Orthopedics Flashcards
Normal oddities in peadiatric anatomy
Bow legs
knock knee
flat feet
what should you be concerned with crawling
When legs are moving differently. one can only rotating, hips may need adjusting.
Look when kids look like they want to walk but cant
what are gait affecting issues
Toe walk: see if can heel toe walk to rule out cerebral palsy
Anatomic kid problems
Club foot.
scoliosis
Congenital hip dislocation.
club foot treatment diagnosis
t weeks of birth
treatment: stretch, casts, brace, surgery
Scoliosis treatment
Abnormal lateral curverature of the spine: 10% have them.
monitor to ensure isn’t progression
congenital hip dislocation
Hip click chest on infant well child visit
ortalani maneuver
what is the Ortalani maneuver
Always do them one at a time!!!
flex thigh onto abdomen to right angle,
fully abduct to the side
should feel a cluck if is dislocated
what is the most common cause of limb pain in children
Trauma:
Causes of limb pain in trauma
- trauma
- growing pains
- infection
- arthritis
- JRA
- lyme disease
- other
ssx of growing pains
worse at night: halmark
bilateral
intermittent pain not signs of inflammation
Idiopathic
ssx of possible osteolyelitis
sudden-onset unilateral bone pain with fever
Fever
point tenderness, swelling
heat at site of infection
what should be done for hyperextensible extreamities
avoid activities that want you to be flexible.
ie gym
location of growing pain:
shins, feet, ankles, wrist theighs.
treatment
arnica or trammel gel near the bed.
Arnica homeopathic
Cal mag supplement at night
most common osteomyelitis
staph and strep most common cause
femur and tibia
septic arthritis ssx
ONE JOINT: looks slick inflammation of infected joint, mostly male, 2-6 fever, warm and swollen
JRA
MULTIPLE JOINTS: not as sick
one joint for minimum of 6 weeks
refer to rheumatologist
Lyme disease
Hx of rash and tick bite
osteochrondroses
Localized pain and tenderness
Osgood schlatter: apophysis of tibial tubercle
leg calve parthese: fadehemoral
Tumors
bone pain
unremitting worse at night
Slipped capital femoral epiphysis
painful limp loss of mobility
chondromalacia patellae.
localized knee pain with crepitis
softening of underside of patella
limp c
auses
Check from feet to lower back and look for trauma trauma inflammation inflection for fun
Nursemaids’s elbow/dislocated of radial head
- small children
- longitudinal pull while elbow is pronated
- kid wont use arm
Can move shoulder, will hit you if they
stabalize at elbow, hold wrist and supinate then and up palm of hand on shoulter
shoulder dislocation
teens/ athletes
Refer
PE for trauma
ROM, can they sleep
X ray refer
ER if cant bear weight, abnormal ROM, can’t sleep, or visable bone deformity or severe swelling in 30 min
trama treatment if not fracture
arnica
RICE
analgesics
excuse from PE
