengthening exercisesoveruse injury treatment
wear protective gear, perform warm-up exercises, stop when fatiuged how to prevent overuse injuries
autosomal dominant x linked boysMD
most common MDduchene 1 in 3500 births
toe walking, large firm calf musclesMD
doughy feel to muscles, waddling gaitMD
lower extremities show earlier weakness MD
3-6 years of age, failure to meet motor milestones or loss of milestones, toe walking,MD
history of good and bad daysMD

Section 3

Question Answer
fainted or lost consciousness during exercise #1 question to askpre-sports eval
systolic murmur that increases on sitting or with valsalva maneuvermust get EEG
arrythmia that does not subside with exercisecards
scoliosis screen, duck walk up 4 stepspre-sports eval
atlantoaxial instability (down syndrome)can NOT do contact-collision sports
carditiscan NOT do contact-collision sports
diagnosed hypertensioncan NOT do contact-collision sports
absence of a paired organcan NOT do contact-collision sports
poorly controlled seizure disordercan NOT do contact-collision sports
hepatosplenomegalycan NOT do contact-collision sports
VP shuntcan NOT do contact-collision sports
Long QT syndrome