Congenital and Neuromuscular conditions (PAEDS)

Question 1

What are some neuromuscular conditions that orthopaedics are involved in

Answer 1

Cerebral palsy (walking and non walking)
Tip toe walking
Duchenne Muscular Dystrophy
Caves Foot

Question 2

Boys are more likely to have clubfoot than girls. True or False

Answer 2

True

Question 3

Clubfoot is always bilateral. True or False

Answer 3

False there is a 50% chance of this

Question 4

What is the treatment for clubfoot?

Answer 4

Plaster casting and then splints every night until their fourth birthday

Question 5

Is club foot supination or pronation

Answer 5

Supination

Question 6

How many different types of skeletal dysplasia are there?

Answer 6

> 200

Question 7

What is the commonest form of dwarfism

Answer 7

Achondroplasia

Question 8

What are some of the primary problems caused by cerebral palsy

Answer 8

Loss of selective motor control
injury to normal balance mechanisms
Abnormal tone

Question 9

What are some of the secondary problems caused by cerebral palsy

Answer 9

Muscle contractures
deformity of bone
scoliosis
Hip subluxations

Arise indirectly with time and growth because of the neurological injury

Question 10

What causes spasticity

Answer 10

When there is confusion between nerves from muscles and CNS. You can get cocontraction where 2 muscle groups are contracting at the same time

Question 11

Why do we treat spasticity

Answer 11

It causes pain
inhibits muscle growth and increases the risk of fixed contractors
Puts joints at risk of dislocation

Question 12

What does the GMFCS allow us to do?

Answer 12

Risk assess the patient and decide who we should operate on and who we shouldn’t
Those with levels 4 and 5 still have a high risk of dislocation despite the fact they may be bed bound or chair bound

Question 13

How can we help a walking child with cerebral palsy

Answer 13

Botox A
Splints / Orthotics
Physio
Surgery

Question 14

If a child is still tip toe walking after the age of 3, what might this be a sign of ?

Answer 14

Cerebral Palsy

Question 15

How can we help a child that tip toe walks

Answer 15

Physio and observation
Splinting / casting
Botox
Surgery

Question 16

What type of condition is DMD

Answer 16

X linked recessive disease

Question 17

At what age do patients with DMD present?

Answer 17

Between 2 and 5 years

Question 18

What are some signs of Cavus Feet

Answer 18

Sensate 
Clawed toes 
Parents feet 
Neuromuscular 
Progressive