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Orthopaedics > Paediatric orthopaedics > Flashcards

Paediatric orthopaedics Flashcards

1
Q

At what age should a child be able to sit alone and crawl?

A

6 - 9 months

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2
Q

At what age should a child be able to stand?

A

8 - 12 months

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3
Q

At what age should a child walk?

A

14 - 17 months

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4
Q

At what age should a child jump?

A

24 months

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5
Q

At what age should a child be able to walk up stairs independantly?

A

3 years

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6
Q

Describe briefly the normal lower limb development from birth (in relation to varus/valgus)

A
  1. At birth, children normally have varus knees (bow legs)
  2. These become neutrally aligned at about 14 months
  3. They then become slightly valgus (knock kneed) at age 3
  4. This gradually regresses to physiological valgus by about age 7-9
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7
Q

What is the physiological alignment of the knees?

A

6 degrees valgus

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8
Q

What does varus mean?

A

Inward angulation of the distal segment of a bone or joint. In knees this appears as a bow legged.

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9
Q

What does valgus mean?

A

Outward angulation of the distal segment of a bone or joint. In knees this appears as knock kneed.

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10
Q

In a valgus deformity is there a larger or smaller gap than normal between the ankles?

A

Larger

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11
Q

What in genu varum?

A

Bow legs

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12
Q

What is genu valgus

A

Knock knees

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13
Q

What is blounts disease

A

A growth disorder of the medicl proximal tibial physis which results in excessive genu varum

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14
Q

What is in toeing?

A

Children who have feet that point towards the midline when walking and standing.

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15
Q

Give three possible causes of in toeing?

A

Femoral neck anteversion
Internal tibial torsion
Forefoot adduction

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16
Q

Are flat feet usually normal or pathological?

A

Normal variation

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17
Q

What is important to determine when a child presents with flat footedness? What is the difference?

A

Whether they flat feet are mobile or fixed.
Mobile flat feet are those where the flattened medial arch does form with dorisflexion of the big toe. In rigid flat feet the arch remains flat regardless of load or big tow dorsiflexion.

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18
Q

Are medial arch support orthoses required in children with flat feet?

A

No

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19
Q

What could rigid flat footedness imply?

A

An underlying bony abnormality (tarsal coaltitiion)

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20
Q

Are girls or boys more commonly affected by hip dysplasia?

A

Girls

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21
Q

What is transient synovitis?

A

A self limiting inflammation of a joint, most commonly seen in the hip.

22
Q

What is meant by an antalgic gait?

A

A change in gait in response to pain

23
Q

Which nerve supplies both the hip and the knee joint?

A

The obturator nerve

24
Q

What is the mainstay of treatment for adolescent knee pain?

A

Physiotherapy to strengthen muscles

25
Q

What is the more common name for a hallux valgus deformity?

A

A bunion

26
Q

What is a scoliosis?

A

A lateral curvature of the spine with a rotational deformity

27
Q

What is spondylolisthesis?

A

Slippage of one vertabra over another at the L4/L5 or L5/S1 level. Can be due to developmental defect or recurrent stress fracture

28
Q

Give the reasons why children’s fractures are given special attention; what is different about their bones?

A
  1. Their bones are more elastic and pliable and tend to buckle/partially fracture/splinter with some continuity of fibres (like breaking a green stick!) rather than break completely
  2. Periosteum is much thicker and tends to remain intact which can help stability and can assist reduction.
  3. Fractures heal more quickly due to the thicker periosteum which is a rich source of osteoblasts
29
Q

Are childrens fractures surgically stabilised more or less often than adult fractures?

A

Less often

30
Q

What is a salter harris 1 fracture?

A

A purely physeal separation

31
Q

What is a salter harris 2 fracture?

A

These make up the majority of fractures; it is a physeal separation with a small metaphyseal attachment also.

32
Q

What is a salter harris 3/4 fracture?

A

Intra articular and with the fracture splitting the physis (In this type there is greater potential for growth arrest. These fractures need to be reduced and stabilized.

33
Q

What is a salter 5 injury?

A

A compression injury to the physis with subsequent growth arrest. These injuries can not be diagnosed on an x ray and are only detected once angular deformity had occured.

34
Q

How would an extension type fracture or the supracondylar elbow commonly occur?

A

Heavy fall onto the outstrectched hand

35
Q

How would a flexion type fracture or the supracondylar elbow commonly occur?

A

Fall onto the point of the flexed elbow

36
Q

What is commonly referred to as the toddlers fracture?

A

Undisplaced spiral fracture of the tibial shaft

37
Q

How is an undisplaced spiral fracture of the tibial shaft treated?

A

Short time in a cast

38
Q

what is the most common cause of paediatric hip pain?

A

Transient synovitis

39
Q

Give three causes of in toeing?

A

Femoral neck aversion
Internal tibial torsion
Forefoot adduction

40
Q

What should you do if a child presents with a painful scoliosis?

A

This is a red flag symptom and warrants urgent infection (MRI to look for tumour or infection)

41
Q

Give four risk factors for DDH?

A
  1. Family history
  2. Down syndrome
  3. Female
  4. Breech position
42
Q

Which group of people are at highest risk of SUFE?

A

Overweight, pre pubescent, adolescent boys

43
Q

Which group of people is perthes disease more common in?

A

Active, short boys between the ages of 4 and 9

44
Q

In girls, what may predispose them to SUFE?

A

Hypothyroidism or renal disease

45
Q

Alignment of the knee in which the distal end of the tibia is angling towards the axis of the femur/midline. There is an increased gap between the knees complared to the ankles
What is this?

A

Genu varum

46
Q

Alignment of the knee in which the distal end of the tibia is angled away from the axis of the femur/midline. There is an increased gap between the ankles complared to the knees
What is this?

A

Genu valgum

47
Q

What is apophysitis?

A

Inflammation of a growing tubercle where a tendon attached. It can occur at either end of the patellar tendon due to repetitive strain.

48
Q

What is Osgood Schlatter’s disease?

A

Inflammation of the tibial tubercle apophysis

49
Q

How do you treat osgood schlatter’s disease?

A

It is usually self limiting and requires rest and sometime physiotherapy

50
Q

What is sinding - larsen - johanssen disease? How do you treat it?

A

Inflammation of the inferior pole of the patella. Self limiting, treated with rest and physiotherapy

51
Q

A valgus malformation will predispose the patient to early arthritis in which compartment of the knee?

A

Lateral

52
Q

A varus malformation will predispose the patient to early arthritis in which compartment of the knee?

A

Medial

Orthopaedics (8 decks)

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