CME expires October 1, 2029
Go beyond traditional learning with a 360° perspective on orthopedic topics.
Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.
This Instructional Course Lecture provides a detailed and evidence-based review of posttraumatic limb deformity in pediatric and adolescent patients, with emphasis on physeal injury surveillance, growth arrest, displaced intra-articular fractures, chronic infection, and segmental bone loss.
Editor
Dustin Greenhill, MD, FAAOS
Learning Objectives
- Evaluate traumatic extremity injuries in pediatric and adolescent patients with attention to physeal involvement, remaining growth, soft-tissue injury, infection risk, bone loss, and long-term limb function.
- Apply surveillance strategies after physeal injury, including serial radiographs, alignment measurements, Park-Harris growth lines, contralateral comparison imaging studies, CT scans, MRIs, and bone-age assessment.
- Select treatment options for posttraumatic physeal arrest based on bar size, location, remaining growth, deformity progression, leg-length discrepancy, and feasibility of bar resection versus completion epiphysiodesis.
- Manage displaced intra-articular fractures in skeletally immature patients by restoring articular congruity, physeal alignment, compression, and stability while minimizing iatrogenic injury to cartilage and physis.
- Develop staged treatment strategies for pediatric chronic osteomyelitis that integrate infection eradication, local antibiotic delivery, provisional stabilization, definitive reconstruction, and management of angular or length deformity.
- Compare reconstructive options for segmental bone defects, including the induced membrane technique, bone transport, free vascularized fibular transfer, and acute shortening followed by lengthening.
- Incorporate patient-specific variables, including age, skeletal maturity, psychosocial context, family transportation, support network, prosthetic access, soft-tissue status, and family goals into limb reconstruction decision making.
- Anticipate pitfalls in complex pediatric limb reconstruction, including recurrent physeal bars, persistent infection, antibiotic carrier complications, inadequate débridement, unstable fixation, compromised soft tissue, and failure to plan staged reconstruction.
Earn up to 5 AMA PRA Category 1 CME credits™.