Childrens orthopaedics - congenital and neuromuscular conditions - 30/10/18 Flashcards
What are some congenital orthopaedic conditions?
CLubfoot
Rocker bottom foot
Neurofibromatosis
Skeletal dysplasia
What are some neuromuscular conditions?
Cerebral palsy
Tip toe walking
Duchenne muscular dystrophy
High arch
What are the features of clubfoot?
Cavus
Adductus
Varus
Equinus
What are the characteristics of clubfoot?
Birth defect Boys Idiopathic Assoc with Myelomeningocoele Dwarfism Tibial hemimelia
How is clubfoot treated?
Ponseti casting
What is rocker bottom feet?
Irreducible dislocation of talus on navicular
Round plantar surface
Equinus hindfoot
What is neurofibromatosis?
COngenital Extremities Spine Sking NF1 most common AD NF1 gene Chromosome 17
What is the diagnostic criteria for NF?
> cafe au lait spots > 2 neurofibromas Freckling axilla Optical glioma >2 lisch nodules Cortical thinning First degree relative affected
What are skeletal dysplasias?
Dwarfism
Shortening of involved bone
Short stature
What is the most common form of skeletal dysplasia?
Achondroplasia FGFR3 AS Normal trunk Frontal bossing Genu varus Normal intelligence Motor delay
What is cerebral palsy?
Non progressive neuromuscular disorder Injury to immature brain Prematurity Perinatal Features UMN Early - abnormal muscle forces Late - Contractures/Fixed deformity/dislocation
What are some cerebral palsy treatments?
Benzodiazepines Baclofen Selective dorsal rhizotomy Botulinum Toxin
DMD
Commonest MD Only Boys Inherited Progressive muscle weakness Absdence dystrophin protein Replacement of muscle with fibrofatty tissue Presentation 2-5 years Keep abulatory Decrease contractures
What are the features of DMD?
Muscle weakness Clumsy walking Positive gowers sign Scoliosis Diagnosis CPK/muscle biopsy Poor prognosis
WHat is cavus foot?
Elevated longitudinal arch and varus hindfoot