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Epiphyseal Trauma


Presentation

  • Considered as the "go-to" reference for orthopaedic trauma surgeons and pediatric orthopaedic trauma surgeons, Green’s Skeletal Trauma in Children presents practical, focused guidance on managing traumatic musculoskeletal injuries in children and adolescents[books.google.de]
  • Practical tables provide a quick reference to essential information, including normal developmental anatomic milestones, developmental anomalies, common presentations and symptoms of diseases, and much more. 400 new and replacement images are added to[books.google.de]
  • Final cultures: Blood cultures obtained at initial presentation were positive for Staphylococcus aureus.[gait.aidi.udel.edu]
Falling
  • Cause : can be associated with low grade trauma, eg falls, as well as high velocity trauma, eg HBC (RTA) and high rise syndrome in cats. Trauma may cause total or partial closure of growth plate(s).[vetstream.com]
  • They are usually the result of intense trauma, such as a high speed motor vehicle accident or a fall from height onto one’s back. They can also occur from a fall on an outstretched arm if the humeral head impacts on the glenoid cavity.[cvosm.com]
  • Unstable SCFE often happens after a trauma, such as a sports injury or a fall. Falling can also cause a stable SCFE to become unstable. What are the symptoms of stable SCFE? A child who has stable SCFE may first have stiffness in the hip.[familydoctor.org]
  • Growth plate injuries are caused by accidental falls or blows to the limbs during sports activities such as gymnastics, baseball, or running.[ypo.education]
Swelling
  • Signs : major or minor deviation of limb, pain, swelling, non-weight bearing lameness. Treatment : surgical. Restoration of alignment of articular surfaces essential. Salter Harris classification of growth plate fractures.[vetstream.com]
  • The symptoms include severe ankle pain, inability to walk, swelling and tenderness.[cvosm.com]
  • Patient was found to have signs of impending compartment syndrome (pain to passive stretch, feeble dorsalis pedis pulsation, swelling of the entire leg).[omicsonline.org]
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker Call PhysioWorks Book Online[physioworks.com.au]
Surgical Procedure
  • Procedures The surgical procedure your doctor recommends will depend upon the severity of the slip. Procedures used to treat SCFE include: In situ fixation. This is the procedure used most often for patients with stable or mild SCFE.[orthoinfo.aaos.org]
  • The treatment of non-union fractures can be achieved by non-surgical or surgical procedures.[cvosm.com]
Veterinarian
  • UR - UR - M3 - Article VL - 31 JO - Compendium: Continuing Education For Veterinarians JF - Compendium: Continuing Education For Veterinarians SN - 1940-8307 IS - 8 ER -[scholars.opb.msu.edu]
Limb Pain
  • Signs : major or minor deviation of limb, pain, swelling, non-weight bearing lameness. Treatment : surgical. Restoration of alignment of articular surfaces essential. Salter Harris classification of growth plate fractures.[vetstream.com]
Fracture
  • Rely on a unique emphasis on outcomes assessment of children’s fractures to make the most valid clinical decisions.[books.google.de]
  • Details on surgical treatment of growth plate fractures are beyond the scope of this article.[scholars.opb.msu.edu]
  • Salter Harris classification of growth plate fractures. Displacement of fracture fragments more common than crush injuries in the cat. Prognosis : fair to good provided correct anatomical alignment of articular surfaces.[vetstream.com]
  • Management 586 Authors Perspective C Stress Injury Little Leaguers Shoulder Anatomy 589 Evaluation Management 590 Authors Perspective References 591 Distal Femur Anatomy and Grow 595 Epidemiology 598 Evaluation 603 Management 608 Complications 627 A Birth Fractures[books.google.com]
  • The ligaments and tendons of children are stronger than the bone structure, thus sprains and strains are not as common as fractures. Certain organs are in a less protected position in a child and may readily be injured from relatively minor trauma.[books.google.de]
Joint Deformity
  • In some instances hip arthroscopy can also be used to correct a portion of the underlying hip joint deformity (procedure known as an arthroscopic osteoplasty). In younger adults with more significant deformity, open debridement may be recommended.[orthotrauma.com.au]
  • […] joint through epiphysis, physis, and out through metaphysis Needs perfect reduction (often open reduction is required) Poor prognosis, lost blood supply and high risk of growth failure (especially femur or tibia) May result in focal fusion of bone and joint[fpnotebook.com]
  • deformity are not encountered at a later date.[dynamicchiropractic.com]
  • Arrest of one epiphysis in paired bones will lead to joint deformity. In the case illustrated, the radial epiphysis on the right has suffered complete growth arrest following a displaced lower radial epiphysis.[europeanmedical.info]
Joint Dislocation
  • Most IP joint dislocations are dorsal, meaning that the more distal bone is dorsally displaced in relation to the proximal bone. Lateral dislocations also commonly occur.[reliasmedia.com]
  • Forces that produce ligamentous tearing and joint dislocation in adults may lead to growth plate injury in the child, as the joint capsule and ligamentous structures are two to five times stronger than the growth plate.[dynamicchiropractic.com]
  • A method for open reduction and internal fixation of the unstable posterior sternoclavicular joint dislocation. J Orthop Trauma. 1997; 11 (5):378–381. [ PubMed ] [ Google Scholar ] 23. Armstrong A.L., Dias J.J.[ncbi.nlm.nih.gov]
  • This is the same dilemma that presents itself when trying to code for open joint dislocations, for which ICD-10 does not allow or identify any codes.[icd10orthocoder.com]
  • ., The false appearance of a joint dislocation on radiographs is related to the small and unossified epiphysis of the distal clavicle, which maintains its normal relationship to the acromioclavicular joint, while the distal metaphysis is superiorly displaced[radsource.us]
Muscle Strain
  • Slipped Capital Femoral Epiphysis Symptoms Gradual onset over weeks to months Complaints of groin, hip, thigh or knee pain (similar to that of a muscle strain) Walking with a limp Hip joint range of motion restricted It can also be associated with shortening[physioworks.com.au]
  • Since the pain is frequently referred to the knee, early diagnosis may be missed, while the symptoms are attributed to "growing pains" or muscle strain.[healthcentral.com]
Distractibility
  • Introduction 885 Procedure 886 Distraction of a Physis with a Bar 887 with Concurrent Bar Excision Physeal Distraction Followed by Bar Excision Bar Excision Followed by Physeal Distraction Complications 888 References 890 Physeal Cartilage Transplantation[books.google.com]
  • Physeal distraction    External fixator is used to span the arrest . Gradual distraction until arrest separates Distraction injury may cause complete cessation of normal physeal growth 55.[slideshare.net]
  • These options include observation, completion of a partial physeal arrest, epiphysiodesis, physeal bar resection, or physeal distraction.[plasticsurgerykey.com]
  • The knee is commonly subjected to compression, distraction, flexion, extension, rotation, valgus or varus stress, and sliding forces.[ahcmedia.com]
Neglect
  • The other possible causes which can lead to growth plate injuries are: Child abuse or neglect – Growth plate fractures are one of the most common fractures that occur in abused or neglected children.[ypo.education]
  • Inflammatory conditions: neglected septic arthritis. Endocrine: Hypothyroidism, hypopituitarism, growth hormone deficiency, pseudohypoparathyroidism, vitamin D deficiency. 91% will be below the tenth percentile for height [ 5 ].[patient.info]
Abnormal Gait
  • A child with SCFE may limp or have an abnormal gait. X-rays This type of study provides images of dense structures, such as bone.[orthoinfo.aaos.org]
Seizure
  • […] cephalic presentation or direct traction in a breech delivery 5/1000 live births assoc with : birth wght, forceps delivery, prolonged 2nd stage in primip R more than L due to LOA position Trauma fall on outstretched hand or on point of shoulder direct blow seizures[flinders.edu.au]
Foot Drop
  • Injury to this nerve may result in a foot drop. 5 Intact dorsiflexion at the ankle must be documented with any significant trauma to the proximal fibula. The static stability of the knee joint depends on its surrounding ligaments ( See Figure 1 ).[ahcmedia.com]

Workup

  • […] by antecedent epiphysiolysis slower displacement periosteum remains intact (chronic SCFE) in acute SCFE, periosteum is can be partially torn anteriorly over the prominent metaphysis Associated conditions endocrine disorders indications for endocrine workup[orthobullets.com]

Treatment

  • Details on surgical treatment of growth plate fractures are beyond the scope of this article.[scholars.opb.msu.edu]
  • Make the best use of the newest techniques by effectively applying problem-focused clinical judgment and state-of-the art treatment options found in this reference.[books.google.de]
  • This book aims to help with their understanding of the causes of the injury, its diagnosis, treatment, and how they may contribute towards reducing the risk of it recurring.[books.google.com]
  • Treatment : surgical. Restoration of alignment of articular surfaces essential. Salter Harris classification of growth plate fractures. Displacement of fracture fragments more common than crush injuries in the cat.[vetstream.com]

Prognosis

  • This article reviews the development of long bones, the microanatomy and physiology of the growth plate, the closure times and contribution of different growth plates to overall growth, and the effect of, and prognosis for, traumatic injuries to the growth[scholars.opb.msu.edu]
  • Salter-Harris type I and II most common, good prognosis, eg proximal and distal femur, proximal tibia. Salter-Harris type IV, poor prognosis unless accurate reduction and fixation, eg distal humerus (rare).[vetstream.com]
  • prognosis as the proliferative and reserve zones are interrupted type IV t hrough or t ransverse or t ogether intra-articular 10% fracture plane passes directly through the metaphysis, growth plate and down through the epiphysis poor prognosis as the[radiopaedia.org]
  • 1 Factors affecting the prognosis Severity of the trauma.[www0.sun.ac.za]
  • […] extend into metaphysis or epiphysis XRay is typically normal (or physis may be wider) until callus formation is visible by 10 days after Fracture Diagnosed clinically based on point tenderness over the epiphysis Managed with Splinting and then Casting Prognosis[fpnotebook.com]

Etiology

  • Pathogenesis Etiology Trauma: high or low impact. Pathophysiology Variable outcome according to classification of fracture and location. Salter-Harris type I and II most common, good prognosis, eg proximal and distal femur, proximal tibia.[vetstream.com]
  • 799 Classification Complications Authors Perspective A Cervical Spine Anatomy and Growth Epidemiology Evaluation 802 Anatomy and Growth Management Complications Classification 803 Evaluation Management Complications References 804 Ribs References 807 Etiology[books.google.com]
  • THIS IS CASE 679 OF 1,134 JUMP TO CASE 678 Stenosis Mid Thoracic Aorta of Uncertain Etiology c/w Mid Aortic Syndrome 677 GSW with Pulmonary Trauma and Pelvic Trauma with Bladder Injury CURRENT CASE Tibial Fracture Thru the Epiphyseal Plate 680 Multiple[ctisus.com]
  • Etiology of Physeal injuries  Infection Standing anteroposterior lower extremity x-ray of a 12-year-old boy with multifocal physeal disturbance from purpura fulminans associated with meningococcemia.[slideshare.net]
  • .: Observation on the etiology of tibia vara. J. Bone Joint Surg. 45B , 320 (1963) Google Scholar 9. Ham, A.W.: Histology (7th ed.) Philadelphia: Lippincott 1974 Google Scholar 10. Poland, J.: Traumatic separation of the epiphysis.[link.springer.com]

Epidemiology

  • Distal Ulna Anatomy and Growth 525 Evaluation Epidemiology 527 Management 531 Complications 534 Authors Perspective 542 References 546 Proximal Humerus Anatomy and Growth 549 Epidemiology Evaluation 553 Management 559 Complications 575 Authors Perspective[books.google.com]
  • It emphasizes the unique aspects of children's fractures in terms of epidemiology, mechanisms, management, and the challenges of treating the skeletally immature patient.[books.google.de]
  • Abstract Objectives : to report epidemiological, clinical and radiological aspects of recent fractures with epiphyseal separation of the child's ankle.[ispub.com]
  • Jersey Finger Injury Epidemiology.[reliasmedia.com]
  • Epidemiology [ 4 ] The incidence is 10/100,000 children per year [ 1 ]. Overall prevalence is between 0.7 and 10.8 per 100,000 children. Most commonly it occurs in boys at 13 years of age and 11.5 years for girls.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Variable outcome according to classification of fracture and location. Salter-Harris type I and II most common, good prognosis, eg proximal and distal femur, proximal tibia.[vetstream.com]
  • Epiphyseal growth plate fracture- separations: a pathophysiologic approach. Orthopedics 1982; 5:720-736. (2) Rogers LF, Poznanski AK. Imaging of epiphyseal injuries. Radiology 1994;191:297-308.[www0.sun.ac.za]
  • Pathophysiology [ edit ] SCFE is a Salter-Harris type 1 fracture through the proximal femoral physis. Stress around the hip causes a shear force to be applied at the growth plate.[en.wikipedia.org]
  • […] bilaterality at presentation, possibly related to increased rates of childhood obesity acetabular retroversion and femoral retroversion increased mechanical shearing forces at the physis history of previous radiation therapy to the femoral head region Pathophysiology[orthobullets.com]

Prevention

  • Classification 803 Evaluation Management Complications References 804 Ribs References 807 Etiology Anatomy 811 Influence of Gender Influence of Age Influence of Site 813 Influence of Fracture Type 814 Influence of Treatment 815 Incomplete Partial Physeal Bar 817 Prevention[books.google.com]
  • The ultimate goal in SCFE is to diagnose the condition early in order to prevent the head of the femur from slipping further off of the thigh bone, thus preventing hip deformity.[stanfordchildrens.org]
  • PREVENTION Poor shoe choice has been the predominate predisposing factor in injuring the calcaneal epiphysis.[vtsports.com]
  • . - ant fibres act to prevent upward motion of the clavicle - post fibres act to prevent downward motion of the clavicle Interclavicular lig - connects the superomed ends of each clavicle with the capsule and the upper sternum - acts to prevent upward[flinders.edu.au]
  • The principle of initial treatment is to prevent continued progresson of the deformity. This involves an operation where a screw is placed across the weakened growth plate to stabilise the bone and prevent further slipping.[orthotrauma.com.au]

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