Orthopedic Surgery Flashcards
Child with uneven gluteal folds. Physical exam of hips reveals that one can be easily dislocated posteriorly with a jerk and a click and return to normal position with a snapping. What is it? How do you diagnose? Management.
Developmental dysplasia of the hip. Congenital dislocation of the hip.
Physical exam.
Abduction splinting with Pavlik harness
Nerve at risk for injury in Colle’s fracture
Colles fracture may occur when falling on outstretched arm and may injure MEDIAN nerve.
Six-year-old boy has insidious development of limping with decreased hip motion. He complains occasionally of knee pain on that side. He walks into the office with an antalgic gait. Passive motion of the hip is guarded. What is it? Management.
Legg-Perthes disease– Avascular necrosis of the capital femoral epiphysis.
AP and lateral x-rays for diagnosis. Contain the femoral head within the acetabulum by casting and crutches
A 13-year-old obese boy complains of pain in the groin and is noted by the family to be limping. He sits in the office so if his foot on the affected side pointing toward the other foot. Physical exam is normal for the knee, but shows limited hip motion. As the hip is flexed, the leg goes into Extertal rotation and cannot be rotated internally. What is it? Management.
Slipped capital femoral epiphysis. An orthopedic emergency.
AP and lateral x-rays for diagnosis. The orthopedic surgeons will pin the femoral head in place.
A little toddler has a febrile illness. Disorder of the hip. What is it?
Septic hip.
Aspirate and drain. This is a surgical emergency!
Hip problem in a six year old.
Avascular necrosis.
Hip problem at around the age of 13, male, chubby, or tall and lanky.
Slipped capital femoral epiphysis
Disorder of the hip in a newborn?
Developmental dysplasia of the hip. Congenital dislocation of the hip.
A child with a febrile illness but no history of trauma has persistent, severe localized pain in a bone. What is it? Management.
Acute hematogenous osteomyelitis.
X-ray will not show anything for two weeks. MRI is diagnostic. Then antibiotics.
Genu varum
Bow leg, normal up to Age 3
Genu valgus
Knock knee.
Normal between the age of 4–8.
Varum deformity or bowlegs persists beyond its normal age range, beyond age of three
Blount disease – Disturbance of the medial proximal tibial growth plate. Surgery.
Persistent pain right over the tibial tubercle aggravated by contraction of the quadriceps. Localized tenderness over the tibial tubercle on physical exam. What is it? Treatment?
Osgood-schlatter disease – osteochondrosis of the tibial tubercle.
Treated with immobilization of the knee and an extension or cylinder cast for 4 to 6 weeks.
Baby boy born with both feet turned inward. Inversion of the foot. What is it? Treatment
Club foot – Talipes equinovarus
Treatment needs serial plaster casts started in the neonatal period. Those require surgery are operated on after the age of 6 to 8 months, but before 1 to 2 years of age.
16-year-old boy complains of low grade but constant pain in the distal femur present for several months. X-rays show a large bone tumor breaking through the cortex into the adjacent soft tissue and exhibiting a “Sunburst” pattern.
What is it?
Which ages is this commonly seen in?
Where does it commonly occur?
Osteogenic sarcoma – The most common primary malignant bone tumor.
Seen in ages 10 to 25 and usually occurs around the knee – lower femur or upper tibia
