Chapter 2: Orthopedics Flashcards
When should developmental dysplasia of the hip be diagnosed?
Diagnosed right after birth and runs in families.
How do children with developmental dysplasia of the hip present?
Children have uneven gluteal folds and PE of the hips shows that they can be easily dislocated posteriorly with a jerk and a click and returned to normal with a snapping.
What is diagnostic for developmental dysplasia of the hip?
Sonogram is diagnostic, do not order X-rays, the hip is not calcified in newborns.
What is the treatment for developmental dysplasia of the hip?
Abduction splinting with pavlik harness for about 6 months.
How will hip pathology in children present?
Hip pain or it may show up as knee pain
What is Legg-Calve -Perthes disease?
A vascular necrosis of the capital femoral epiphysis
How does Legg-Calve -Perthes disease present?
Occurs around age 6, insidious development of limping, decreases hip motion and hip or knee pain. Kids walk with an antalgic gait and passive motion of the hip is guarded.
How do you diagnose Legg-Calve -Perthes disease?
By AP and lateral hip X-rays
What is the treatment for Legg-Calve -Perthes disease?
Containing the femoral head within the acetabulum by casting and crutches.
How does a slipped capital femoral epiphysis present?
Orthopedic emergency, chubby or lanky boy around 13. Complain of groin or knee pain are noted to be limping.
When someone who has slipped capital femoral epiphysis what happens when they sit?
With legs dangling, the sole of the foot on the affected side points toward the other foot.
What happens on physical exam with someone how has slipped capital femoral epiphysis
There is limited hip motion and as the hip is flexed the thigh goes into external rotation and cannot be rotated internally.
How is slipped capital femoral epiphysis diagnosed?
X-ray
What is the surgical treatment for slipped capital femoral epiphysis
Pinning the femoral head back in place.
