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PEDIATRIC ORTHOPEDICS (OSGOOD-SCHLATTER DISEASE (TREATMENT (IN ACUTE STAGE…
PEDIATRIC ORTHOPEDICS
OSGOOD-SCHLATTER DISEASE
- OSTEOCHONDROSIS OF TIBIAL TUBEROSITY
- MALES, 10 - 15 YEARS OF AGE.
- FREQUENTLY BILATERAL
- CLINICAL SIGNS
PAIN, SWELLING, TENDERNESS TO PALPATION OF TIBIAL TUBEROSITY, ERYTHEMA
- RADIOLOGICAL SIGNS
IRREGULAR OSSIFICATION OF THE TIBIAL TUBEROSITY
TREATMENT
IN ACUTE STAGE - WALKING CYLINDER CAST (FULL EXTENSION FOR 3-6 WKs)
AVOID SPORTS THAT INVOLVE HEAVY QUADRICEPS LOADING
SURGICAL - ossicle excision in refractory cases RARELY
BLOUNT’A-BARBER’A
3 TYPES
- INFANTILE:
1-3 Y. of AGE
BILATERAL
INTERNAL TORSION OF LOWER LEG due to undisturbed fibular growth
FEMALES MORE
PREDISPOSING FACTORS: OBESITY, EARLY WALKER, BLACK RACE
- JUVENILE:
4-10 Y. of AGE
UNILATERAL
NO INTERNAL TORSION OF LOWER LEG
MARKED LEG LENGTH DISCREPANCY
- ADOLESCENT: 11-14 Y. of AGE
- TIBIA VARA INFANTUM / IUVENUM / ADOLESCENTICUM
- GROWING DISTURBANCE OF MEDIAL PART OF PROXIMAL TIBIAL PHYSIS
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SCHEUERMANN (KYPHOSIS IUVENILIS, ROUNDBACK)
- 14 - 18 YEARS OF AGE, MALES
- ETIOLOGY: OSTEOCHONDROSIS
- CLINICAL SIGNS:
BACK PAIN, GROWING DURING STANDING, & PHISCICAL ACTIVITY, INCREASING KYPHOSIS
- RADIOLOGIC SIGNS:
1.WEDGING OF AT LEAST 3 ADJACENT VERTEBRAL BODIES OF MORE THAN 5 DEGREES
2.THORACIC KYPHOSIS MORE THAN 45 DEGREES
3.SCHMORL’S NODES
- TREATMENT:
POSTURAL EXERCISES, CAST AND/OR BRACING
SEVERE PROGRESSION - SPONDYLODESIS