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year 2 - musculoskeletal > paediatric orthopaedics > Flashcards

paediatric orthopaedics Flashcards

1
Q

developmental dysplasia of the hip risk factors

A
  • first born
  • female
  • breech position
  • family history
  • increased birth weight
  • having other congenital disorders
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2
Q

developmental dysplasia of the hip pathophysiology

A
  • occurs when there is dislocation and subluxation of the femoral head from the acetabulum during the prenatal period
  • failure to maintain close apposition of the components of the hip joint will result in a shallow acetabulum, altered biomechanics, one limb being shorter than the other and ultimately accelerated osteoarthritis of the affect hip
  • more common in left hip
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3
Q

developmental dysplasia of the hip presentation

A
  • limb shortening
  • asymmetric groin
  • asymmetric skin folds of groin
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4
Q

in developmental dysplasia of the hip ultrasound if

A
  • first degree family history of hip problems in early life
  • breech at or after 36 weeks
  • multiple pregnancy
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5
Q

what is Ortolani test

A
  • abduction and pressing the hip anteriorly
  • positive test if clunking sound is heard due to relocation of the femoral head into the acetabulum
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6
Q

what is Barlow’s test

A
  • adduction and pressing leg posteriorly
  • positive test if clicking sound heard due to dislocation of the femoral head
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7
Q

developmental dysplasia of the hip diagnosis

A
  • ultrasound
  • if child if > 4.5 months –> x-ray
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8
Q

developmental dysplasia of the hip management 0-6 months

A

Pavlik’s harness for 3 months

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9
Q

developmental dysplasia of the hip management 6-18 months

A

closed reduction and 3 month hip spica cast

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10
Q

developmental dysplasia of the hip management > 18 months

A

open reduction and femoral osteotomy

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11
Q

transient synovitis is most common in

A

boys aged 2-10

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12
Q

transient synovitis causes

A

most commonly following on from respiratory viral infection

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13
Q

what is transient synovitis

A

self limiting inflammation of the synovium of the hip joint

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14
Q

transient synovitis presentation

A
  • limp
  • reluctance to weight bear
  • restricted range of movement
  • low grade fever
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15
Q

transient synovitis diagnosis

A
  • exclusion
  • rule out septic arthritis by doing bloods and cultures
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16
Q

transient synovitis management

A

NSAIDs, rest and review

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17
Q

Perthes disease is most common in

A

short, active boys 4-9 years old

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18
Q

what is Perthes disease

A
  • idiopathic osteochondritis of the femoral head
  • results in transient loss of blood supply to the femoral head and eventually avascular necrosis and abnormal growth
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19
Q

Perthes presentation

A
  • limp
  • pain in hip/knee
  • usually unilateral
  • loss of internal rotation
  • loss of abduction
  • Trendelenburg gait
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20
Q

Perthes diagnosis

A
  • x-ray showing joint space widening, decreased size of femoral head, collapse and deformity of the femoral head
  • if x-ray if normal then MRI
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21
Q

Perthes management

A
  • bed rest, analgesia, avoidance of exercise and regular monitoring
  • osteotomy (only indicated if severe subluxation and deformity of the femoral head)
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22
Q

slipped upper femoral epiphysis is most common in

A

obese boys aged 10-16

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23
Q

what is slipped upper femoral epiphysis

A

femoral head epiphysis slips inferiorly from neck of femur

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24
Q

slipped upper femoral epiphysis presentation

A
  • limp
  • pain (hip, anterior thigh, knee)
  • unable to weight bear
25
Q

slipped upper femoral epiphysis management

A

surgical stabilisation of the epiphysis (internal fixation)

26
Q

genu varum causes

A
  • Rickets
  • trauma
  • osteochondroma
27
Q

what is genu varum

A
  • pathological amount of varus in the tibia and fibula –> bow legs
  • normally resolves by 4
28
Q

genu valgum causes

A
  • idiopathic
  • trauma
  • enchondroma
29
Q

what is genu valgum

A
  • normal legs have small degree of valgus
  • pathological amount of valgus in the tibia and fibula –> knock knees
30
Q

patellofemoral dysfunction is most common in

A

adolescent girls

31
Q

patellofemoral pain disorder is most common in

A

athletes (especially those with recent increase in activity/experiences recent trauma)

32
Q

patellofemoral pain disorder presentation

A

anterior knee pain on walking up the stairs or after prolonged periods of sitting

33
Q

patellofemoral pain disorder management

A

rest, analgesia and physiotherapy

34
Q

Osgood Schlatter disease is most common in

A

boys aged 10-15 years old

35
Q

what is Osgood Schlatter disease

A

inflammation of the tibial tuberosity, which is the site of attachment of the patella ligament

36
Q

Osgood Schlatter disease presentation

A
  • knee pain, history of strenuous activity
  • pain worse on contraction of the quadriceps (straight leg raise)
37
Q

Osgood Schlatter disease management

A

rest, analgesia and physiotherapy

38
Q

club foot (talipes equinovarus) cause

A

develops due to abnormal alignment of the joint between the talus, calcaneus and navicular bones

39
Q

club foot (talipes equinovarus) risk factors

A
  • male
  • family history
  • breech position
  • low amniotic fluid content during development
40
Q

club foot (talipes equinovarus) presentation

A
  • plantar flexion of the ankle
  • supination of the forefoot
  • varus alignment of the forefoot
41
Q

club foot (talipes equinovarus) management

A

Ponsetti technique
- regime of serial casts started soon after birth
- most children require Achilles tenotomy
- brace worn 23 hours a day for 3 months and then at night until the age of 3

42
Q

what is Salter Harris classification type 1

A

complete separation of the epiphysis

43
Q

what is Salter Harris classification type 2

A

complete separation of the epiphysis with a small fragment of metaphysis

44
Q

what is Salter Harris classification type 3

A

intra-articular fracture of the epiphysis

45
Q

what is Salter Harris classification type 4

A

intra-articular fracture of the epiphysis with a small fragment of metaphysis

46
Q

what is Salter Harris classification type 5

A

compression fracture that doesn’t show up on x-ray and is associated with growth arrest and angular deformity

47
Q

what is a supracondylar fracture

A

supracondylar area of humerus fracture

48
Q

supracondylar fracture management

A

K wires

49
Q

what is a radial buckle fracture

A

buckle fractures of radius occurring within the metaphysis

50
Q

radial buckle fracture cause

A

arise due to compression of one side of the bone, causing the opposite side to bend away

51
Q

radial buckle fracture diagnosis

A

x-ray showing bulge on metaphysis of radius

52
Q

radial buckle fracture management

A

splint for 3-4 weeks

53
Q

what is a Greenstick fracture

A

incomplete fracture of the diaphysis of the radius

54
Q

Greenstick fracture cause

A

arise due to bending of the forearm, with the fracture occurring on the convex side (bulging side)

55
Q

Greenstick fracture management

A

cast and closed manipulation if angulated

56
Q

what is a toddler’s fracture

A

fracture of the tibia that isn’t displaced

57
Q

toddler’s fracture presentation

A

irritable child that is reluctant to weight bear

58
Q

toddler’s fracture management

A

cast

year 2 - musculoskeletal (20 decks)

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