AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...
AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...
AAHS ASPN ASRM - 2013 Annual Meeting - American Association ...
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Pediatric Upper Extremity Fractures<br />
Scott Kozin, MD<br />
Dorit H. Aaron, MA, OTR/L, CHT<br />
I. Properties of Children<br />
a. Different than adults<br />
b. Short attention span<br />
c. Honest, open, and love life<br />
d. Literal interpretation<br />
e. No secondary gain<br />
f. Literal interpretation<br />
g. Loose- tend NOT to stiffen!!!!!!!<br />
II. Evaluation of Stiffness in Children<br />
a. Why??<br />
b. Evaluation<br />
i. History of injury<br />
ii. Treatment<br />
iii. Immobilization- length and position<br />
c. X-rays/ Advanced imaging studies<br />
III. Treatment- non-operative<br />
a. Time and patience<br />
b. Time for remodeling<br />
c. Therapy<br />
i. Low load prolonged stretch<br />
ii. Total end range time<br />
iii. Modalities<br />
d. Exercise- play!!<br />
IV. Treatment- operative<br />
a. Correct underlying deformity<br />
b. Restore anatomy<br />
c. Joint release<br />
d. Arthroplasty- resurfacing<br />
V. A Glimpse in to the Future<br />
a. What can we learn form children?<br />
b. Fetal healing<br />
c. Beredjiklian et al<br />
<strong>American</strong> <strong>Association</strong> for Hand Surgery<br />
Specialty Day 2007<br />
Rapid Recovery- The Fast Track<br />
References<br />
Brink HE, Miller GJ, Beredjiklian PK, Nicoll SB. Serum-dependent effects on adult and fetal tendon fibroblast migration<br />
and collagen expression. Wound Repair Regen (2006 Mar-Apr) 14(2):179-86<br />
Favata M, Beredjiklian PK, Zgonis MH, Beason DP, Crombleholme TM, Jawad AF Soslowsky LJ . Regenerative properties<br />
of fetal sheep tendon are not adversely affected by transplantation into an adult environment. J Orthop Res (2006 Nov)<br />
24(11):2124-32<br />
Gausepohl T, Mader K, Pennig D. Mechanical distraction for the treatment of posttraumatic stiffness of the elbow in<br />
children and adolescents. J Bone Joint Surg Am (2006 May) 88(5):1011-21<br />
Lambertz D, Mora I, Grosset JF, Perot C. Evaluation of musculotendinous stiffness in prepubertal children and adults,<br />
taking into account muscle activity.<br />
J Appl Physiol (2003 Jul) 95(1):64-72<br />
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