Children's Orthopaedics: Normal Growth and Development Flashcards
in what directions do bones grow and where from?
longitudinally from the epiphyseal growth plate OR
circumferentially from the periosteum
what is the process of longitudinal bone growth called?
enchondral ossification
what is the process of circumferential bone growth called?
appositional growth
what factors can contribute to short stature
diet vitamin d and a injury illness GH genetics
bones with the highest epiphyseal activity
shoulder
wrist
common age for a child to stand?
8-12 months
what age would a child normally be able to manage stairs alone
3
what age is common for children to start saying their first words?
9-12 months
what is genu varum
bow legged
what is genu valgum
knock knees
is it normal for a child under 2 to have genu varum
yes
when would a genu varum be considered abnormal?
unilateral
>16 degrees away from normal
short stature
pain
differential diagnoses for a pathological genu varum
skeletal dysplasia rickets tumour blounts disease physeal injury
what is blounts disease?
growth arrest of medial tibial physis
what does blounts disease show on x ray?
beak like protrusion
tumours that may present with genu valgum?
enchondroma
osteochondroma
conditions other than cancer that may be associated with genu valgum?
neurofibromatosis
rickets
when would you consider surgery in a child with genu valgum?
> 8cm intermalleolar distance
what is intoeing?
walking with toes pointed aka pigeon toed
possible causes of intoeing?
femoral neck anteversion
internal tibial torsion
metatarsus adductus
common clinical finding in femoral neck anteversion
patients can sit in W position
what ages is internal tibial torsion common in?
toddlers - 1-3 yrs
what should be done for internal tibial torsion
nothing, should resolve by itself by age 6
what is metatarsus adductus
foot slants medially
how common are flat feet?
1 in 5 adults have it
how to tell the difference between fixed flat feet and flexible flat feet?
if you raise the foot and you see an angle its flexible
which toes are most commonly affected by curly toes?
3rd and 4th
who is most likely to get anterior knee pain
teenage girls
why should the hips be checked in anterior knee pain?
hip problems can refer to the knee
