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Musculoskeletal Disorders in the Pediatric Population

Musculoskeletal Disorders in the Pediatric Population. Kathryn Stilp. Anatomic Differences. Fontanels Long Bones Maturation complete at age 20 Growth takes place at the epiphyseal plate Muscular system mature at birth. Disorders of the Feet & Hands. Metatarsus Adductus Clubfoot

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Musculoskeletal Disorders in the Pediatric Population

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  1. Musculoskeletal Disorders in the Pediatric Population Kathryn Stilp

  2. Anatomic Differences • Fontanels • Long Bones • Maturation complete at age 20 • Growth takes place at the epiphyseal plate • Muscular system mature at birth

  3. Disorders of the Feet & Hands • Metatarsus Adductus • Clubfoot • Genu Varum & Genu Valgum

  4. Metatarsus Adductus • Most common congenital foot disorder • Inward turning of the forefoot “intoeing” • 1 in 1000 births • Uterine positioning & genetic • Simple exercises • Resolve spontaneously

  5. Club Foot • Congenital/ obvious @ birth • 1-3 in 1000 births • Intrauterine positioning, neuromuscular/vascular problem, genetic, family hx • Box p. 1321

  6. Genu Varum & Genu Valgum • Varum=“bowlegs” • Valgum= “knock knee” • Normal until age 4-5 • Blount Disease & Rickets • Braces • Surgery

  7. Disorders of the Hip • Developmental Dysplasia of the Hip • Legg-Calve’-Perthes Disease • Slipped Capital Femoral Epiphysis

  8. Developmental Dysplasia of the Hip • Hip instability, dislocation, sublaxation,dysplasia • Genetic factors • Limited abduction of the affected hip • Gluteal & thigh fat folds (affected side) • Ortolani & Barlow maneuver • Pavlik harness • Traction, keep in abduction

  9. Legg-Calve’-Perthes Disease • Self-limiting • Avascular necrosis of the femoral head • Interruption of blood to femoral epiphysis • Premies, Increased parental age, tobacco smoke • Stages box. P. 1327 • Toronto brace & non-wgt bearing

  10. Slipped Capital Femoral Epiphysis • Femoral head is displaced from the femoral neck • Cause unknown • Adolescent growth • Acute sudden onset vs chronic • Surgery usually necessary

  11. Disorders of the Spine • Scolosis • Torticollis, Kyphosis, & Lordosis

  12. Scoliosis • Lateral S or C shape to the spine • Girls ages 10-13 • Measured in degrees (10=abnormal) • Congenital, idiopathic or acquired • Exercises, braces, electric stimulation, rods (pass through spine canal)

  13. Torticollis, Kyphosis & Lordosis • Tilt of head caused by rotation of the cervical spine • Kyphosis= hunchback • Lordosis= swayback • Box p. 1335

  14. Disorders of the Bones & Joints • Osteomyelitis • Osteogenesis Imperfecta • Juvenile Rheumatoid Arthritis

  15. Osteomyelitis • Infection of the bone (long) • Age 1- 12 • Boys > girls (trauma) • Microorganisms, staph, strep, h flu • Pain, edema, tenderness, erythema • Antibiotics (IV) 6 weeks or longer

  16. Osteogenesis Imperfecta • Connective tissue disorder • 1 in 30,000 boys=girls • Multiple fx, blue sclera, thin, soft skin, short stature, joint flexibility, enlarged fontanel • Mistaken for abuse • No cure

  17. Juvenile Rheumatoid Arthritis • Debilitating disease • Connective tissue disorder • Need periods of rest • Medications

  18. Muscular Dystrophies • Duchenne • Baker • Facioscapulohumeral • Emery-Dreifuss • Congenital • Box p. 1340

  19. Injuries to the Musculoskeletal System • Fractures • Amputations

  20. Fractures • Types box. 1342 • Trauma • Chronic/direct repetitive activities • Complications box p. 1343 • Traction box p. 1345

  21. Amputations • Trauma • Congenital • Phantom pain

  22. Nursing Management • You tell me!!!!

  23. NANDAS

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