Lecture 30 Children’s Orthopaedics- Complex needs- CP, Talipes, Scoliosis Flashcards
Name the 6 complex exception needs
Learning and mental functions Communication Motor skills Self-care Hearing Vision
A child or young person (<19) is defined as having CEN if___
Severe impairment of at least 4 categories of with enteral/parenteral feeding
Severe impairment in at least 2 categories and ventilation/CPAP and impairments are sustained for more than 6 months
Name 6 examples of having CEN with orthopaedic involvement
Cerebral palsy Spina bifida Muscular dystrophy Anthrogryposis Neurofibromatosis Syndromes- Downs, Turners
Name prenatal causes of cerebral palsy
Placental insufficiency, toxaemia, smoking, alcohol, drugs, infection such as toxoplasmosis, rubella, CMV and type II HSV (TORCH)
Name perinatal causes of cerebral palsy
Prematurity, anoxic injuries, infections, kernicterus, haemolytic disease
Name postnatal causes of cerebral disease
Infection(CMV, rubella), head trauma
What is level 1 CP Classification GMFCS
Walks without limitation
What is level 2 CP Classification GMFCS
Walks with limitation
What is level 3 CP Classification GMFCS
Walks using a hand-held mobility device
What is level 4 CP Classification GMFCS
Self-mobility with limitations, may use powered mobility
What is level 5 CP Classification GMFCS
Transported in a manual wheelchair
What hip problems occur in Cerebral Palsy
Hip displacement in 1/3 by maturity
Painful and upsets sitting posture
What are the non-surgical managements of CP
Physiotherapy Seating Baclofen- oral Diazepam Botulinum toxin Baclofen intra-thecal (pump)
What are the surgical treatments of deformity in CP
Soft tissue release
Bone realignment
How is clubfoot surgically treated
Percutaneous tenotomy of Achilles tendon to allow dorsiflexion
