Children's Orthopaedics

Question 1

Early DDH treatment

Answer 1

Pavlik harness

Question 2

Late DDH

Answer 2

> 3 months
Worse outcomes
Surgery required

Question 3

Slipped Upper Femoral Epiphysis

Answer 3

Ages 8-18
Weakness in the epiphysis causes slip (but hip still stays in joint)
Can cause hip/groin/knee pain

Question 4

SUFE Presentation

Answer 4

Antalgic gait
Lower limb is shortened, externally rotated
Pain

Question 5

SUFE prevention

Answer 5

Screw in place

Question 6

Transient synovitis

Answer 6

Often secondary to viral illness
2-8 years old, more common in boys
Limp + hip/groin pain
May present with referred pain to knee
Hip lying flexed/externally rotated
Pain at end range of hip movements

Question 7

Diagnosis of transient synovitis

Answer 7

Kocher’s criteria
Ultrasound +/- aspiration

Question 8

Septic arthritis

Answer 8

Surgical emergency
Destruction of joint + potential osteonecrosis of hip
Short duration of symptoms
Unable to weight bear and hip/groin pain
Hip lying flexed/externally rotated
Severe hip pain on passive movement
Usually pyrexial

Can develop from contiguous osteomyelitis

Question 9

Septic arthritis Dx

Answer 9

Blood tests (FBC, CRP)
Blood cultures
Radiography to rule out other Dx
Ultrasound +/- aspiration

Question 10

Septic arthritis treatment

Answer 10

Open surgical washout
Antibiotics

Question 11

Perthes Disease

Answer 11

Avascular necrosis of the hip
- Idiopathic
4-8 year olds

Small hands and feet
30% have attention disorders

Question 12

Perthes Disease treatment

Answer 12

Containment
Movement
Seeing through fragmentation
Restrictions
Crutches/wheelchairs
Healing