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Traumatic Neonatal Distal Femoral Physeal Injury - Everything You Need To Know - Dr. Nabil Ebraheim скачать в хорошем качестве

Traumatic Neonatal Distal Femoral Physeal Injury - Everything You Need To Know - Dr. Nabil Ebraheim 7 лет назад

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Traumatic Neonatal Distal Femoral Physeal Injury - Everything You Need To Know - Dr. Nabil Ebraheim
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Traumatic Neonatal Distal Femoral Physeal Injury - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describing the condition of difference between traumatic neonatal distal femoral physeal injury and congenital dislocation of the knee. A great article was used as reference in the making of this video: "Neonatal Distal Femoral Physeal Fracture Requiring Closed Reduction and Pinning" Journal of Perinatology 25, 216-219 (2005) Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Physeal injury in the distal femur in the neonate is rare. In general, traumatic neonatal physeal fracture usually occurs in the distal humerus and rarely occurs in the distal femur. The condition usually occurs due to birth trauma and usually result due to physeal separation which results in epiphyseal separation. The thigh will be swollen and there may be hypo-mobility of the extremity. The neonate will be fussy or irritated with significant swelling in the thigh. The condition is under diagnosed. The epiphysis is usually present at birth on x-rays. The condition can become complicated if the epiphysis is not completely ossified at birth or if the child is born prematurely. In this situation, the x-ray interpretation may be difficult. MRI will be really helpful if the doctor is uncertain of the diagnosis. X-rays are taken of the child at birth. Look at the lateral x-ray and find the epiphysis is present and ossified at birth with varying degrees (may not be clear). Each epiphysis will line up with its corresponding bone. Epiphysis of the distal femur should line up with the femoral shaft. Epiphysis of the proximal tibia should line up with the tibial shaft. If the two epiphysis separate from each other, then this is a congenital dislocation of the knee. This can be a spectrum of injury that varies from hyperextension, to subluxation, to frank dislocation. If the epiphysis is separated from its corresponding bone for example the epiphysis of the distal femur is separated from the shaft of the femur, then this is a physeal injury. Because the distal femur is mostly cartilaginous, you don’t see bone shifting, you see a little hint of the separation of the physis by seeing that the small ossified epiphysis is not in its normal position that corresponds with the axis of the bone. You need to know the difference between physeal injury and congenital dislocation of the knee. Accurate, gentle closed reduction with follow up x-rays to confirm the reduction and to detect any early bony bridging.

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