1. Specific Fractures and Joint injury in Children 耕莘醫院骨科部余文輝

2. Special Features of Fractures and Dislocation in Children 1. Fractures more common 2. Stronger and more active periosteum 3. More rapid fracture healing 4. Special problems of diagnosis 5. Spontaneous correction of certain residual deformities 6. Differences in complications 7. Different emphasis on methods of treatment 8. Torn ligaments and dislocations less common 9. Less tolerance of major blood loss

3. Fractures More Common

4. Stronger and More Active Periosteum

5. More Rapid Fracture Healing

6. Special Problems of Diagnosis

7. Spontaneous Correction of Certain Residual Deformities Angulation Incomplete apposition Shortening Rotation

8. Differences in Complications

9. Difference Emphasis on Methods of Treatment

10. Torn Ligaments and Dislocations Less Common

11. Less Tolerance of Major Blood Loss

12. Special Types of Fractures in Children Fractures that involve the Epiphseal plate Anatomy Histology Physiology

13. Special Types of Fractures in Children Fractures That Involve the Epiphyseal Plate Diagnosis of Epiphyseal Plate Injuries Salter-Harris Classification of Epiphyseal Plate Injuries

14. Salter-Harris Classification of Epiphyseal Injuries Type I Type II Type III Type IV Type V

15. Prognosis Concerning Growth Disturbance 1. Type of Injury 2. Age of the Child 3. Blood Supply to the Epiphysis 4. Method of Reduction 5. Open or Closed Injury 6. Velocity and Force of the Injury

16. Dislocation and Subluxation of the Hip Developmental Displacement of the Hip; Developmental Dysplasia of the Hip Incidence Etiology and Pathology Diagnosis Treatment

17. Diagnosis of the DDH Physical examination Barlow test Ortolani test Allis’ or Galeazzi’s sign Trendelenburg’s test Radiologic Findings

18. Treatment of the DDH Birth to Three Months Three Months to Eighteen Months Eighteen Months to Five Years After the Age of Five Years

19. Metatarsus Primus Varus

20. Metatarsus Adductus ( Metatarsus Varus )

21. Talipes Equinovarus Clubfoot Incidence Etiology and Pathology Diagnosis Treatment

22. Neoplasms of Musculoskeletal Tissue Neoplasm-like Lesions True Neoplasms

23. Classification of Neoplasm-like Lesions of Bone ( I ) A. Osteogenic 1. Osteoma 2. Single osteochondroma 3. Multiple osteochondroma 4. Osteoid osteoma 5. Benign ostoblastoma B. Chondrogenic 1. Enchondroma 2. Multiple enchondromata

24. Classification of Neoplasm-like Lesions of Bone ( II ) C. Fibrogenic 1. Subperiosteal cortical defect 2. Nonosteogenic fibroma 3. Monostotic fibrous dysplasia 4. polyostotic fibrous dysplasia 5. Osteofibrous dysplasia 6. “ Brown tumor “

25. Classifiction of Neoplasm-like Lesions of Bone ( III ) D. Angiogenic 1. Angioma of bone 2. Aneurysmal bone cyst E. Uncertain origin 1. Simple bone cyst

26. Classification of True Primary Neoplasms of Bone ( I ) A. Osteogenic 1. Osteosarcoma 2. Surface osteosarcoma ( parosteal sarcoma; periosteal sarcoma ) B. Chondrogenic 1. Benign chondroblastoma 2. Chondromyxoid fibroma 3. Chondrosarcoma C. Fibrogenic 1. Fibrosarcoma of bone 2. Malignant fibrous histiocytoma of bone

27. Classification of True Neoplasms of Bone ( II ) D. Angiogenic 1. Angiosarcoma of bone E. Myelogenic 1. Myeloma of bone 2. Ewing’s sarcoma 3. Hodgkin’s lymphoma of bone 4. Non-Hodgkin’s lymphoma 5. Skeletal reticuloses 6. Leukemia F. Uncertain origin 1. Giant cell tumor of bone

28. General Consideration Incidence Diagnosis Clinical Features Diagnostic Imaging Laboratory Investigation Biopsy

29. Diagnosis of Bone Tumor Clinical Features

30. Diagnosis of Bone Tumor Diagnostic Imaging Plain Radiography Plain ( conventional ) Tomography Computed Tomography ( CT ) Scintigraphy ( Bone Scan )

31. Diagnosis of Bone Tumor Laboratory Investigations Complete blood count ( CBC ) Erythrocyte sedimentation rate ( ESR ) Serum calcium Serum phosphorus Serum alkaline phosphatase Serum acid phosphatase Prostatic specific antigen ( PSA ) Serum protein electrophoresis Urinary Bence-Jones protein

32. Treatment of Bone Tumor Surgical Procedures Chemotherapy Radiotherapy

33. Disorders of Epiphyses and Epiphyseal Growth Idiopathic Avascular Necrosis of Epiphyses ( The Osteochondroses )

34. Pathogenesis and Pathology of the Osteochondroses Early Phase of Necrosis ( The phase of Avascularity ) Phase of Revascularization with Bone Deposition and Resorption Phase of Bone Healing Phase of Residual Deformity

35. Osteochondrosis of the Femoral Head (Legg-Perthes’ Disease) Clinical Features Diagnosis Treatment

36. Osteochondrosis of the Capitellum (Panner’s Disease)

37. Osteochondrosis of a Metatarsal Head (Freiberg’s Disease)

38. Osteochondrosis of Secondary Centers of Ossification in the Spine (Scheuermann’s Disease)

39. Osteochondrosis of the Tarsal Navicular (Kohler’s Disease)

40. Osteochondrosis of the Lunate (Kienbock’s Disease)

41. Osteochondrosis of a Primary Center of Ossification in the Spine (Calve’s Disease)