Ortho Flashcards
What is AMC (Arthrogryposis multiplex congenita)
causes permanent tightening of muscles, skin, and tendons
causes severe weakness
What are the unique signs of AMC
pterygium- a triangular membrane of shortened skin and other tissues on the back of the leg
T or F: is surgery indicated for infants with AMC?
no
What is RED-S
Some combination of problems w/
metabolic rate
menstral function
bone health
immunity
protein synthesis
and cardiovascular health
common amongst adolescent athletes that emphasis lower body weight
T or F: RED-S includes males
T
Who is at high risk of RED-S
recommendation for sports:
- Anorexia or other eating disorders
- extreme weight loss
- medical disorders that cause low energy
Recommendation: no competition, supervised training allowed if medically cleared
Who is at medium risk of RED-S
What is the recommendation for sports?
- prolonged atypical bodyfat
- substantial weight loss
- reduced BMD
- Abnormal menstral function
- disordered eating behaviors
Recommendation: may compete once medically cleared under supervision
Who should be screened for RED-S
patients who have recurrent injuries (stress fractures)
If you see sudden onset of limping in an adolescent, you must rule out what conditions
SCFE(slipped capital femoral epiphysis) and LCP(leg calve perthes)
SCFE presents with
most common in males 10-16
A loss of hip ROM (IR and Adduction) (also possible to only complain of knee pain)
Emergency situation! Need radiograph or MRI
What artery is involved in Leg Calve Perthes
Medial circumflex artery
In LCP what is typically limited
IR and ABDUCTION
compared to SCFE: IR and ADDuction
How will LCP typically present?
Child 3-12 with history of limping OR trendelenburg gait and hip pain
Cam vs Pincer impingement
Cam- enlarged femoral head
Pincer- Enlarged acetabulum
What is the typical sign of FAI
C - sign
antero-lateral hip pain
What are the signs of medial tibial stress syndrome
Female athlete doing too much too fast
Impaired flexibility of gastroc/soleus
pain with running
ACL injury is most common in
female athletes
What condition are these signs and symptoms of?
- AL hip pain
- pain with Hip flexion & IR
- short hip flexors
- (+) FADIR and/or FABER
- Trendelenburg Sign
FAI
What is the important pediatric consideration for ACL reconstruction?
Growth Plates
* are the weakest part of the bone
* and directly in path of where surgical holes would be drilled
* reconstruction srugery can potentially injure the physis
ACL Post-Op Precautions
- be sure pt and parent understand post-op protocol
- monitor activities
- prevent anterior knee shear force on tib-fem joint on graft
- progress pt as per surgeon’s post-op protocol
- consider RTS testing or assessment
What is a precaution of PCS?
avoid overstimulation during rehab that may trigger a headache, dizziness or nausea and may delay recovery
What is a complication of PCS?
pre-existing conditions of anxiety or depression, eye alignment issues (amblyopia), learning disabilities, ADHD, hx of migraines
What are the 4 patient severity outcome measures for PCS?
- Verbal Rating Scale for ranking of symptoms
- PCSS: Post concussion symptom scale
- ImPACT
- DHI: Dizziness Handicap Inventory
What does VOMS screen for?
- smooth pursuit
- hor/vert saccades
- near point of convergence distance
- horizontal VOR
- visual and motion sensitivity
Define PCS
persistent symptoms beyond 7-10 day time recovery
- includes 3+ of the following symptoms: fatigue, sleep disturbance, headache, dizziness, concentration difficulty, and memory difficulties
For PCS we treat based on symptom severity. Sx are allowed to increase ___ points on VRS & should recover with a brief rest before beginning the next exercise
2 points
What are the PCS symptoms?
- somatic
- cognitive
- sleep disturbances
- mood disruptions
- functional deficits
- altered cerebellar, oculomotor, and vestibular function
- cervical muscular weakness or flexibility impairments
