Paediatric orthopaedics

Question 1

MSK problems related to cerebral palsy?

Answer 1

joint contractures
scoliosis
hip dislocation

Question 2

What is the commonest skeletal dysplasia?

Features?

Answer 2

Achondroplasia
Features: prominent nose, large forehead, short limbs, joints lax
NORMAL mental development

Question 3

what type of collagen is defective in osteogenesis imperfecta? is it usually aut dom or rec?

Answer 3

type 1

usually aut dom but worse if aut rec

Question 4

signs of osteogenesis imperfecta

Answer 4

fragility fractures in kids
blue sclerae
hearing loss
short

Question 5

DDH - more common in M or F?

Answer 5

F - 80%

Question 6

DDH - tests

treatment?

Answer 6

Barlow and Ortolani manœuvres
Xray if over 6 months
US if under 6 months
treatment - Pavlik harness

Question 7

Perthes
Who gets it?
What does it present with?
Is it usually unilateral or bilateral?
1st clinical sign?

Answer 7

boys 4-9 yrs, short, active
presents with pain and a limp
usually unilateral
1st clinical sign is loss of internal rotation

Question 8

SUFE
Who gets it?
What happens?
What does it present with?
What imaging is necessary?
Treatment?

Answer 8

Overweight prepubertal boys
femoral head epiphysis slips down
loss of internal rotation but can present purely with knee pain!
lateral X-ray view necessary - Trethowans sign
Urgent surgery because risk of AVN

Question 9

Most common cause of childhood hip pain?
who usually gets it?
What is it usually following?
treatment?

Answer 9

Transient synovitis
usually boys 2-10 yrs
commonly after URTI
tx - short course of NSAIDs and rest

Question 10

What is a monteggia fracture?

Answer 10

fracture of proximal ulna with dislocation of head of the radius

Question 11

What is a Galeazzi fracture?

Answer 11

fracture of the radius with dislocation of the distal radio ulnar joint

Question 12

Name the mild and severe forms of spina bifida?

Answer 12

Mild form - spina bifida oculta

Severe form - spina bifida cystica

Question 13

Talipes equinovarus (clubfoot)
risk factors?
features?
technique used?
what do most require?

Answer 13

RFs: breech position, oligohydramnios
features: plantar flexion, supination of forefoot, varus alignment of forefoot
Posenti technique
80% require achilles tenotomy then need to wear a brace until age 3/4

Question 14

Duchenne muscular dystrophy
X linked dom or rec?
defect in what gene?
CK increased or decreased?
What is the sign seen?

Answer 14

X linked recessive
defect in dystrophin gene
CK increased
Gowers sign - weakness of proximal muscles

Question 15

which salter harris #s are intra articular

Answer 15

III and IV

Question 16

can shortening/malrotation of tibial spiral #s in toddlers be accepted?

Answer 16

NO

Question 17

above what age can adult type IM nails be used

Answer 17

12

Question 18

unable to make “ok” sign

Answer 18

supracondylar elbow #

Question 19

jones fracture

why problematic?

Answer 19

fracture in region of proximal diaphysis of 5th mtrsl

this area has poor blood supply

Question 20

are buckle distal radius fractures stable?

Answer 20

yes

Question 21

what is spondyloisthesis

Answer 21

slippage of one vertebra over another

Question 22

percentage of talipes equinovarus that are bilateral

Answer 22

50%