Congenital And Developmental Conditions Flashcards
What is the dominant feature of Developmental Dysplasia of the Hip (DDH)? What is the consequence of this feature?
The dominant feature of Developmental Dysplasia of the Hip (DDH) is capsular laxity, resulting in a loss of the tight fit between the femoral head and acetabulum. Consequently, the hip becomes unstable, allowing the femoral head to slide in and out of the acetabulum.
Describe the Barlow and Ortolani maneuvers used to diagnose DDH in newborns.
The Barlow maneuver involves adducting the hip while applying posterior pressure on the knee, attempting to dislocate the femoral head from the acetabulum. The Ortolani maneuver involves abducting the hip while applying anterior pressure on the femur, attempting to reduce a dislocated hip back into the acetabulum.
Explain the primary aim of treatment for DDH.
The primary aim of treatment for DDH is to reduce the hip and maintain its reduction to provide an optimal environment for the proper development of the femoral head and acetabulum.
Differentiate between coxa vara and coxa valga in terms of neck-shaft angle and effects.
Coxa vara refers to a neck-shaft angle of the femur less than the normal range (125°-139°), leading to limb shortening and weakness of hip abductors. Coxa valga, on the other hand, is characterized by a neck-shaft angle greater than the normal range, often resulting in leg length discrepancy (LLD).
What is Perthes disease, and what age group does it typically affect?
Perthes disease is a condition characterized by avascular necrosis of the femoral head, leading to its disintegration, deformity, and limb shortening. It most commonly affects boys between the ages of 5 and 10.
Describe the typical presentation of recurrent dislocation of the patella, including the direction of dislocation.
Recurrent dislocation of the patella typically presents with the patella dislocating laterally. Patients often complain of their knee locking in flexion, accompanied by severe pain. This condition is more common in adolescent girls.
Explain the developmental progression of genu valgum in children and when surgical intervention might be considered.
Many children present with genu valgum (knock-knees) when they first start walking. This typically corrects spontaneously by the age of 6, unless there is an underlying cause like rickets. In rare cases, it can persist or begin later. Surgical correction may be considered if it hasn’t resolved by 11 or 12 years of age.
What is Blount’s disease, and how does it affect the lower limb? What is the main treatment approach?
Blount’s disease, also known as tibia vara, is a developmental defect in the upper part of the medial tibial epiphysis, leading to a progressive bow-leg deformity. It can be unilateral or bilateral. The main treatment approach is osteotomy of the upper end of the tibia, which may need to be repeated during growth.
Describe the appearance of a foot with talipes calcaneovalgus. What is the suspected cause of this deformity?
A foot with talipes calcaneovalgus presents with marked dorsiflexion at the ankle joint and eversion at the subtalar joint. The dorsum of the foot often touches the anterior shin. This deformity is thought to be caused by intrauterine malposition or molding.
What are the three main deformities seen in congenital talipes equinovarus (clubfoot)?
The three main deformities seen in congenital talipes equinovarus (clubfoot) are: 1) equinus and inversion of the hindfoot, 2) plantarflexion of the forefoot on the hindfoot, and 3) adduction of the forefoot on the midfoot (the sole of the foot pointing medially or even upwards).
