Paediatric orthopaedics Flashcards
Most common hip condition in the under 5’s
Developmental hip dysplasia
Most common hip condition in the 5-10 group
Perthe’s disease
Most common hip condition in children older than 10
Slipped upper femoral epiphysis
Risk factors for developmental hip dysplasia
Female, Family history, Breech birth, First born, Olighydramnios
Symptoms of developmental hip dysplasia
Clicking hip, Limping
Signs of developmental hip dysplasia
Leg length discrepancy, Reduced abduction, Asymetrical toe walking, Positive Barlow’s test, Positive Ortolani’s test
Describe Barlow’s test
Dislocates hip by adducting and depressing a flexed hip
Describe Ortolani’s test
Reduces hip by adducting and elevating a flexed hip
Investigations for developmental hip dysplasia
USS, X-ray
Management of developmental hip dysplasia
Conservative: Pavlik harness, Spica
Surgical: Pelvic/femoral osteotomy
Risk factors for slipped upper femoral epiphysis
Obesity, Femoral retroversion
Symptoms of slipped upper femoral epiphysis
Pain (in groin, thigh, or knee - relieved by crossing leg over), Limp
Signs of slipped upper femoral epiphysis
Abnormal gait, Externally rotated hip, Reduced internal rotation, Decreased abduction, Quadriceps atrophy
Investigations for slipped upper femoral epiphysis
X-ray
Management of slipped upper femoral epiphysis
Surgical: Percutaneous pinning, ORIF, Femoral osteotomy
Define Perthe’s disease
Avascular nercosis of the femoral head
Risk factors for Perthe’s disease
Male, Family history, Low birth weight, Abnormal birth presentation, Exposure to second hand smoke, Thrombophilia
Symptoms of Perthe’s disease
Painless limp, Intermittent pain (in hip, knee, thigh)
Signs of Perthe’s disease
Decreased internal rotation, Decreased abduction, Antalgic gait, Limb length discrepancy
Investigations for Perthe’s disease and findings
X-ray (Irregular ossification, medial joint space widening, Cresent sign)
Define cresent sign
Linear subchondral lucency - (Perthe’s disease)
Management of Perthe’s disease
Conservative: Reduce impacts
Surgical: Femoral/Pelvic osteotomy
