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Ped Muscuskeletal

Pediatric Musculoskeletal disorders.

What makes children susceptible to fractures? Spontaneous exercise; not fully coordinated; tramps, skateboards exc.....
How are children's bones different? growing; flexible; thicker periosteum; growth plate; heal faster; remodel easier.
What are the most common sites of fractures in children? Ulna, clavicle, tibia, elbow and femur.
What are the types of fractures and what do they look like? Torus = Buckle; greenstick; Spiral; Oblique; Transverse; Comminuted.
What are the reduction methods of closed and open fractures? Closed: Manual alignment of the fragments followed by immobilization; Open: Surgical insertion of internal fixation devices, such as rods, wires, or pins to help maintain alignment.
What are the retention methods for fractures? Align fracture, then maintain position and protect fracture site through the application of a cast or traction.
What are some nursing interventions for a trauma fracture? Assess A,B,C's; Hx of circumstances; Examine site; Immobilize affected extremity; If compound splint extremity and cover the wound w/ sterile dressing.
What are the three types of types of traction and describe them? Manual (use hand placed distally to site), Skin (Buck's extension, Russell traction, Cervical), Skeletal (metal device inserted into the bone Crutchfield Tongs, 90/90 Femoral, Dunlop, balanced suspension).
Skin traction should not be used when child has skin infection open wound or extensive tissue damage. T/F True.
Skin traction is best for which age and weight of child? 2-3yrs old or less than 30lbs.
What is a major complication with skeletal traction? Osteomyelitis.
What are the five P's Pain, Pallor, pulselessness, paresthesia, paralysis.
What are the Interventions for immobility? Constipation, skin, urinary retention, respirations, disuse of limbs.
What is Scoliosis? Idiopathic (mostly in adolescent girls); Congenital (result of vertebral anomalies); Neuromuscular (common in those with conditions such as cerebral palsy, muscular dystrophy, paraplegia).
What are the signs and symptoms of Scoliosis? Back pain, fatigue, unequal pelvic and shoulder heights, different leg length.
What are the measurements for mild and severe scoliosis? less than 20 degrees is mild; greater than 40 degrees is severe.
What are the treatments for Scoliosis? Bracing 18-23hrs/day; Surgery Spinal fusion.
What is Juvenile Ideopathic Arthritis (JIA)? Systemic inflammatory disease that involves the joints, connective tissue, and viscera.
What is the gel phenomenon? Morning stiffness in a child with JIA
How do you test for Developmental Dysplasia of the Hip (DDH)? Ortolani and Barlow tests positive or CT and MRI (not definitive).
What are some treatments for DDH? Pavlik harness; Closed reduction and a spica cast; Open reduction.
What is clubfoot? Failure of the ankle joint to develop during fetal life, the foot is abducted and twisted inward.
What are the treatments for clubfoot? Stretching exercises, casting, surgery.
What is Legg-Calve-Perthes Disease? Caused by diminished blood supply to femoral epiphysis resulting in necrosis and degeneration of the femoral head.
Who is most at risk for LCP Disease? Boys between 4-8 with average onset at 6
What are the S/S for LCP Disease? Painful Limp; hip; thigh or knee soreness or stiffness.
What are the treatments for Legg-Calve-Perthes Disease? Bed rest w/ROM; Bracing; Surgery. COMPLIANCE is important.
Created by: zj mepn