General Editor: Christopher Colton, Fergal Monsell

AO Surgery Reference - Pediatric

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  1. Distal humerus

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Lateral decubitus position
    Prone for medial approach
    Prone position
    Approaches
    Overview
    Distal humeral anatomy
    Lateral approach
    Medial approach
    Posterior approach
    Anterior approach
    Reduction & Fixations
    Overview
    13-E/1.1 - Simple epiphysiolysis, SH I
    Splint immobilization
    Closed reduction; K-wire fixation
    13-E/2.1 - Simple epiphysiolysis with metaphyseal wedge, SH II
    Splint immobilization
    Closed reduction; K-wire fixation
    13-E/3.1 - Simple epiphyseal, SH III
    Cast immobilization
    Open reduction; K-wire fixation
    13-E/4.1L - Simple epi-/metaphyseal, lateral condyle, SH IV
    Cast immobilization
    Closed indirect reduction, K-wire fixation
    Minimally invasive cannulated screw fixation
    Open reduction; K-wire fixation
    Open reduction; screw fixation
    13-E/4.1M - Simple epi-/metaphyseal, medial condyle, SH IV
    Cast immobilization
    Open reduction; screw fixation
    13-E/4.2 - Multifragmentary epi-/metaphyseal, SH IV
    Open reduction; screw and K-wire fixation
    Open reduction; screw and plate fixation
    Open reduction; screw and external fixator
    13-E/7L - Avulsion of/by the collateral ligament
    Cast immobilization
    Open reduction; K-wire fixation
    Open reduction; screw fixation
    Open reduction; suture or suture and anchor fixation
    13-E/8.1 - Simple intraarticular flake
    Arthrotomy and excision
    Open reduction; screw fixation
    13-M/3.1 I - Simple, incomplete, nondisplaced
    Collar and cuff immobilization
    Splint immobilization
    13-M/3.1 II - Simple, incomplete, displaced
    Collar and cuff immobilization
    Splint immobilization (without reduction)
    Closed reduction; splint immobilization
    Closed reduction; K-wire fixation
    13-M/3.1 III and IV - Simple, complete with/without contact between fracture planes
    Splint immobilization
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixator
    ESIN
    Olecranon screw traction
    13-M/3.2 III and IV - Multifragmentary, complete with/without contact between fracture planes
    Closed reduction; K-wire fixation
    External fixator
    ESIN
    Olecranon screw traction
    Open reduction; internal fixation
    13-M/7M - Avulsion of the epicondyle (extraarticular)
    Splint immobilization
    Closed elbow reduction; splint immobilization
    Open epicondylar reduction and internal fixation
  2. Forearm shaft

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position for casting
    Supine position
    Approaches
    Overview
    Forearm anatomy
    Safe zones for pins (radius)
    Safe zones for pins (ulna)
    ESIN entry points (radius)
    ESIN entry points (ulna)
    Anterior approach (radius)
    Posterolateral approach (radius)
    Approach to the ulna
    Lateral (Kocher) approach
    Posterolateral approach
    Reduction & Fixations
    Overview
    22-D - Both bones, combination of radial and ulnar fracture
    Cast or splint fixation without reduction
    Closed reduction; cast fixation +/- wedging
    External fixation
    ESIN
    Open reduction; plate fixation
    22r-D/1.1 - Radius, bowing
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    ESIN
    22u-D/1.1 - Ulna, bowing
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    ESIN
    22r-D/2.1 - Radius, greenstick
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    ESIN
    22u-D/2.1 - Ulna, greenstick
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    ESIN
    22r-D/4.1 - Radius, complete transverse, simple
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    External fixation
    ESIN
    Open reduction; plate fixation
    22u-D/4.1 - Ulna, complete transverse, simple
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    External fixation
    ESIN
    Open reduction; plate fixation
    22u-D/4.2 - Ulna, complete transverse, multifragmentary
    Cast or splint fixation without reduction
    External fixation
    ESIN
    Open reduction; bridge plating
    22r-D/5 - Radius, complete oblique or spiral
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    External fixation
    ESIN
    Open reduction; plate and screw fixation
    Open reduction; bridge plating
    22u-D/5 - Ulna, complete oblique or spiral
    Cast or splint fixation without reduction
    Closed reduction; cast or splint fixation
    External fixation
    ESIN
    Open reduction; plate and screw fixation
    Open reduction; bridge plating
    22u-D/6 - Monteggia lesion
    Closed reduction; cast fixation
    External fixation
    ESIN
    Open reduction; plate fixation
    22u-D, 21r-E/M - Monteggia equivalent
    Cast fixation without reduction
    External fixation
    ESIN
    Open reduction; plate fixation (ulna)
  3. Pediatric distal forearm

    Diagnosis
    Overview
    Preparations
    Overview
    Supine positioning
    Approaches
    Overview
    Anatomy of the distal forearm
    Volar (anterior) approach
    Ulnar approach
    Reduction & Fixations
    Overview
    23r-E/1.1 - Simple epiphysiolysis, Salter-Harris I, radius
    Short or long arm cast
    Closed reduction; Short or long arm cast
    23u-E/1.1 - Simple epiphysiolysis, Salter-Harris I, ulna
    Short or long arm cast
    Closed reduction; Long arm cast
    23-E/1.1 - Simple epiphysiolysis, Salter-Harris I, both bones
    Short or long arm cast
    Closed reduction; Short or long arm cast
    23r-E/2.1 - Simple epiphysiolysis with metaphyseal wedge, Salter-Harris II, radius
    Short or long arm cast
    Closed reduction; Short or long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    23u-E/2.1 - Simple epiphysiolysis with metaphyseal wedge, Salter-Harris II, ulna
    Splint
    Short or long arm cast
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    23-E/2.1 - Simple epiphysiolysis with metaphyseal wedge, Salter-Harris II, both bones
    Short or long arm cast
    Closed reduction; Short or long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    23r-E/2.2 - Multifragmentary epiphysiolysis with metaphyseal wedge, Salter-Harris II, radius
    Long arm cast
    Closed reduction; Long arm cast
    External fixation
    23r-E/3.1 - Simple epiphyseal fractures, Salter-Harris III, radius
    Short or long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    23-E/3.1 - Simple epiphyseal fractures, Salter-Harris III, both bones
    Short or long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    23r-E/4.1 - Simple epi-/metaphyseal fracture, Salter-Harris IV, radius
    Short or long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    23u-E/7 - Avulsion of the styloid, ulna
    Splint
    Short or long arm cast
    Open reduction; K-wire fixation
    23r-M/2.1 - Metaphyseal, torus/buckle fractures, radius
    Splint
    Short or long arm cast
    23u-M/2.1 - Metaphyseal, torus/buckle fractures, ulna
    Splint
    Short or long arm cast
    23-M/2.1 - Metaphyseal, torus/buckle fractures, both bones
    Splint
    Short or long arm cast
    23r-M/3.1 - Metaphyseal, simple complete, radius
    Short or long arm cast
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    Open reduction; Plate fixation
    23u-M/3.1 - Metaphyseal, simple complete, ulna
    Short or long arm cast
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    23-M/3.1 - Metaphyseal, simple complete, both bones
    Long arm cast
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    Open reduction; Plate fixation
    23r-M/3.2 - Metaphyseal, multifragmentary complete, radius
    Long arm cast
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    Open reduction; Plate fixation
    23-M/3.2 - Metaphyseal, multifragmentary complete, both bones
    Closed reduction; Long arm cast
    Closed reduction; K-wire fixation
    Open reduction; K-wire fixation
    External fixation
    Open reduction; Plate fixation
  4. Pediatric proximal femur

    Diagnosis
    Overview
    Preparations
    Overview
    Supine position
    Lateral position
    Approaches
    Overview
    Vascular anatomy
    Anterolateral approach
    Lateral via trochanteric flip
    Transgluteal approach
    Anterior approach
    Lateral approach
    Surgical hip dislocation
    Minimally invasive approach
    Reduction & Fixations
    Overview
    31-E/1.1 - Traumatic epiphysiolysis, SH I
    Hip spica
    In situ fixation with K-wires or screws
    Open reduction, K-wire fixation
    Open reduction, screw fixation
    31-E/2.1 - Epiphysiolysis with metaphyseal wedge, SH II
    Hip spica
    In situ fixation with K-wires or screws
    Open reduction, K-wire fixation
    Open reduction, screw fixation
    Open reduction, pediatric hip locking plate
    31-E/7 - Avulsion of/by the ligament of the head of the femur
    Removal of osteochondral fragment
    Open reduction, resorbable pin fixation
    Open reduction, headless screw fixation
    31-E/8 - Intraarticular flake(s)
    Removal of osteochondral fragment
    Open reduction, resorbable pin fixation
    Open reduction, headless screw fixation
    31-M/2.1 I - Incomplete midcervical
    Hip spica
    In situ fixation with K-wires or screws
    Pediatric hip locking plate
    31-M/2.1 II - Incomplete basicervical
    Hip spica
    In situ fixation with K-wires or screws
    Pediatric hip locking plate
    31-M/2.1 III - Incomplete transtrochanteric
    Hip spica
    In situ fixation with K-wires or screws
    Pediatric hip locking plate
    31-M/3.1 I - Complete midcervical, simple
    Open reduction, K-wire fixation
    Open reduction, screw fixation
    Open reduction, pediatric hip locking plate
    31-M/3.1 II - Complete basicervical, simple
    Open reduction, K-wire fixation
    Open reduction, screw fixation
    Open reduction, pediatric hip locking plate
    31-M/3.1 III - Complete, transtrochanteric, simple
    Open reduction, pediatric hip locking plate
    ESIN
    31-M/3.2 II - Complete basicervical, multifragmentary
    Open reduction, pediatric hip locking plate
    31-M/3.2 III - Complete transtrochanteric, multifragmentary
    Open reduction, pediatric hip locking plate
    ESIN
    31-M/7 - Avulsion of the greater or lesser trochanter
    Nonoperative treatment
    Open reduction, tension band (greater trochanter)
    Open reduction, screw fixation (greater trochanter)