Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Orthobullets > OITE - Pediatrics > Flashcards

OITE - Pediatrics Flashcards

1
Q

Distal humeral physeal separation, suspicious for what?

A

-Child abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Xray finding of distal humeral physeal seperation

A
  • Radius ulna maintain normal relationship
  • radius still lines up with capitellum
  • but distal humerus metaphysis is disconnected from rad+ulna
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define sequestrum

A

Nidus of residual necrotic infected bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Osteomyelitis organisms, most common?

A
  • Staph aureus (most common)
  • Kingella kingae (culture it longer in CO2 rich medium)
  • GBS in neonates
  • Salmonella (g-ve), in sickle cell, -H influenza (if not vx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Involucrum?

A

New bone formed by elevated periosteum (in an effort to wall off infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long do xrays remain normal, in context of osteomyelitis

A

Upto first 2 weeks (7-10 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 lab markers for osteo?

A
  • CRP peaks and normalizes earlier (track short term response)
  • ESR requires 3 weeks to normalize (track long term abx tx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clubfoot aka ?

A

Congenital talipes equinovarus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clubfoot position?

A

Hindfoot - equinovarus
Forefoot - supination, adductus
Midfoot - cavus
CAVE (cavus, adductus, varus, equinus) - order of ponsetti correction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is achilles tenotomy done in ponseti method?

A

At 6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How long are Denis-Brown bars used for ?

A

2-4 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is tib ant transfer needed? Prevalence?

A
  • Residual recurrent forefoot supination after 2 years
  • 10 to 30%
  • must have a flexible deformity, and competent tib ant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Late deformities associated with clubfoot surgery?

A

Undercorrection/recurrence - medial spin, intoeing
Overcorrection - flatfoot, hindfoot valgus, calcaneus gait (weak gastroc/soleus)
AVN - (talus), -Dorsal bunion (injury to peroneus longus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are length unstable femur fx (in school age children)?

A
  • Comminution

- Large oblique fx pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to tx length unstable femur fx.

A
  • ORIF
  • Submuscular bridge plating
  • Ex fix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What fx pattern is most commonly associated with a pediatric elbow dislocation?

A
  • Medial epicondylar fx (rate of 50%)
  • Due to avulsion of flex-pronator wad
  • ulnar nerve may be entrapped (within joint, after reduction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What radiographic view will demonstrate max degree of fx displacement, if suspecting lateral condyle fx?

A
  • Internal rotation oblique view

- MRI arthrogram can be useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does non-union of lat condyle fx result in?

A

Cubitus valgus –> and ulnar neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where should you avoid dissection in ORIF of lat condyle fx

A

Posterolateral dissection should be avoided (can compromise blood supply)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Infantile Blount’s Disease?

A
  • Progressing worsening genu varum
  • Metaphyseal diaphyseal angle > 13 deg
  • Onset prior to 3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Surgical tx for infantile blounts?

A
  • Langenskiold stage 3 or more
  • Failure of bracing
  • Best result if prox tib fib osteotomy done before age of 4
  • Plan for prophylactic fasciotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Distal femoral physeal injury is more common than ligamentous knee injury in peds, due to what?

A

Epiphyseal ligament insertions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Rate of physeal arrest in Distal femoral physeal injury?

A

30-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to treat physeal arrest in dist fem physeal fx?

A
  • Partial arrest - bar resection if 2cm growth remaining. (PMMA interposition to occupy space left)
  • If >50% involvement, perform ipsilatearl completion of arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do you ascertain degree of interosseous mold of a cast, in context of DR fx?
Look at Cast Index = (sag width / coronal width) | Want CI
26
Name 7 characteristic UE deformities in cerebral palsy
- Shoulder IR, Elbow flexion, Forearm pronation - Wrist flexion, wrist ulnar deviation - Thumb in palm - Finger swan neck
27
Name 2 reasons to tx UE CP contracture
1-hygeine (antecubital fossa, wrist + hand) | 2- improve function
28
When would you consider PSF for scoliosis of Duchenne Muscular Dystrophy
PSF for curves progressing > 25 to 30 | Operate early, as it is better tolerated
29
Hallmarks of DMD ?
- Decreased motor skills - Gower's sign (proximal muscle weakness, from sit to stand) - Calf pseudohypertrophy - Markedly Elevated CPK
30
Distal humeral physeal seperation
- Posteromedial displacement of rad/ulna shafts to distal humerus - difficult to diagnose (arthrogram), -children
31
Flexible flatfoot (pes planovalgus)?
- Low medial arch, valgus heel, and forefoot abduction | - NORMAL subtalar motion, no heel cord contracture
32
Surgical tx for flexible pes planovalgus?
- Calcaneal neck lengthening osteotomy (most common) - Lengthen achilles tendon - possible Medial cuneiform osteotomy
33
Acceptable angulation and rotation in BBFA?
10 angulation 10, rotation 30 (shaft) | Dorsal angulation 30 deg (10 yo)
34
Legg-Calve-Perthes Disease (coxa plana)?
Boys 4:1 Lateral pillar classification has significant prognostic value -early fragmentation phase (best time) -approx 6 months onset of symptoms
35
What is the lateral pillar classification for Legg-Calv-Perthes?
A - none B - 50% loss of height C - >50% loss of height
36
Sprengel's deformity?
- Failure of scapular descent (high small scapula) - Assoc with Klippel feil - Diminished ABDUCTION is most affected function
37
Posteromedial tibial bowing can be associated with what other manifestation?
- assoc with calcaneovalgus foot - often resolves spontaneously - 2-5cm LLD at maturity
38
Lysosomal storage diseases, all have an increased risk for what?
Carpal tunnel syndrome
39
Vertical talus other names ?
Talipes equinovalgus Congenital convex pes valgus -p/w rocker bottom feet
40
Xray findings on lateral plantar flexion view, for vertical talus?
- Talus not in line with metatarsals | - Navicular dorsally dislocated
41
What is the genetic cause of dwarfism characterized by hitch-hikers thumb, cauliflower ears, and severe clubfeet?
``` Diastrophic dysplasia (ARecessive, twisted dwarf) -Sulfate transport protein ```
42
Marfan's is an AD disorder with defective gene encoding?
Fibrillin
43
Most common cause of peroneal spastic flatfoot?
- Calcaneonavicular coalition | - commonly presents as recurrent ankle sprains
44
Tarsal coalition surgical tx?
50% joint involvement -- Arthrodesis
45
Initial tx of spastic flat foot?
Casting
46
In Monteggia fx, want to close reduce and immobilize how?
- Hyperflexion (110 deg) and supination | - relaxes biceps and TIGHTENS IOM
47
When would you order an endocrine workup for SCFE
If child less than 10 years old | Pin bilateral if there is endocrine etiology
48
SCFE has a fx through what zone?
Hypertrophic zone
49
What position is the neck displaced in SCFE?
Neck displaced anteriorly | Neck externally rotated
50
What measure is used to determine radiographic severity of the epiphyseal slip, in order to guide treatment?
Southwick Severity Angle (epiphyseal-shaft angle difference) | Mild 50
51
Which 2 lines are used to divide hip into 4 quadrants, in DDH?
Hilgenreiner and Perkins | head is above H, and lateral to P
52
When does proximal femur ossific nucleus appear on xray?
6 months of age
53
Neurofibromatosis is associated with all of the following what?
Cafe au lait spots (smooth borders) Hemihypertrophy Scoliosis Pseudoarthrosis (anterolateral bowing)
54
What lesion is hallmark and pathognmemonic for neurofibromatosis?
Plexiform neurofibromas
55
What is the most common skeletal dysplasia?
Achondroplasia | FGFR-3
56
Features of Dwarfism?
Rhizomelic limb shortening Frontal bossing Spinal stenosis Champagne pelvis
57
Osteogenesis imperfecta associated with residue substitution?
Glycine substitution in procollagen molecule
58
Charcot Marie Tooth Disease, aka?
Peroneal muscular atrophy
59
Charcot Marie Tooth Disease, is AD. What are its features?
Cavus feet Hammer toes Motor deficits (tib ant, peron brevis, intrinsics foot and hand)
60
Myelodysplasia (myelomeningocele, spina bifida). What is the most common level involved? Results most often in what dislocation?
L3/L4 Hip dislocations (tx if L4 or L5 level) --L3 levels and higher have poor results with recon maneuvers
61
Osteopetrosis?
- AR - Failure of osteoclast to remodel (carbonic anhydrase dysfuncn) - High mortality rate (tx with bone marrow transplant)
62
Arithmetic method about LE growth?
Prox femur 3mm / yr Distal femux 10mm / yr Prox tibia 6mm / yr Distal tibia 5mm / yr
63
According to arithmetic method, when is growth cessation in boys and girls?
Boys 16 yo | Girls 14 yo
64
Accessory navicular first line tx?
- Non op | - Excision after 6 mo of non-op attempts
65
In tibial tubercle fx, injury to what artery most likely causes compartment syndrome?
Anterior tibial recurrent artery
66
What is cavocarus foot?
- Elevation of medial arch from relative forefoot equinus | - Spasticity of contracted plantar fascia + weak Tib Ant
67
In in toe-ing, what are the 4 measurements for rotational profile?
- FPA (foot progression angle) - Hip rotation (for femoral anteversion) - Thigh foot angle and transmalleolar axis (tibial torsion - Heel bisector (measure for metatarsus adductus)
68
Another name for Toddler's fracture of the tibia?
CAST - childhood accidental spiral tibial fx
69
Best predictors of septic hip, in order, are what?
- Fever > 101.3 - CRP >2.0 -ESR > 40 - Inability to bear weight - WBC > 12,000
70
Which joints have an intra-articular metaphysis (and are therefore more at risk for osteomyelitis)?
hip, shoulder, elbow, ankle
71
Most common cause of septic arthritis in adolesecents?
N. gonorrhea
72
Prognosis for spont recovery for involved arm after obstetrical brachial plexopathy? After Horner's?
90% will resolve | Horner's
73
Erb's palsy?
C5-6
74
Klumpkes palsy?
C8-T1
75
When is early surgery in obstetric brachial plexopathy indicated?
Early sgx - complete flail arm or Horners | Later sgx - Tendon transfer or osteotomy
76
How do you treat radial neck fx.
less than 30 deg angulation - immobilize >30 deg angulation - Closed reduction >30-60 -- open reduction
77
Bone growth in humerus ratio?
80/20 prox/distal
78
Order of appearance of elbow growth centres?
CRITOE | 1 -3 - 5 - 7 - 9 -11
79
Order of closure of elbow growth centres?
CTE -R-O-I | 12,12,12 - 15-15-17
80
Ortho manifestation of sickle cell disease?
- Osteomyelitis, septic arthritis - Dactylitis (acute hand and foot swelling) - Osteonecrosis, bone infracts - Growth retardation
81
What injuries and fx pattern are suspicious for child abuse?
- Corner fx - Fx in non-walker (long bone) - multiple fx in various stages of healing - bruises of different ages

Orthobullets (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions