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MSK > Children's Orthopaedics > Flashcards

Children's Orthopaedics Flashcards

1
Q

What is the steps involved in Cerebral palsy progression?

A
  • Brain injury
  • Increased tone
  • Abnormal posture
  • Contracture
  • Bony deformity
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2
Q

What is the migration index?

A
  • gives % of hip ball out of socket, then gives the % risk factor for dislocation
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3
Q

What is the GMFCS score?

A
  • Cerebral palsy

- Score 1-5 at risk children

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4
Q

In the gait cycle what percentage is swing and what percentage is stance?

A
  • stance = 60%

- swing = 40%

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5
Q

What is ambulation?

A
  • Walking
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6
Q

What is dependant on for normal walking?

A

-An appropriate and adequate force acting via a rigid lever of appropriate length on a stable joint

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7
Q

What are the prorities of normal gait?

A
  • Stability in stance
  • Clearance in swing
  • Pre-position of foot in terminal swing
  • Adequate step length
  • Conservation of energy
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8
Q

What are the main orthopaedic complications with CP?

A
  • Hip dislocation
  • Scoliosis
  • Gait
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9
Q

Causes of CP CNS insult?

A
  • In utero (2nd or 3rd trimester)
  • Prematurity birth
  • Very few obstetrics
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10
Q

Muscle dystrophy in males?

A
  • Duchenne muscle dystrophy
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11
Q

In club foot what region of the foot is in contact with the ground?

A
  • Dorsum of the foot
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12
Q

CAVE nmenonic for deformity of club foot?

A

o Cavus
o Adduct
o Varus
o Equinus

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13
Q

Rockerbottom vs clubfoot?

A
  • Club foot towards midline

- Rockerbottom laterally

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14
Q

Leg pain red flags

A
  • Asymmetry
  • Good localisation
  • Short history
  • Persisting limp
  • Not thriving
  • Pain worsening
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15
Q

Treatment of clubfoot?

A
  • Boots and bar (bracing)
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16
Q

Knee pain means what examination should be done?

A
  • Hip examination

- referred pain

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17
Q

HSMN stands for?

A
  • Hereditary sensory and motor neuropathy
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18
Q

What may be seen in HSMN in the foot?

A
  • High arched foot

- foot weakness

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19
Q

Why are babies USS of their hips?

A
  • To assess for developmental dysplasia
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20
Q

What are specific hip tests in babies?

A

o Barlow’s

o Ortolani

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21
Q

What are you checking for when inspecting a babie’s hips?

A

o Asymmetry
o Loss of knee height
o Crease asymmetry
o Less abduction in flexion

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22
Q

How is Barlow’s test preformed?

A

-Adduction with downward pressure

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23
Q

Risk factors for developmental dysplasia?

A 
o	Females
o	Breech (foot first)
o	Family history
o	Oligohydramnios (low level of amniotic fluid)
o	Moulded baby 
o	First born
o	Weight >4kg
24
Q

How is Ortolani’s exam performed?

A

-Clunk towards the midline

25
Q

Treatment of early DDH?

A
  • Pavlik Harness
  • 23-24hrs per day for 12 weeks
  • Hips are abducted and flexed
26
Q

Treatment of late DDH?

A
  • Age > 3months
  • Surgery
    o CR spica
    o OR spica
  • Will not get a normal hip
27
Q

What is Antalgic gait

A
  • painful limp
28
Q

Symptoms of SCFE – Slipped Capital Femoral Epiphysis

A

o Short
o Externally rotated
o Loss of internal rotation
o Loss of deep flexion

29
Q

Tip toe walking may be normal variation up to what age?

A
  • 3 years
30
Q

Tip toes walking may be a sign of?

A
  • Cerebral Palsy
31
Q

What is SCFE/SUFE?

A
  • Ball of the hip (epiphysis) starts to flip off the growth plate (physis)
32
Q

Transient synovitis may occur after what?

A
  • viral infection
33
Q

What position may a child lie in with transient synovitis?

A
  • lie with the hip flexed and externally rotated
34
Q

What must you rule out in a possible case of transient synovitis?

A
  • Septic arthritis
35
Q

What does septic arthritis lead to?

A
  • destruction of the joint
36
Q

What may be the presenting features of septic arthritis in paediatrics?

A
  • severe pain
  • lie with hip flexed and externally rotated
  • severe pain
  • struggle to walk
  • high fever
37
Q

What is the treatment of septic arthritis?

A
  • surgical drainage

- antibiotics

38
Q

What criteria is used in septic arthritis?

A
  • Kocher’s criteria
39
Q

DDH vs SCFE/SUFE

A
  • DDH - born with, not painful

- SCFE/SUFE - acquired, painful, teenage years

40
Q

What is Perthes disease?

A
  • Avascular necrosis of the hip
41
Q

What forms at the apical ectodermal ridge?

A
  • Hand development
42
Q

What gene may be affected that leads to hand deformities?

A
  • Sonic Hedgehog gene
43
Q

What hip is most commonly affected in DDH?

A
  • the left hip
44
Q

Define cavus

A
  • foot has a very high arch

- seen in CP

45
Q

Define equinus

A
  • Lacks the flexibility to bring the toes closer to the leg
46
Q

What is another term for osteogenesis imperfecta

A
  • Brittle bones disease
47
Q

What gene is affected in osteogenesis imperfecta

A
  • defect of the maturation and organisation of type 1 collagen
48
Q

What are some symptoms of osteogenesis imperfecta

A
  • Multiple fragility fractures
  • short stature
  • blue sclerae
  • loss of hearing
49
Q

What gene is affected in Marfan’s syndrome?

A
  • Fibrillin gene
50
Q

What are the symptoms of Marfan’s syndrome?

A
  • tall stature
  • out of proportion long limbs
  • laxity
51
Q

What is abnormally formed in Ehlers-Danlos syndrome?

A
  • abnormal elastin and collagen formation
52
Q

What gene is defected in Duchenne muscular dystrophy?

A
  • Dystrophin gene (calcium transport)
53
Q

Explain varus gait?

A
  • angulation of the distal segments of a bone or joint towards the midline
54
Q

Explain valgus gait?

A
  • angulation of the distal segments of a bone or joint away for the midline
55
Q

What is the treatment for talipes equinovarus (clubfoot)

A

-Ponseti technique splints

MSK (16 decks)

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