Monteggia
Definition
Fracture / plastic malformation of proximal ulna with dislocation of radial head
Xray
Radio-capitellar line disrupted
paediatric
Femoral Fractures
Aetiology
Varies per age group
Trauma
- 60%
Non Accidental Injury
- 15 - 30%
- suspect if non walker / < 1 year
- walking status single best indicator of risk
- paediatric team to investigate
- history taking from parent
- consider metabolic investigations
ACL Avulsion Fracture
Meyers & McKeever classification
Type I: Undisplaced avulsion fracture
Type II: Anterior portion displaced & hinged
Type IIIA: Displaced
Type IIIB: Displaced & Rotated
Metastasis
DDx
Leukemia
Neuroblastoma
Wilm's
Last two usually occur in < 5 year age group
Bone scan is method of choice for screening for metastasis
Leukemia
Epidemiology
Most common form of cancer in children 30%
- ALL 5 x AML
- 3 : 100 000