Childhood Problems - Major Flashcards
What causes congenital dislocation of the hip?
malformation of the femoral head, acetabulum or both.
How does CDH present?
in 1/2 in 1000 births, the gip is displaced, more commonly in girls and sometimes bilaterally. children are screened at birth and at 3,6 and 12 months.
How does an examiner confirm CDH?
a definitive clunk occurs if the hip is dislocated or a slight click is suspicious.
Clinical signs include shortened limb, asymmetrical skin creases or limited adduction and limp.
How is CDH managed?
all clunks should be treated form birth.
radiographs can confirm.
if a hip is relocated successfully and remains in the acetabulum then it will settle on its own usually.
if discovered late, traction and manipulation is required before splinting in plaster for 3 months.
If walking has commenced before CDH is discovered, how is it treated?
surgical to deepen the acetabulum and reshape the femoral head. Secondary arthritis is common.
What are the two forms of club foot?
mild postural
fixed
How does the mild postural form of clubfoot occur?
after breech birth due to the babies position in the womb.
What is associated with the fixed form of club foot?
developmental abnormalities of nerves and muscles of the leg
How is clubfoot managed?>
Mild form is corrected by manipulation at birth. More severe forms require surgery.
What are the two stages of manipulative treatment of the talipes?
first the hindfoot equinus is corrected.
secondly the mid and forefoot varus is corrected.
What are the long-term risks of talipes?
difficulties in shoe fitting
sores
Name two causes of clubfoot?
posture in the womb
defects of nerves and muscles
What is spina bifida occulta?
minor bony abnormality in the spine
What is tethering of the spinal cord to the higher lumbar vertebrae?
diastamatomyelia
What is spina bifida cystica?
where a baby is born without covering of the neural plate tissues
