By Lynn T. Staheli MD
Geared to the typical wishes of pediatricians, fundamental care physicians, and orthopedists, Fundamentals of Pediatric Orthopedics, Fourth Edition is a whole and elementary consultant to prognosis and administration of pediatric orthopedic difficulties. cures are reviewed and illustrated and pitfalls, together with basic adaptations, are mentioned. Emphasis is at the welfare of the total baby, and father or mother schooling details is included.
The uniquely photograph presentation during this best-selling e-book beneficial properties 1,025 full-color drawings and pictures, that have been stronger for this variation. different Fourth version highlights contain better emphasis on fundamental care, additional information on trauma rules, and up to date treatments and father or mother education.
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Fat in aspirate 5/30/07 9:18:19 AM 36 Evaluation / Diagnostic Procedures Diagnostic Procedures Other studies are sometimes helpful. Electromyography Tissue Electromyography (EMG) is done using either surface or deep electrodes. Surface electrode studies are limited because of artifacts and poor muscle selectivity. The placement of deep electrodes is painful and thus poorly tolerated in children. Furthermore, EMG studies do not show the strength of contraction, only the electrical activity. EMG is useful in evaluating peripheral nerve injuries, anterior horn cell degeneration, and diseases such as myotonia and myelitis.
E Arthrography Initial radiograph showed a lateral displacement of the upper femoral metaphysis (red arrows), suggesting the possibility of a hip dislocation or subluxation. The arthrogram showed the femoral head to be reduced (yellow arrow) and established the diagnosis of coxa vara. 31 D Plastic model from CT reconstruction Models in plastic can be created that allow preoperative planning and execution of operative correction. Uses for Arthrography DDH—initial evaluation and when management uncertain Perthes disease—to assess shape of cartilaginous femoral head Complex trauma—such as elbow injuries in the infant Osteochondritis dissecans F Arthrography uses These are typical examples of the use of arthrograms for assessing musculoskeletal problems in children.
Range of motion (ROM) The normal values of joint motion change with age. Generally, the arc of motion is greatest in infancy and declines with age. Specific joints are affected by intrauterine position. For example, lateral hip rotation is greatest in early infancy and declines during the first 2 or 3 years of growth. In assessing ROM, a knowledge of normal values is helpful. Make certain that the position of the pelvis is determined by palpation when assessing hip abduction [D]. Contractures of diarthrodial muscles are common in children and sometimes require lengthening.
Fundamentals of Pediatric Orthopedics by Lynn T. Staheli MD