Miscellaneous Pediatric Orthopedic Conditions19.1+ Pediatric Hip Conditions 19.2

Question 1

What is the treatment modality for a child <6 m with femoral shaft fracture?

Answer 1

Pavlik harness or

Hip spica

Question 2

Treatment of child 7m - 5 yrs femoral shaft fracture

Answer 2

Hip spica or
ORIF with plate and screws
External fixator
Flexible nail

Question 3

Treatment of child 6 - 11 yrs with femoral shaft fracture

Answer 3

ORIF with plate and screws
Flexible nails
External fixator

Question 4

Treatment of child >11 yrs with femoral shaft fracture

Answer 4

ORIF with olate and screws
Flexible nail
Intramedullary nail

Question 5

What is the management of Talipes equinovarus

Answer 5

Serial casting (ponseti technique)
Soft tiasue procedures (tenotomies, tendon transfer)

Question 6

According to Salter Harris classification of fractures of distal ends of long bones;
Describe Type 1 fracture

Answer 6

Through growth plate (growth plate is intact)

Question 7

Describe type 2 salter harris class of fracture

Answer 7

Through growth plate and metaphysis (growth plate intact)

Question 8

Desribe type 3 fracture of salter harris classification

Answer 8

Through growth plate and epiphysis (growth plate cut)

Question 9

Describe Type 4 fracture in salter harris classification of fractures

Answer 9

Through all 3 elements (epiphysis, growth plate cut, metaphysis)

Question 10

Describe type 5 fracture in slater harris classification of fractures

Answer 10

Growth plate crushed

Question 11

What is the most common pediatric fracture

Answer 11

Supracondylar humerus fracture

Question 12

Management of supracondylar humerus fracture

Answer 12

• Non-displaced fractures
• Conservative in a back splint
with close follow up
• Displaced fractures
• Emergency closed vs open
reduction and k.wire fixation

Question 13

What is osgood schlatter disease?

Answer 13

Inflammatory apophysitis of the tibial tubercle due to repetitive microtensile trauma (beynot keter)

Question 14

Management of osgood schlatter disease

Answer 14

• Reassurance
• NSAIDs
• Ice
• Withhold sport activities until condition subsides
• Patellar tendon strap

Question 15

In Developmental dysplasia of the hip(DDH) what is the primary modality of imaging from birth to 4 m age

Answer 15

Ultrasound

Question 16

What is the primary imaging modality in developmental dysplasia of the hip in age >4 m of age?

Answer 16

XRay

Question 17

Management of developmental dysplasia of the hip

Answer 17

• Non operative
• Pavlik harness ( <6 months )
• Closed reduction + hip spica (6-18 months)
• Operative
• Open reduction + hip spica (> 18 months )
• Open reduction + femoral osteotomy
or pelvic osteotomy or both

Question 18

What is the sign in xray of SUFE (slipped upper femoral epiphysis?

Answer 18

Melting ice cream cone sign

Question 19

Management of SUFE (slipped upper femoral epiphysis)

Answer 19

No role for operation but Percutaneous in-situ fixation might be done
• Contralateral prophylactic fixation

Question 20

What is the pathology of Developmental dysplasia of the hip

Answer 20

Defective shallow acetabulum (dysplasia)
• Coxa valga (wide angle)
• Soft tissue interposition in acetabulum (pulvinar

Question 21

Management of irritable hip (sinovitis)

Answer 21

Must exclude septic arthritis then Reassurance
• Close observation
• NSAID’s
• Activity modification / rest
• Treat the cause