orthopaedic paediatrics Flashcards
when would you do spinal fusion on a child ?
cobb angle >45 degrees
11-13 years old
what is fused during spinal fusion surgery?
T2 fused to pelvis
what does normal motion depend on
-an appropriate adequate force acting via a rigid lever of appropriate length on a stable joint
what are some features of a normal gait?
- stability in stance
- clearance in swing
- pre position of foot in terminal swing
- adequate step length
what 3 types of scoliosis are there?
infantile <3
juvenile 3-10
adolescent 11-18
how do long bones grow?
from the physes- increase in length
how do long bones grow?
from the physes- increase in length
what zones does the physes consist of?
- hypertrophic zone
- proliferative zone
- reserver zone
what is required for bone growth?
- good diet
- sunshine
- vitamins
- growth plates
- hormones
how to assess growth?
- growth chart
- menalaus chart
- moseley chart
- look at lower limb
what is normal variation is babies knees?
start - varus
end up- valgus
then have normal knees
what suggests infection/being unwell in the bone?
Harris lines
what is a type 1 fracture?
goes through growth plate
diastrophic meaning
bent/curve
what does a higher GMFC mean?
-higher risk of dislocation
what can tiptoe walking suggest?
- autism
- congenital tightness of muscle
- problem with CNS or PNS system
what is this?
clubfeet/ CTEV
what is CTEV?
Congenital deformity of foot causing feet to turn in (varus) due to in utero abnormal alignment of joint between talus, calcaneus and navicular
who is clubfoot/ congenital talipes equinovarus more common in?
- babies in breech position
- oligohydramnio (low amniotic fluid content)
- boys 2x more affected than girls
what is the treatment for early clubfoot?
Ponsetti technique (early splinatge)
- held in cast with 5 or 6 weekly changes
- 80% require tenotomy of achilles to maintain correction
- once correction achieved , child placed in brace consisting of boots attached to bar which worn 23 hours a day for 3 months and used during sleep until age 3-4
what is SUFE (slipped upper femoral epiphysis)?
A condition where the femoral head epiphysis slips inferiorly in relation to femoral neck
what causes slipped upper femoral epithysis (SUFE)?
The cause is not fully understood
-growth plate (physis) not strong enough to support body weight
who is more likely to experience slipped upper femoral epithysis (SUFE)?
- Linked to hypothyroidism or renal disease
- More common in boys
- More common if overweight
- 10-16 yo
how does SUFE present?
1/3 cases are bilateral
- Pain and limp
- limited movement
- externally rotated foot
- pain in knee, hip or groin (due to obturator nerve supplying both hip and knee)
- loss of internal rotation of hip
