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Home Patient's Information Clinic Network Pediatrician's Section Orthopaedic's Surgeons Section Calcium and Bone Health Links Contact   Orthopaedic's Surgeons Section       Acceptibility Cliteria For Reductions In Paediatric Fractures     Percutaneous Osteotomy For Correction Of Cubitus Varus Using Mini External Fixator     Assessment Of The Untreated Clubfoot     Osteotomies Around The Hip Physeal Injuries   Musculoskeletal consequences of spasticity   Acceptibility Cliteria For Reductions In Paediatric Fractures A. Upper Limb B. Fractures of Lower Limb             Upper Limb       1. Proximal Humerus : > 11 years of age : > 50 deg. contact   < 20 deg. angulation     < 11 years of age : relatively greater displacement and angulation can be accepted. Good to excellent long term outcomes can be expected regardless of the # displacement.       2. Shaft Humerus : Internal rotation : < 15 deg.     Shortening : upto 1 to 2 cms. Displacement and Angulation:   < 5 years : Total displacement, Upto 70 deg. angulation 5 to 12 years :  40 to 70 deg. angulation > 12 years :  50 % contact , < 40 deg. angulation       3. # SCSH : Anterior humeral line transecting capitellum. Baumann angle - 70-78 deg. or equal to the other side. Intact olecranon fossa.       4. Radius Ulna : Ulna - Primary indicator of angulation Radius - Indicator of rotation     < 9 years 15 deg. angulation   45 deg. malrotation   Complete displacement   Straightening of radius     9-14 years 10 deg. angulation   30 deg. malrotation   Complete displacement   Some loss of radial bow       5. Fracture Radial Neck : Younger children : 30-45 degrees Older Children : 15 degrees       top       Fractures of Lower Limb       1. Fracture Neck Femur : Only anatomical reduction is acceptable       2. Fracture Shaft Femur : 0-6 months of age : < 1.5 cm. Of shortening Older Children : < 30 deg angulation in varus valgus plane   < 30 deg. angualtion in AP plane     6 months - 6 years : < 2 cms of shortening   15 deg. angulation in varus valgus plane   < 20 deg. anterior angulation     6 - 10 years < 1.5 cms. shortening   < 10 deg. varus valgus angulation   < 15 deg. AP angulation     > 10 years < 1 cm shortening   < 5 deg. varus valgus angulation   < 10 deg. AP angulation       3. Fracture - Separation of Distal Physis of Femur : In Salter Harris type 1 and 2 < 10 years < 20 deg. anterior or posterior angulation > 10 years Only minimal AP angulation   < 5 deg. varus valgus angulation     In Salter Harris type 3 and 4     Anatomical reduction and ORIF       4. Fracture Tibial Tuberosity : Only minimally displaced fractures with possible active extension of knee to 0 deg. can be acceptable. Rest require ORIF       5. Patella : < 3 mm articular step off < 3 mm diastasis on xray Intact extensor mechanism       6. Fracture of Tibia and Fibula : Proximal metaphysis : Closed reduction to anatomic position or slight varus is acceptable   Diaphysis :   < 8 years > 8 years Varus 10 deg. 5 deg. Valgus 5 deg. 5 deg. Ant. angulation 10 deg. 5 deg. Post. Angulation 5 deg. 0 deg. Shortening 10 mm 5 mm Rotation 5 deg. 5 deg. Distal tibial fractures   Salter Harris type I & II 1. In patients with atleast 2 years of growth remaining   < 15 deg. of posterior angulation   < 10 deg. of valgus angulation   0 deg. of varus angulation     2 In patients with less than 2 years of growth remaining   Angulation in all planes < 5 deg.       Salter Harris type III & IV   < 2 mm displacement       top

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