Pediatric Orthopedics and Sports Medicine: A Handbook for Primary Care Physicians [2 ed.] 9783030481377, 9783030481384

Table of contents :
Preface
Contents
Contributors
1: Introduction to Orthopedic Nomenclature
Physis (the Growth Plate)
Epiphysis
Apophysis
Metaphysis
Diaphysis (Shaft)
Primary Center of Ossification
Secondary Center of Ossification
Periosteum
Some Anatomical Nomenclature
Deformities Definitions
General Orthopedic/Joint Examination
Orthopedic Surgeries/Procedures
Suggested Reading
2: Pediatric Musculoskeletal Imaging
Plain Radiographs
Computed Tomography (CT) Scan
Bone Scan (Bone Scintigraphy)
Magnetic Resonance Imaging (MRI)
Ultrasonography (US)
3: Growth and Development and Their Relation to Musculoskeletal Conditions
Introduction
Basics of Normal Growth
Assessment of Growth Potential and Estimation of Degree of Skeletal Maturity
Clinical Assessment
Radiological Assessment
Developmental Milestones
Growth of Children with Neuromuscular Disorders
Prediction of Limb Length Discrepancy (LLD) at Skeletal Maturity
Limb Equalizing Procedures
Suggested Reading
4: Metabolic Conditions
Rickets
Definition
Clinical Presentation
Laboratories
Treatment
When to Refer
Prevention
Mucopolysaccharidoses
Causes
Skeletal Manifestations of Specific Types of MPS
Osteogenesis Imperfecta
Definition
Types of Osteogenesis Imperfecta
Clinical Presentation
Laboratory
Radiological Features (Fig. 4.4)
Genetic Testing
Skin or Bone Biopsy
Dual-Energy X-Ray Absorptiometry
Management
Musculoskeletal Diseases Associated with Childhood Obesity
Definition of Obesity
Musculoskeletal Disorders Associated with Obesity
Pediatric Osteoporosis
Definition in the Pediatric Age Group
Causes
Clinical Presentation
Diagnosis
Radiology
Treatment
High Yield Facts
5: General Conditions Affecting the Bones
Dysplasia
Achondroplasia
Neurofibromatosis
Marfan Syndrome
Arthrogryposis
Epidemiology
Etiology
Clinical Presentation
Management
Lyme Disease
Clinical Presentation
Diagnosis of Lyme disease:
Treatment
High-Yield Facts
Suggested Reading
6: Birth Injuries and Orthopedic Manifestations in Newborns
Birth Injuries
Obstetric Brachial Plexus Palsy (OBPP)
Types of OBPP
Neurological Types
Erb’s Palsy
Definition
Risk Factors
Clinical Presentation
Imaging Studies
Prognosis
Management
Indication for Orthopedic Referral
Fractures During Birth
Clavicle Fracture
Differential Diagnosis
Femoral Fracture
Humeral Fracture
Differential Diagnosis for Fracture During Birth
Other Orthopedic Conditions at Birth
High-Yield Facts
Suggested Reading
7: The Hip
Introduction to the Hip Joint Anatomy
Examination of the Hip Joint
Common Hip Pathologies
Developmental Dysplasia of the Hip (DDH)
Legg–Calve–Perthes Disease (LCPD)
Slipped Capital Femoral Epiphysis (SCFE)
Septic Arthritis and Transient Synovitis of the Hip Joint
Septic Arthritis of the Hip Joint: (see Septic Arthritis in Chap. 23)
Transient Synovitis
Impingement of the Hip (Femoroacetabular Impingement)
Pelvic Causes of Hip Pain
Suggested Reading
8: The Knee/Leg
Anatomy of the Knee Joint
Examination of the Knee Joint
Normal Knee Alignment
Genu Varum (Bow Leg)
Genu Valgum (Knock Knee)
Blount Disease (Tibia Vara)
Knee Pain in Children
Osgood–Schlatter Disease
Sinding–Larsen–Johansson Disorder
Jumper’s Knee
Osteochondritis Dissecans
Patellar Instability (Recurrent Patellar Subluxation and Dislocation)
Popliteal Cyst (Baker Cyst)
Patellofemoral Pain Syndrome
Congenital Condition Affecting the Leg
High-Yield Facts
Suggested Reading
9: The Foot
Introduction
Intoeing
Definition
Causes of Intoeing
Approach to a Child with Intoeing
Excess Femoral Anteversion
Internal Tibial Torsion (ITT)
Metatarsus Adductus (Metatarsus Varus)
Clubfoot (Talipes Equinovarus)
Cleft Foot
Calcaneovalgus Foot
Congenital Vertical Talus
Cavus Foot
Flat Foot (Pes Planovalgus)
Tip Toe Walking
Adolescent Hallux Valgus
Extra Digit (Polydactyly)
Foot Infections:
Ingrowing Toenail
Osteochondritis of Foot Bone
Sever Disease
Accessory Navicular
What is The Best Shoe to Wear? (A Common Question Asked by Parent):
High-Yield Facts (Table 9.2)
Suggested Reading
10: Hand and Upper Extremity
Hand Embryogenesis
Congenital Hand Deformities
Common Congenital Anomalies
Phocomelia (Fig. 10.3)
Polydactyly (Supernumerary Digit)
Radial Hypoplasia (Radial Longitudinal Deficiency Syndrome, Radial Club Hand)
Ulna Hypoplasia
Camptodactyly
Clinodactyly
Syndactyly (Congenital Webbing)
Some Congenital Syndromes That Have Hand Affection
Congenital Trigger Thumb
Congenital Proximal Radioulnar Synostosis
Hand Infections
Snake Bite
Anatomy of the Nail (Fig. 10.17)
Nail Bed and Fingertip Injuries
Suggested Reading
11: Sports Medicine: General Aspects
Pre-Participation Evaluation
Medical Conditions
Bleeding Diathesis
Cardiovascular Disease
Diabetes Mellitus II
Cerebral Palsy (See Chap. 16)
Clinical Presentation and Diagnosis (See Spasticity)
Eating Disorders
Infections and Fever
Heat Illness
Pregnancy
Sickle Cell Disease and Trait
Obesity (See Chap. 4 Metabolic Conditions)
Solitary Kidney
Undescended Testes
Eyes
Skin Infections
Seizure
Exercise-Induced Bronchoconstriction
Osgood-Schlatter Syndrome (See Also Chap. 8)
Sinding-Larsen-Johannsen Disease (See Also Chap. 8)
Little Leaguer’s Shoulder and Elbow (See Also Chap. 10)
Little Leaguer’s Shoulder
Little Leaguer’s Elbow
Mild Traumatic Brain Injury (Concussion)
Suggested Reading
12: Sport Injury: Lower Extremity
Introduction
Hip Joint
Avulsion Injuries of the Pelvic Apophyses
Other Hip Sport Injuries
Knee Sports Injury
Patellofemoral Pain Syndrome (see also Chap. 8)
Osteochondroses (see also Chap. 8):
Patellar Instability/Dislocation (see also Chap. 8):
Osteochondritis Dissecans (See Chap. 8)
Synovial Plica
Discoid Meniscus
Anterior Cruciate Ligament (ACL) Injury (See Chap. 8)
Meniscal Injury:
Medial Collateral Ligament Injury
Ankle Injuries
Ankle Sprain
Osteochondritis Dissecans of the Talus
Suggested Reading
13: Sport Injuries: Upper Extremity
Introduction
Shoulder
Elbow
Distal Forearm and Wrist
Hand and Fingers
References
14: Management of Pediatric Orthopedic Patients During the Postoperative Period
Assessments of Patients in the Immediate Postoperative Period
Re-establishing Oral Intake in the Immediate Postoperative Period
Postoperative Nausea and Vomiting (PONV)
Postoperative fever
Analgesia in the Immediate Postoperative Period
Evaluation of Pain in Nonverbal Patients
Postoperative Analgesia with NSAIDs
Postoperative Analgesia with Opioids
Antibiotic management
Range of Motion (ROM) Exercises
Specific Orthopedic Examination for Inpatients with Orthopedic Conditions
Vascular Injuries
Nerve Injuries
Important Aspects for Inpatient with Certain Orthopedic Conditions:
Child Abuse
Suggested Reading
15: Tumors and Tumor-Like Conditions
General Pathological Considerations
Classification of Bone Tumors
Clinical Presentation of Bone Tumors
Investigations for Bone Tumors
Benign Tumors:
Enchondroma
Chondroblastoma
Osteoid Osteoma
Fibrous Cortical Defect (FCD) and Non-ossifying Fibroma (NOF)
Malignant Tumors
Osteosarcoma
Conventional (classic) osteosarcoma
Ewing’s Sarcoma
Bone Cysts
Aneurysmal Bone Cyst
Bone Manifestations in Acute Leukemia
Suggested Reading
16: Spasticity and Gait
Cerebral Palsy
Abnormal Tone in Cerebral Palsy Children
Spasticity
Dystonia
Rigidity
Pathophysiology of Cerebral Palsy
Gait in Cerebral Palsy
Assessment of a Child with Cerebral Palsy
Normal Gait
Gait Patterns in Ambulatory Cerebral Palsy
Rotational Malalignment and Mechanical Axis Deviations in Cerebral Palsy
Suggested Reading
17: Non-accidental Trauma
High-Yield Facts
Suggested Reading
18: Orthopedic Trauma
Fractures
General Management of Fractures
Open Fractures
Salter-Harris Injuries
Common Fractures in Pediatric Patients
Proximal Humeral Fracture
Humeral Shaft Fracture
Elbow Fractures
Supracondylar Fracture of the Humerus
Complications of Supracondylar Fracture Humerus
Lateral Condyle Fracture
Medial Epicondyle Fracture
Radial Neck Fracture
Fracture Shaft of Both Bones of the Forearm
Fracture of the Distal Radius and Ulna
Distal Radial Physeal Injuries (Salter-Harris Injury)
Galeazzi Fracture Dislocation
Monteggia Fracture Dislocation
Hand Fractures
Lower Extremity Fractures
Fracture Proximal Femur
Fracture Femoral Shaft
Fracture of the Distal Femur Physis (Salter-Harris Injuries)
Proximal Tibial Physis Injuries (Salter-Harris)
Patellar fracture
Tibial Shaft Fracture
Toddler Fracture
Ankle Fracture
Common Foot Fractures
Calcaneus Fracture
Fracture Base of the 5th Metatarsal Bone
Spine Injuries
Soft Tissue Injuries
Peripheral Nerve Palsy
Clinical Picture of Some Common Nerve Injuries
Dislocations
Nursemaid Elbow (Pulled Elbow)
Hip Dislocations
Pathological Fractures
Suggested Reading
19: Approach to a Limping Child
Introduction
Classification of Limping According to Age, Chronicity, and Pain Condition
Management
Examination
Imaging
Suggested Reading
20: Casts, Splints, and Braces
Casts and Splints
Management of common cast complications
Removal of the cast
Braces (Orthosis)
Suggested Reading
21: Pediatric Spine
Growth and Development of Spine
Scoliosis
Adolescent Idiopathic Scoliosis (AIS)
Congenital Scoliosis
Thoracic Insufficiency Syndrome
Early Onset Scoliosis
Kyphosis
Infection of the Spine
Spondylolysis and Spondylolisthesis
Torticollis
Klippel-Feil Syndrome
Sprengel Deformity
Back Pain in Children
High-Yield Facts
Suggested Reading
22: Neuromuscular Conditions
Introduction
Cerebral Palsy
Myelodysplasia (Spina Bifida)
Muscular Dystrophies
Spinal Muscular Atrophy
Charcot-Marie-Tooth Syndrome (hereditary sensory and motor neuropathy)
High-Yield Facts
Suggested Reading
23: Musculoskeletal Infections
Acute Hematogenous Osteomyelitis
Definition
Incidence
Predisposing Factors
Pathology
Microbiology
Clinical Picture
Differential Diagnosis
Treatment
Indications of Surgical Intervention in Cases of Osteomyelitis (Indications for Orthopedic Consults)
Complications of Acute Hematogenous Osteomyelitis
Non-Hematogenous Osteomyelitis
Causes
Management
Osteomyelitis of the Spine
Chronic Osteomyelitis
Definition
Pathology
Management
Septic Arthritis
Definition
Pathology
Clinical Picture
Diagnosis
Treatment
Complication of Septic Arthritis
Gonococcal Arthritis
Treatment
Septic Arthritis of the hip
Lyme Disease
Animal and Human Bites
Incidence
Dog Bites
Cat Bites
Human Bites
Other Animals
Microbiology
Imaging Studies
Management of Human and Animal Bites
Puncture Wound
High-Yield Facts
Pitfalls
Suggested Reading
Index