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2) Patho 2 > 8) Pediatric Orthopedics > Flashcards

8) Pediatric Orthopedics Flashcards

1
Q

Why does age matter?

A

Bc if a child is hit by a car, it will hit a different body part depending on their height

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2
Q

Priorities of pediatric trauma

A
  • ABC’s
  • Limb Ischemia
  • Open Fx
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3
Q

Finish the phrase: Children are not _______.

A

Small adults

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4
Q

What does the fact that a kid’s head is larger than their trunk incr the tendency for?

A

Trunk flexion

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5
Q

What does post-fx bone remodeling potential depend on?

A
  • Age
  • Which growth plates are involved
  • Proximity of injury to growth plate
  • Plane of jt motion
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6
Q

What is a sleeve fx?

A

Periosteum gets ripped off the bone & then the bone fx’s in a certain location depending on the area

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7
Q

What causes compartment syndrome?

A

Build-up of pressure in a closed space in the body

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8
Q

What can compartment syndrome cause?

A

Compromised circulation, necrosis, or nerve damage

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9
Q

What are the 5 P’s of compartment syndrome?

A

Pulse, Pain, Parasthesia, Paresis, & Pressure

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10
Q

Describe the pain of compartment syndrome

A

Pain will be out of proportion to the injury

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11
Q

What can a fx at femoral growth plates cause?

A

Leg length discrepancy

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12
Q

What are the causes of leg length discrepancy?

A
  • Fx at femoral growth plates
  • Devo disorder
  • Congenital disorder
  • Infection
  • Dysplasia
  • Metabolic disorder
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13
Q

Pathological fx’s are the result of what?

A

Tumors

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14
Q

What do you need to know about in-toeing/out-toeing?

A

If its local & where the twist is coming from

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15
Q

Tx for club foot

A

Ponsetti stretching & percutaneous heel cord tendinotomy

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16
Q

What is miserable malalignment

A

Femur gets turned in, tibia turns out, & the patella tracks laterally causing patellar instability or dislocation

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17
Q

When are flat feet not a problem?

A

If they’re flexible but not painful

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18
Q

What can cause flat feet?

A

Pathological from tight achilles, tarsal coalition, neuromuscular, etc

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19
Q

By what age should a child have straight legs?

A

18 months

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20
Q

By what age should a kiddo have max valgus/varus?

A

Age 3 or 4

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21
Q

Ricketts

A

Whitening & cupping of growth plates

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22
Q

Is ricketts a systemic problem?

A

Yes

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23
Q

What are the pathological causes of malalignment?

A
  • Trauma
  • Metabolic
  • Infection
  • Tumor
  • Developmental
  • Bone Dysplasia
24
Q

When is imaging needed?

A

For kiddies w/severe deformity, asymmetries, short stature, & dysmorphic features

25
Q

Risk factors for hip dysplasia

A
  • 1st born
  • Female
  • FHx
  • Intrauterine crowding
  • Breech delivery
  • Torticollis
  • Post-natal positioning
  • Ethnicity
26
Q

What happens if hip dysplasia is dx’ed after the child is 18mo?

A

Tx becomes more invasive

27
Q

How is hip dysplasia dx’ed?

A
  • Barlow Test
  • Ortolani Test
  • Asymmetric thigh creases
  • Abduction deficits
28
Q

Tx for hip dysplasia

A
  • Closed reduction
  • Anterior open reduction if CR fails
  • Pelvic Osteotomy
  • Femoral Shortening
  • Capsulorraphy
  • Adductor tendonotmy
  • Arthrogram
  • FU CT
  • Pavlik harness/Abduction brace
  • Positioning in 100° of flexion & 50° abduction
29
Q

How many wks of tx for hip dysplasia does it take to achieve clinical stability?

A

6-12wks

30
Q

Perthe’s Disease

A

Idiopathic necrosis of the femoral head

31
Q

Tx for perthe’s disease

A

Containment & mobility

32
Q

Who does perthe’s disease most commonly effect?

A

Males ages 4-10

33
Q

For a pt w/perthe’s disease, what is prognosis based on?

A

Amount of femoral head involvement & age of onset

34
Q

Cerebral Palsy

A

Group of permanent developmental & postural disorders as the result of non-progressive insult to UMN’s

35
Q

What can CP effect?

A

Cognition, Behavior, & MSK system

36
Q

Diplegia

A

LE’s are more involved than UE’s

37
Q

What is the role of PT for CP?

A

Stretching, strengthening, gait training, positioning, pt ed, & emotional support

38
Q

Types of Orthotics

A
  • Standing Frame
  • RGO
  • HKAFO
  • KAFO
  • AFO
  • SMO
  • Inserts
39
Q

Other modalities that can be good for CP

A
  • Water therapy
  • Hippotherapy
  • Botox for spasticity
  • Baclofen pumps
  • Selective dorsal root rhizotomy
40
Q

What is the management of leg length discrepancy based on?

A
  • Predicted LLD
  • Predicted height
  • Jt Instability
  • Foot/Ankle Form & Fxn
  • Psychosocial
  • Surgeon bias
41
Q

Tx for LLD

A

Shoe lift & prosthetics

42
Q

Describe the surgery done for LLD

A

Cut the bone, put in a fixation, distract, & then new bone will grow in the gap

43
Q

What are the stages of LLD surgery?

A

1) Latency
2) Distraction
3) Consolidation

44
Q

What will be the WB status of a pt who just had LLD surgery w/internal lengthening nails?

A

TTWB

45
Q

What can LLD surgery cause?

A

Contractures

46
Q

What are the disadvantages of LLD surgery?

A
  • Compromises fxn for length
  • Jt instability
  • Psychological stress
  • Misleading info
  • Unrealistic goals
  • Lack of planning
47
Q

Blount’s Disease

A

Growth disorder of the tibia that causes pt to be bowleg

48
Q

What is the tx for blount’s disease?

A

Tibial osteotomy

49
Q

Congenital Radial Club Hand

A

Radius is missing

50
Q

Chondrolysis

A

Degeneration of the acetabuluar labrum

51
Q

Scoliosis

A

7° lateral curvature of the spine

52
Q

What are the indications for an MRI for scoliosis?

A
  • Atypical Sx’s
  • Neurological findings
  • Atypical curve pattern
  • Rigid curve
  • Rapid progression
53
Q

Management of Scoliosis

A
  • Observation
  • Bracing
  • Surgery
54
Q

True or False: Stim, exercises, & manips have no substantial effect to pt’s w/scoliosis

A

True

55
Q

When will they do bracing for pt’s w/scoliosis?

A

If the pt has a curve between 25°-40° & they still have growing to do

56
Q

When will they do surgery on a pt w/scoliosis?

A

If the pt has a curve >45° or curve gets worse even w/bracing

57
Q

Who is at risk for compartment syndrome?

A

Kids w/tibial or forearm fx

2) Patho 2 (20 decks)

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