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 radiographs
- Presentation of conservative and operative treatment options and illustration of all typical situations
Author(s): Ingo Marzi, Johannes Frank, Stefan Rose
Publisher: Springer
Year: 2022
Language: English
Pages: 624
City: Cham
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
