Children's Orthopaedics: Normal Growth and Development

Question 1

Appositional Bone Growth

Answer 1

Outward bone growth causing increases in bone thickness

Question 2

Factors affecting bone growth

Answer 2

Vitamin D and A
Diet
Injury
Illness
Hormones

Question 3

Genu Varum

Answer 3

Outward knee movement

Normal: <2 years

Question 4

Genu Varum Abnormal

Answer 4

> 16 degrees from mean
Short. stature
Painful

Question 5

Genu varum aetiology

Answer 5

Skeletal dysplasia 
RIckets
Tumours 
Blounts disease (growth arrest of the proximal medial tibial physio- beaks like protrusion on X-ray) 
Trauma

Question 6

Genu Valgum

Answer 6

Inward movement of knees

Normal- ~3.5 years

Question 7

Genu Valgum abnormal

Answer 7

Asymmetrical
>2 standard deviation from mean
Painful

Question 8

Genu Valgum aetiology

Answer 8

Tumours
RIckets
Neurofibromatosis
Idiopathic

Question 9

Intoeing Associations

Answer 9

Femoral neck anteversion Internal tibial torsion

metatarsus adducts

Question 10

Femoral neck anteversion

Answer 10

Can predispose to patellofemoral problems

Usually of no consequence

Femoral neck points anteriorly

Question 11

internal tibial torsion

Answer 11

Affects toddlers

Most resolve by 6 years

Treatment: Surgery

Question 12

Metatarsus Adductus

Answer 12

Metatarsals are adducted

benign

Common

Self-limiting

Treatment: Serial casting

Question 13

Pes Planes

Answer 13

Flat foot

Question 14

Pes Plans aetiology

Answer 14

Normal as the medial arch will develop as the posterior tibias strengthens

ligamentous laxity

Tightness of the gastrocnemius complex

Tarsal coalition (fixed)

Question 15

Pes Planes types

Answer 15

Fixed

Flexible (returns to normal on tip toes)

Question 16

Pes Plans treatment

Answer 16

Surgery when painful

Question 17

Curly toes

Answer 17

Most commonly affects 3rd or 4th toes

Question 18

Curly toes treatment

Answer 18

if severe or not resolved after 6 years

- Flexor tendonotomy

Question 19

Anterior knee pain epidemiology

Answer 19

Adolescents

Question 20

Anterior knee pain predisposes to

Answer 20

Arthritis posterior to the patella

Question 21

Anterior knee pain exacerbations

Answer 21

Squats

Stairs

Question 22

Anterior knee pain treatment

Answer 22

Physiotherapy