An in-depth review of pediatric femoral shaft fractures.

If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!

1/10
Pediatric femoral shaft (PFS) fractures constitute a small portion of pediatric fractures roughly 1-2% with a bimodal age distribution

Most common causes:
✯ Toddlers: falls
✯ Teenage/adolescent: MVA
In children younger than walking age child abuse must be suspected. As high as 80% of PFS fractures in this age group are due to child abuse.

In the toddler age group as high as 25% of PFS fractures are due to child abuse, so it must be ruled out.
Length Stable vs. Length Unstable fractures may guide treatment decisions, though recent studies have brought this into question.

Which of the following is a length unstable fracture pattern?
Length Unstable Fractures are described as:
✯ Long Oblique or Spiral Fractures
-Fracture length is > 2x the width
✯ Comminuted Fractures
✯ Commonly they have > 2 cm shortening
Fracture treatment is guided by the patient's age and weight.

Which of the following would be a good treatment option for a 3 y.o. 14 kg boy presenting with a minimally displaced short oblique mid-femoral shaft fracture?
Treat options based on age, weight, and stability of fracture:
Non-operative management:
Children < 6 mo: Pavlik Harness (left)
Children 6 mo-5 yo: Spica Casting (right)

Acceptable reduction criteria for casting:
Sagittal angulation: 20°
Coronal angulation: 10°
Malrotation: 10°
Shortening: 2 cm
Operative management:

Flexible Intramedullary nailing: (left)
< 11 yo.
< 50 kg
Length Stable Fx

Rigid IM nail (right) / plating:
> 11 yo.
> 50 kg
Length Unstable Fx
Complications:
✯ Leg length discrepancy
✯ Nonunion is rare
✯ Muscle Atrophy
✯ Femoral Head AVN

Lateral trochanteric entry has a ↓ risk of AVN when compared to piriformis entry for antegrade nailing.
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Author: @CSMorford

#FemurFracture #Pediatric #Peds #Ortho #Orthopedics #OrthoTwitter #Bones #Trauma #MedEd #MedicalEducation #MedTwitter #ERAS #MedStudent #Tweetorials #Radiology

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What is an eponym for this fracture? Image
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If you're interested in orthopedics, you'll definitely want to check this review out.

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Distal radius (DR) fractures have a bimodal age distribution. “accounting for around 25% of fractures in the pediatric population and up to 18% of all fractures in the elderly age group.” (2)

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1/15
@MedTweetorials @RosenelliEM
#MedEd #OrthoTwitter #Tweetorials
The meniscus function is two-fold. It increases stability by deepening the tibial surface and it aids in force transmission by increasing the contact area to spread force over a larger surface area. The meniscus is responsible for 50% of load transmission across the knee. (1)

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The lateral meniscus has a more circular shape than the C-shaped medial meniscus. The lateral meniscus covers a larger portion of the articular surface and is also more mobile than the medial meniscus. The medial meniscus is relatively immobile and is attached to the MCL.

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Septic arthritis: a review

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Where art thou osteoclasts?
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Osteopetrosis is a disease that results from defective osteoclast function. Failed bone resorption leads to dense bone that may cause fracture, bone marrow encroachment, or skull foramen narrowing.

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3/12 Osteoclasts derive from which of the following precursor cells?
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