Fractures and dislocations (peds) - Revision history

Rossdonaldson1 at 11:06, 12 March 2022

2022-03-12T11:06:52Z

Rossdonaldson1: /* Clavicle & Shoulder */

2022-03-12T11:03:14Z

Clavicle & Shoulder

← Older revision		Revision as of 11:03, 12 March 2022
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	==Clavicle & Shoulder==		==Clavicle & Shoulder==
	*[[Clavicle fracture (peds)\|Clavicle fracture		*[[Clavicle fracture (peds)\|Clavicle fracture]]
	**Treatment: Sling/swathe x3 weeks, no sports x3 weeks		**Treatment: Sling/swathe x3 weeks, no sports x3 weeks
	**Consult ortho immediately for neurovascular compromise		**Consult ortho immediately for neurovascular compromise

Rossdonaldson1 at 11:03, 12 March 2022

2022-03-12T11:03:01Z

Show changes

Rossdonaldson1: /* See Also */

2022-03-12T10:50:04Z

Rossdonaldson1: Text replacement - "<" to "<"

2017-01-23T21:41:19Z

Text replacement - "<" to "<"

← Older revision		Revision as of 21:41, 23 January 2017
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	\| Shaft fracture		\| Shaft fracture
	\|		\|
	Consider abuse of ~~<~~3 years old		Consider abuse of <3 years old

	Radial nerve palsy is common, resolved with treatment<br>		Radial nerve palsy is common, resolved with treatment<br>
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	75% are distal third, isolated ulna very rare		75% are distal third, isolated ulna very rare

	treatment: ~~<~~10° sugar-tong splint, immediately consult ortho for >10° angulation<br>		treatment: <10° sugar-tong splint, immediately consult ortho for >10° angulation<br>

	\|-		\|-

Rossdonaldson1: Text replacement - ">" to ">"

2017-01-23T17:22:30Z

Text replacement - ">" to ">"

← Older revision		Revision as of 17:22, 23 January 2017
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	\| [[Proximal humerus fracture]]		\| [[Proximal humerus fracture]]
	\|		\|
	Generally can tolerate ~~>~~50° angulation		Generally can tolerate >50° angulation

	'''Classification''' - using the Neer classification system to divide humerus into 4 parts:<br>		'''Classification''' - using the Neer classification system to divide humerus into 4 parts:<br>
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	treatment: Older kids/adolescents - Hanging long arm cast, ortho outpatient follow up in 3-5 days		treatment: Older kids/adolescents - Hanging long arm cast, ortho outpatient follow up in 3-5 days

	Immediate ortho consult: Child ~~>~~20° or adolescent ~~>~~10° angulation and/or radial nerve injury		Immediate ortho consult: Child >20° or adolescent >10° angulation and/or radial nerve injury
	\|}		\|}

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	\|-		\|-
	\| Lateral condylar		\| Lateral condylar
	\| Displace ~~>~~2 mm, requires ortho reduction<br>		\| Displace >2 mm, requires ortho reduction<br>
	\|-		\|-
	\| Medial epicondylar		\| Medial epicondylar
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	treatment: splint elbow 90° forearm pronated/neutrol, always follow up with ortho		treatment: splint elbow 90° forearm pronated/neutrol, always follow up with ortho

	Immediate ortho consult for angulation ~~>~~15°<br>		Immediate ortho consult for angulation >15°<br>

	\|-		\|-
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	75% are distal third, isolated ulna very rare		75% are distal third, isolated ulna very rare

	treatment: <10° sugar-tong splint, immediately consult ortho for ~~>~~10° angulation<br>		treatment: <10° sugar-tong splint, immediately consult ortho for >10° angulation<br>

	\|-		\|-
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	*Greenstick/complete: Long arm posterior or sugar-tong		*Greenstick/complete: Long arm posterior or sugar-tong

	Immediate ortho consult for angluation ~~>~~10-15°		Immediate ortho consult for angluation >10-15°

	\|-		\|-
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	treatment: Distal 5th (boxer's) if nondisplaced apply gutter splint with MCP joint at 70°		treatment: Distal 5th (boxer's) if nondisplaced apply gutter splint with MCP joint at 70°

	Immediate ortho consult if ~~>~~30-40° angulation; closed reduction often needed		Immediate ortho consult if >30-40° angulation; closed reduction often needed

	\|-		\|-
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	Non-dislocated: cylindrical cast x4-6 weeks		Non-dislocated: cylindrical cast x4-6 weeks

	Displaced ~~>~~3-4mm: ORIF		Displaced >3-4mm: ORIF

	\|-		\|-

Neil.m.young: Text replacement - " ==" to "=="

2016-08-03T15:29:03Z

Text replacement - " ==" to "=="

← Older revision		Revision as of 15:29, 3 August 2016
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	==Clavicle & Shoulder ==		==Clavicle & Shoulder==

	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==Elbow ==		==Elbow==

	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==Hip/Femur ==		==Hip/Femur==

	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==Knee ==		==Knee==

	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==Tib/Fib ==		==Tib/Fib==

	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==Ankle & Foot ==		==Ankle & Foot==

	{\| class="wikitable"		{\| class="wikitable"

Rossdonaldson1: Text replacement - "Tx" to "treatment"

2016-08-01T16:20:30Z

Text replacement - "Tx" to "treatment"

← Older revision		Revision as of 16:20, 1 August 2016
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	\| [[Clavicle fracture (peds)\|Clavicle fracture]]		\| [[Clavicle fracture (peds)\|Clavicle fracture]]
	\|		\|
	Tx: Sling/swathe x3 weeks, no sports x3 weeks		treatment: Sling/swathe x3 weeks, no sports x3 weeks

	Consult ortho immediately for neurovascular compromise<br>		Consult ortho immediately for neurovascular compromise<br>
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	Usually anterior/inferior, always get axillary view film		Usually anterior/inferior, always get axillary view film

	Tx: Closed reduction, sling/swathe for several weeks with ortho outpatient follow up due to high risk of recurrence<br>		treatment: Closed reduction, sling/swathe for several weeks with ortho outpatient follow up due to high risk of recurrence<br>

	If posterior dislocation or neurovascular compromise, consult ortho immediately<br>		If posterior dislocation or neurovascular compromise, consult ortho immediately<br>
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	*surgical neck		*surgical neck

	Tx: Sling and swathe for several weeks, ortho outpatient follow up in 3-5 days if		treatment: Sling and swathe for several weeks, ortho outpatient follow up in 3-5 days if

	'''<br>'''		'''<br>'''
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	Radial nerve palsy is common, resolved with treatment<br>		Radial nerve palsy is common, resolved with treatment<br>

	Tx: Older kids/adolescents - Hanging long arm cast, ortho outpatient follow up in 3-5 days		treatment: Older kids/adolescents - Hanging long arm cast, ortho outpatient follow up in 3-5 days

	Immediate ortho consult: Child >20° or adolescent >10° angulation and/or radial nerve injury		Immediate ortho consult: Child >20° or adolescent >10° angulation and/or radial nerve injury
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	Radial/median/ulnar palsies generally resolve with reduction<br>		Radial/median/ulnar palsies generally resolve with reduction<br>

	Tx: Minimally displaced: long arm posterior splint with elbow at 90° and forearm protonated/neutral<br>		treatment: Minimally displaced: long arm posterior splint with elbow at 90° and forearm protonated/neutral<br>

	Ortho follow up in 3-5 days with immobilization for 3 weeks<br>		Ortho follow up in 3-5 days with immobilization for 3 weeks<br>
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	\| Radial head and neck		\| Radial head and neck
	\|		\|
	Tx: splint elbow 90° forearm pronated/neutrol, always follow up with ortho		treatment: splint elbow 90° forearm pronated/neutrol, always follow up with ortho

	Immediate ortho consult for angulation >15°<br>		Immediate ortho consult for angulation >15°<br>
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	Child holds are pronated, slightly flexed		Child holds are pronated, slightly flexed

	Tx: reduce with supination and flexion, post reduction patient uses arm in 5-10 minutes<br>		treatment: reduce with supination and flexion, post reduction patient uses arm in 5-10 minutes<br>

	\|}		\|}
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	75% are distal third, isolated ulna very rare		75% are distal third, isolated ulna very rare

	Tx: <10° sugar-tong splint, immediately consult ortho for >10° angulation<br>		treatment: <10° sugar-tong splint, immediately consult ortho for >10° angulation<br>

	\|-		\|-
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	Distal radius AKA Colles' fracture		Distal radius AKA Colles' fracture

	Tx: Splint and ortho follow up in 3-5 days		treatment: Splint and ortho follow up in 3-5 days

	*Torus: Volar/short arm		*Torus: Volar/short arm
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	\| [[Metacarpal fracture]]		\| [[Metacarpal fracture]]
	\|		\|
	Tx: Distal 5th (boxer's) if nondisplaced apply gutter splint with MCP joint at 70°		treatment: Distal 5th (boxer's) if nondisplaced apply gutter splint with MCP joint at 70°

	Immediate ortho consult if >30-40° angulation; closed reduction often needed		Immediate ortho consult if >30-40° angulation; closed reduction often needed
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	\| [[Phalangeal finger fracture]]		\| [[Phalangeal finger fracture]]
	\|		\|
	Distal tuft crush injury - Tx: laceration closure		Distal tuft crush injury - treatment: laceration closure

	Most other fractures - Tx: buddy tape		Most other fractures - treatment: buddy tape

	\|}		\|}
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	Technically an oblique non displaced fracture of the distal tibia		Technically an oblique non displaced fracture of the distal tibia

	Tx: Posterior splint		treatment: Posterior splint

	\|}		\|}
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	Midfoot fractures are rare		Midfoot fractures are rare

	Tx: bulky posterior splint, crutches, ortho follow up in 3-5 days		treatment: bulky posterior splint, crutches, ortho follow up in 3-5 days

	\|-		\|-

Rossdonaldson1: Text replacement - "f/u" to "follow up"

2016-07-13T11:09:07Z

Text replacement - "f/u" to "follow up"

← Older revision		Revision as of 11:09, 13 July 2016
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	Usually anterior/inferior, always get axillary view film		Usually anterior/inferior, always get axillary view film

	Tx: Closed reduction, sling/swathe for several weeks with ortho outpatient ~~f/u~~ due to high risk of recurrence<br>		Tx: Closed reduction, sling/swathe for several weeks with ortho outpatient follow up due to high risk of recurrence<br>

	If posterior dislocation or neurovascular compromise, consult ortho immediately<br>		If posterior dislocation or neurovascular compromise, consult ortho immediately<br>
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	*surgical neck		*surgical neck

	Tx: Sling and swathe for several weeks, ortho outpatient ~~f/u~~ in 3-5 days if		Tx: Sling and swathe for several weeks, ortho outpatient follow up in 3-5 days if

	'''<br>'''		'''<br>'''
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	Radial nerve palsy is common, resolved with treatment<br>		Radial nerve palsy is common, resolved with treatment<br>

	Tx: Older kids/adolescents - Hanging long arm cast, ortho outpatient ~~f/u~~ in 3-5 days		Tx: Older kids/adolescents - Hanging long arm cast, ortho outpatient follow up in 3-5 days

	Immediate ortho consult: Child >20° or adolescent >10° angulation and/or radial nerve injury		Immediate ortho consult: Child >20° or adolescent >10° angulation and/or radial nerve injury
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	Tx: Minimally displaced: long arm posterior splint with elbow at 90° and forearm protonated/neutral<br>		Tx: Minimally displaced: long arm posterior splint with elbow at 90° and forearm protonated/neutral<br>

	Ortho ~~f/u~~ in 3-5 days with immobilization for 3 weeks<br>		Ortho follow up in 3-5 days with immobilization for 3 weeks<br>

	Immediate ortho consult for more than minimal displacement or neurovascular compromise<br>		Immediate ortho consult for more than minimal displacement or neurovascular compromise<br>
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	\| Radial head and neck		\| Radial head and neck
	\|		\|
	Tx: splint elbow 90° forearm pronated/neutrol, always ~~f/u~~ with ortho		Tx: splint elbow 90° forearm pronated/neutrol, always follow up with ortho

	Immediate ortho consult for angulation >15°<br>		Immediate ortho consult for angulation >15°<br>
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	Distal radius AKA Colles' fracture		Distal radius AKA Colles' fracture

	Tx: Splint and ortho ~~f/u~~ in 3-5 days		Tx: Splint and ortho follow up in 3-5 days

	*Torus: Volar/short arm		*Torus: Volar/short arm
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	\|-		\|-
	\| Tib/fib shaft		\| Tib/fib shaft
	\| Long leg posterior splint, ortho ~~f/u~~ in 3-5 days		\| Long leg posterior splint, ortho follow up in 3-5 days
	\|-		\|-
	\| [[Toddler's fracture]]		\| [[Toddler's fracture]]
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	\| Distal tibia/fibula fractures		\| Distal tibia/fibula fractures
	\|		\|
	Non-displaced: bulky posterior splint and crutches with ortho ~~f/u~~ in 3-5 days		Non-displaced: bulky posterior splint and crutches with ortho follow up in 3-5 days

	Tilaux: Salter III of distal tibia, requires ORIF		Tilaux: Salter III of distal tibia, requires ORIF
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	Midfoot fractures are rare		Midfoot fractures are rare

	Tx: bulky posterior splint, crutches, ortho ~~f/u~~ in 3-5 days		Tx: bulky posterior splint, crutches, ortho follow up in 3-5 days

	\|-		\|-

Neil.m.young: Text replacement - " w/ " to " with "

2016-07-12T01:40:23Z

Text replacement - " w/ " to " with "

← Older revision		Revision as of 01:40, 12 July 2016
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	Usually anterior/inferior, always get axillary view film		Usually anterior/inferior, always get axillary view film

	Tx: Closed reduction, sling/swathe for several weeks w/ ortho outpatient f/u due to high risk of recurrence<br>		Tx: Closed reduction, sling/swathe for several weeks with ortho outpatient f/u due to high risk of recurrence<br>

	If posterior dislocation or neurovascular compromise, consult ortho immediately<br>		If posterior dislocation or neurovascular compromise, consult ortho immediately<br>

← Older revision		Revision as of 10:50, 12 March 2022
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	==See Also==		==See Also==
	*[[Fractures]]		*[[Fractures (main)]]
			*[[Dislocations (main)]]

	==References==		==References==