Management protocol for different thumb injury

Treatment of ligament injuries of the thumb depends on the presence or absence of fracture fragments and on the degree of joint stability

Management of supracondylar fractures in pediatric age group

The pediatric musculoskeletal system differs greatly from that of an adult. Although these differences diminish with age, they present unique injury patterns and challenges in the diagnosis and treatment of pediatric orthopedic problems. Pediatric bone is highly cellular and porous, and it contains a large amount of collagen and cartilage compared with adult bone. The larger amount of collagen leads to a reduction of tensile strength and prevents the propagation of fractures, whereas the abundance of cartilage improves resilience but makes radiologic evaluation difficult. The tensile strength of pediatric bone is less than that of the ligaments, so children are more likely to have bone injuries with mechanisms that would cause only ligarnentous injuries in adults. The periosteum of pediatric hone is comparatively more metabolically active than the adult periosteum, leading to rapid and large callus formation, rapid union of fractures, and a higher potential for remodeling. The periosteum is also thicker and stronger in children. This difference is responsible for some of the unique fracture patterns seen in children [1], [2]

Management of distal tibial fractures

Prlon fractures occurring as aresult of higher energy trauma, with associated soft tissue injuries which are usually massive injured. Early operations through this traumatized soft tissue envelop will lead to increased incidence of local complications. Alternative management strategies were developed

Pavlic harness in management developmental dysplasia of the hip

Developmental Dysplasia of the Hip, DDH - preferred term, also Teratogenic hips, Subluxation and Dislocation-usually posterosuperior [reducible vs irreducible], or Dysplasia are the range of hip problems usually encountered. Risk Factors are, 1/1,000 born with dislocated hip, 10/10,000 born with subluxation or dysplasia, 80% Female and first born children. Also Family history [6% one affected child, 12% one affected parent, 36% one child + one parent], pregnancy related problems as Oligohydramnios, Breech [sustained hamstring forces], Native Americans [swaddling cultures], Left 60% [left occiput anterior], while Right 20%, both 20%, Torticollis or LE deformity. Best if treated before 6 weeks of age 0 - 6 months of age, the Pavlik harness is used, at 6 - 18 months Closed vs open reduction and spica casting is usually successful. At 18-48 months, closed reduction versus Open reduction +/- osteotomies of the femur, pelvis, or both is preferred