Pediatric Skeletal Trauma: A Practical Guide

Description

This book provides all the knowledge needed to treat injuries to the pediatric extremities, spine, and pelvis. It aims to enable age-appropriate diagnosis and optimal treatment selection, with particular consideration of the current developmental age of an injured child. A general overview section presents the features of skeletal growth, growth plate fusion, and the concept of non-growth-damaging treatment of pediatric fractures.   The well-structured specialized chapters detail the characteristics of individual injuries with corresponding case studies. Thus, the book offers a learning opportunity but can also be used as a practical daily reference to facilitate orientation. Three chapters focus on options for the correction of injuries that have healed poorly. The book offers exceptional value through:-   Classifications of fractures and injuries Schematic drawings of typical fractures with developmental characteristics Structured overview tables for all regions of injury with representation of the fracture types and their characteristic radiographsPresentation of conservative and operative treatment options and illustration of all typical situations Preface Contents About the Authors Part I: General Considerations 1: Bone Growth and Healing 1.1 Bony Growth Diametric Growth Longitudinal Growth Epiphyseal Plate Structure Suspension of Growth: Physiological Plate Fusion 1.2 Bone Healing Callus Formation and Consolidation Times Consolidation Times 1.3 Healing and Growth Abnormalities Diametric Growth Longitudinal Growth 1.4 Spontaneous Correction Recommended Literature 2: Injury Patterns and Diagnostics 2.1 Fractures Articular Region Epiphysis/Metaphysis Epiphyseal Separation Compression Fractures Greenstick Fractures Metaphyseal Fractures Stress Fractures Collateral Ligament Avulsions Tendon Avulsion Diaphysis Greenstick Fractures Oblique Fractures Transverse Fractures 2.2 Dislocations Shoulder Elbow Hips Knee 2.3 Radiological Examination Radiography Ultrasound Computed Tomography (CT) Magnetic Resonance Imaging (MRI) Other Approaches 2.4 Radiological Development of the Pediatric Skeleton Coned Epiphysis Pseudoepiphysis 2.5 Radiological Diagnostic Clues Harris Lines Fat Pad Sign Battered Child Syndrome (Child Abuse) Special Pediatric Fracture Forms Buckle (Torus) Fracture Greenstick Fracture Bowing Fracture Chondral and Osteochondral Fractures (Flake Fractures) Apophyseal Avulsions and Epiphyseal Ligament Tears Toddler’s Fracture Vertebral Fractures Pathological Fractures 2.6 Pediatric Fracture Classifications AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) Bone and Segment Fracture Subsegment Code Pediatric Code Fracture Severity Code Exceptions and Displacement Codes Li-La Classification for Pediatric Long Bone Fractures Recommended Literature 3: Treatment Principles 3.1 Conservative Treatment Options Basic Principles Retention Plaster Casts Bandages: Gilchrist, Desault, Velpeau Cast Wedging Traction Figure-of-Eight Bandage Cuff and Collar (Blount) Sling Sarmiento Brace Tape 3.2 Technical Features of Conservative Treatment Basic Casting Principles Cast Wedging Complications Special Casting Techniques Long-Arm Splint Indications Special Features Forearm Splint Indications Special Features Posterior Forearm Splint Indications Special Features Upper Leg Splint Indication Special Features Knee Tutor Indication Special Features Lower Leg Splint Indication Special Features Tape (Ankle Boot) Indication Special Features “Geisha Shoe” Cast Indication Special Features 3.3 Conservative Fracture Treatment Radiographic Controls Follow-Up Consolidation 3.4 Operative Treatment Options Reduction Reduction Criteria Open or Closed? Open Reduction Secondary Open Reduction Primary Open Reduction Fixation Procedures Transfixion Wire Fixation Indications Contraindications Typical Fractures Technique Tricks Hardware Removal Problems Screw Fixation Indications Contraindications Typical Fractures Technique Tricks Hardware Removal Problems Plate Fixation Indications Contraindications Typical Fractures Technique Problems Hardware Removal Tension Band Fixation Indications Contraindications Technique Patella Olecranon Problems Tricks Hardware Removal Intramedullary Nailing: ESIN Indications Contraindications Technique for Femur Fractures Problems Tricks Hardware Removal Conventional Intramedullary Nailing External Fixator Indications Contraindications Typical Fractures Technique Problems Tricks Hardware Removal Further Techniques Hardware Removal Recommended Literature 4: Soft Tissue Injuries 4.1 Vascular Injuries Causes, Mechanism of Injury Classification Diagnostic Assessment Sharp Direct Vascular Injury Blunt Direct and Indirect Vascular Injury Primary Treatment Therapy Complications, Growth Disturbances Follow-Up 4.2 Nerve Injuries Causes, Mechanisms of Injury Classification Diagnostic Assessment Primary Treatment Treatment Complications, Growth Disturbances Follow Up 4.3 Tendon Injuries Causes, Mechanism of Injury Classification Extensor Tendons of the Hand Flexor Tendons of the Hand Diagnostic Assessment Extensor Tendon Injuries of the Hand Flexor Tendon Injuries of the Hand Primary Treatment Therapy Extensor Tendon Injuries of the Hand Acute Flexor Tendon Injuries of the Hand Complications, Growth Disturbances Follow Up Recommended Literature Part II: Specific Injuries 5: Shoulder 5.1 Shoulder Girdle Physiological Findings Clavicle Fractures Incidence, Mechanism of Injury and Clinical Picture Classification Injuries of the Acromioclavicular Joint Incidence, Mechanism of Injury and Clinical Picture Classification Treatment Injuries of the Sternoclavicular Joint Incidence, Mechanism of Injury and Clinical Picture Classification Scapular Fractures Incidence, Mechanism of Injury and Clinical Picture Classification 5.2 Shoulder Joint Glenohumeral Shoulder Dislocation and Rotator Cuff Injuries Incidence Mechanism of Injury and Clinical Picture Classification Recommended Literature 6: Humerus 6.1 Physiological Findings Ossification Centers and Growth Plate Fusion 6.2 Proximal Humerus Fractures Incidence, Mechanism of Injury and Clinical Picture Classification 6.3 Diaphyseal Humeral Fractures Incidence, Mechanism of Injury and Clinical Picture Recommended Literature 7: Elbow 7.1 Physiological Findings Age-Dependent X-ray Findings 7.2 Supracondylar Humerus Fractures Incidence, Mechanism of Injury, and Clinical Presentation Classification and Treatment Concept 7.3 Distal Humerus Transcondylar Fractures Incidence, Mechanism of Injury, and Clinical Presentation 7.4 Elbow Dislocation Incidence, Mechanism of Injury, and Clinical Presentation 7.5 Distal Humerus Epicondylar Fractures Incidence, Mechanism of Injury, and Clinical Presentation Recommended Literature 8: Proximal Radius and Olecranon 8.1 Physiological and Radiological Findings 8.2 Fractures and Dislocations of the Proximal Radius 8.3 Fractures of the Proximal Ulna Recommended Literature 9: Forearm 9.1 Physiological Findings 9.2 Fracture Types and Localisation of the Forearm 9.3 Forearm Fractures 9.4 Monteggia Injuries 9.5 Galeazzi Injuries 9.6 Technical Considerations Recommended Literature 10: Hand 10.1 Carpal Fractures and Dislocations Incidence, Mechanism of Injury and Clinical Picture Classification Diagnostic Assessment Conservative Therapy Operative Therapy Complications/Growth Disturbances 10.2 Metacarpal Fractures Incidence, Mechanism of Injury and Clinical Picture Classification Diagnostic Assessment Goals of Therapy/Limits for Correction Conservative Therapy Operative Therapy Complications/Growth Disturbances 10.3 Finger Fractures and Dislocations Incidence, Mechanism of Injury and Clinical Picture Classification Diagnostic Assessment Goals of Therapy/Limits for Correction Conservative Therapy Operative Therapy Complications/Growth Disturbances Recommended Literature 11: Hip 11.1 Physiological Findings 11.2 Proximal Femur Fractures Incidence, Mechanism of Injury, and Clinical Presentation Classification Type I Fractures Type II Fractures Type III Fractures Type IV Fractures Treatment Objective 11.3 Apophyseal Avulsions 11.4 Traumatic Hip Dislocations 11.5 Transient Synovitis, Legg–Calvé–Perthes Disease (LCPD), and Slipped Capital Femoral Epiphysis (SCFE) Recommended Literature 12: Femur 12.1 Physiological Findings 12.2 Femoral Shaft Fractures Incidence, Mechanism of Injury and Clinical Picture Subtrochanteric Fracture Transverse Fractures Oblique and Spiral Fractures Compound Femur Fractures Distal Femur Fractures Technical Tipps Femur Fractures Recommended Literature 13: Knee 13.1 Physiological Findings 13.2 Fractures around the Knee Incidence, Mechanism of Injury, and Clinical Presentation Distal Femur Fractures around the Knee Proximal Tibia Fractures around the Knee Proximal Tibial Avulsion Fractures 13.3 Patellar Injuries Patella Fracture Patellar Dislocation 13.4 Pediatric Knee Ligament Injuries Intercondylar Eminence (Tibial Spine) Avulsion Fractures Ligamentous Cruciate Ligament Lesions Femoral Collateral Ligament Avulsions 13.5 Meniscus Injuries Recommended Literature 14: Tibia and Fibula 14.1 Physiological Findings Fascial Compartments of the Lower Leg 14.2 Fractures of the Tibial Shaft Incidence, Mechanism of Injury, and Clinical Presentation Classification Fractures of the Proximal Tibia Fractures of the Tibia Shaft Fractures of the Distal Tibia Technical Aspects Recommended Literature 15: Ankle Joint 15.1 Physiological Findings 15.2 Distal Tibia Fractures Incidence, Mechanism of Injury, and Clinical Presentation Classifications 15.3 Epiphysiolysis and Epiphyseal Fractures of the Distal Tibia 15.4 Transitional Fractures 15.5 Ankle Distortion Trauma Incidence, Mechanism of Injury, and Clinical Presentation 15.6 Osteochondritis Dissecans of the Talus Incidence, Mechanism of Injury, and Clinical Presentation Recommended Literature 16: Foot 16.1 Physiological Findings Ossification Centers and Growth Plate Fusion 16.2 Bony Foot Injuries Incidence, Mechanism of Injury and Clinical Presentation 16.3 Talus Fracture Incidence, Mechanism of Injury and Clinical Presentation 16.4 Calcaneus Fracture Incidence, Mechanism of Injury and Clinical Presentation Classification 16.5 Tarsal Fracture: and Hindfoot Injuries Incidence, Mechanism of Injury and Clinical Presentation 16.6 Metarsal and Phalangeal Injuries Recommended Literature 17: Pelvis 17.1 Physiological Findings and Classifications Age-Dependent X-Ray Findings (Figs. 17.3, 17.4, and 17.5) Classification 17.2 Avulsion Injuries (Apophyseal Avulsion Fractures) Incidence, Mechanism of Injury and Clinical Picture Avulsion of the Anterior Superior Iliac Spine (ASIS) Avulsion of the Anterior Inferior Iliac Spine (AIIS) Avulsion of the Ischial Tuberosity 17.3 Pelvic Rim and Pelvic Ring Fractures Incidence, Mechanism of Injury and Clinical Picture Classification A-type pelvic fractures B-type pelvic fractures C-type pelvic fractures 17.4 Acetabular Fractures Incidence, Mechanism of Injury and Clinical Picture Classification 17.5 Complex Injuries Incidence, Mechanism of Injury and Clinical Picture Classification Recommend Literature 18: Spine 18.1 Physiology, Anatomy and Development of the Spine 18.2 Injuries to the Spine: General Incidence Neurological Complications Diagnostic Assessment Differential Diagnosis of Growth-Related Findings Classification Treatment 18.3 Injuries to the Cervical Spine Incidence, Mechanism of Injury and Clinical Picture Classification Particulars Diagnosis Occipital Fracture Incidence, Mechanism of Injury and Clinical Picture Classification Occipitoatlantal Dislocation Incidence, Mechanism of Injury and Clinical Picture Classification Atlas Fracture Incidence, Mechanism of Injury and Clinical Picture Atlantoaxial Dislocation (AAD) Incidence, Mechanism of Injury and Clinical Picture Classification Axis and Dens Fractures Incidence, Mechanism of Injury and Clinical Picture Os Odontoideum Mechanism of Injury and Clinical Picture Injuries to the C2/C3 Segment and Pseudosubluxation Incidence, Mechanism of Injury and Clinical Picture Classification Injuries to C3–C7 Incidence, Mechanism of Injury and Clinical Picture 18.4 Injuries to the Thoracic Spine Incidence, Mechanism of Injury and Clinical Picture Classification 18.5 Injuries to the Lumbar Spine Incidence, Mechanism of Injury and Clinical Picture Classification 18.6 Spinal Cord Injuries Incidence, Mechanism of Injury and Clinical Picture Diagnostic Assessment Treatment and Prognosis Recommended Literature Part III: Secondary Reconstructions 19: Secondary Reconstruction of the Elbow 19.1 Mechanism of Injury 19.2 Deformities of the Distal Humerus Treatment Underlying Principles Operative Therapy Preoperative Preparation Operative Methods 19.3 Deformities of the Proximal Forearm Treatment Underlying Principles Operative Therapy Preoperative Preparation Operative Methods 19.4 Complications 19.5 Practical Conclusions Recommended Literature 20: Secondary Reconstruction of the Forearm and Wrist 20.1 Epidemiology 20.2 Deformities of the Forearm Therapy Basics Corrective Procedures Pre-Operative Preparation Operative Techniques Postoperative Care 20.3 Deformities at the Wrist Level Treatment Underlying Principles Operative Therapy Preoperative Preparation Operative Methods Angulation-Deformity Growth-Arrest 20.4 Complications 20.5 Conclusions Recommended Literature 21: Secondary Reconstruction of the Lower Leg: Femur, Tibia and Ankle 21.1 Epidemiology Differential Diagnosis 21.2 Deformities of the Femur Therapy Basics Corrective Procedures Pre-Operative Preparation Operative Techniques Postoperative Care 21.3 Deformities of the Tibia and Ankle Therapy Basics Corrective Procedures Pre-Operative Preparation Operative Techniques Postoperative Care 21.4 Complications 21.5 Conclusions Recommended Literature