Chapter 16- Neuromuscular Disorders Of Childhood

Question 1

what is a common cause of cerebral palsy?

Answer 1

perinatal anoxia

Question 2

which type of cerebral palsy is important to the orthopaedic surgoen?

Answer 2

spastic cp

Question 3

In children with cp what is the most common deformity of the foot

Answer 3

equinus - with a degree of varus

Question 4

what is the first line management of equinus?

Answer 4

physiotherapy

Question 5

which surgery is indicated if the first line management of an equinus deformity fails?

Answer 5

surgical elongation of the achilles tendon

Question 6

what could occur if the equinus deformity is not managed adequately and surgery is delayed?

Answer 6

mid tarsal break

Question 7

what is the result of a mid tarsal break on the foot? and how is it managed?

Answer 7

a flat valgus foot

surgery: subtalar arthrodesis

Question 8

how do you correct the varus/ adducted midfoot?

Answer 8

lengthening of the tibialis posterior tendon

Question 9

in a child with cp which type of deformity would you find at the knee?

Answer 9

flexion deformity

Question 10

which type of gait would a child with cp and a knee deformity present with

Answer 10

crouching gait

Question 11

how do you manage a flexion deformity of the kneein a child with cp

Answer 11

lengthen or cut components of the hamstrings

Question 12

in a pt with cp - which hip posture do they develop?

Answer 12

flexion adduction posture

Question 13

how do you manage a cp with a hip deformity?

Answer 13

surgical release of the tight soft tissues - adductor and flexor muscle groups with or without obturator neurectomy

Question 14

what is the aim of hip surgery in a child with cp?

Answer 14

improving gait and preventing dislocation of the hip

Question 15

which spinal deformity may develop in a child with cp

Answer 15

scoliosis

Question 16

how is the spinal deformity managed in a child with cp?1. early management
2. late management

Answer 16

1. bracing

2. spinal fusion

Question 17

why is it important to manage a spinal deformity in a patient who cannot walk?

Answer 17

to allow them to sit erect in a wheel chair

Question 18

2 important factors that must be present before surgery of the upper limbs is performed in a patient with cp

Answer 18

good higher cortical sensation

degree of intelligent cooperation by the pt

Question 19

how can one manage a thumb in palm deformity?

Answer 19

tendon lengthening of flexors and pronators? pg 101 confirm

Question 20

In a hemiplegic patient which surgery of the upper limb may be indicated for cosmetic reasons?

Answer 20

wrist arthrodesis