Paediatric Orthopaedics

Question 1

what % of people have flat feet ?

Answer 1

20%

Question 2

Developmental Dysplasia of the Hip (DDH)

• how is it diagnosed?
• more common in girls or boys?
• affects which hip more?
• what % present bilaterally?
• features?

Tx?

Answer 2

• Congenital abnormality of the hip leading to instability.
• during infancy by screening
• More common in girls.
• More common in the left hip.
• 10-30% present bilaterally.
• one leg shorter than the other
• Tx : - Pavlik harness for 6 weeks
• If later, surgery may be indicated

Question 3

Talipes Equinovarus

• what is it?
• more common in boys or girls?
• Tx?

Answer 3

• congenital clubfoot
• boys
• PoP and manipulation soon after birth or surgical lengthening

Question 4

Hip Slip (Slipped upper femoral epiphysis) - SUFE

most common hip disorder in adolescents!!

• posterior-inferior displacement due to Salter-Harris type what fracture through growth plate?
• how do the present?

Tx?

most common complications?

• CLASSIC PATIENT?

Answer 4

due to Salter Harris Type 1 fracture through growth plate.

boy/girl in their teens typically presenting with outward turning of affected leg, sudden pain onset, discrepancy in leg length.

in situ fixation with a single screw inserted through femoral head to prevent it form slipping any further.

most common complications of SFCE is avascular necrosis and chondrolysis

BOY
OVERWEIGHT WITH KNEE/HIP PROBLEMS

Question 5

Perthes Disease

• what is it?
• common in boys or girls?
• presentation?
• Tx?
• complications?

Answer 5

• Congenital osteonecrosis of the femoral head (proximal epiphysis).
• More common in boys, peaks at 4-8 yrs.
• Presentation: painful hip, limp.
• Treatment: rest with traction until pain free, physiotherapy, potentially surgery.
• Complications: secondary OA, pain and loss of function.

Question 6

Osgood Schlatter Disease

• inflammation of which ligament?
• features?
• when does it cause pain?

Answer 6

• Inflammation of the patellar ligament at the tibial tuberosity.
• Characterised by painful bump just below the knee.
• Typically causes knee pain during squatting, running and worse with activity and is releived with rest.

Question 7

what is the difference between a buckle and greenstick fracture?

Answer 7

buckle = partial transverse fracture of long bone below growth plate

greenstick = complete trasnverse fracture of long bone below growth plate

Question 8

A 52-year-old man has an Achilles tendon rupture while playing tennis. He has no past medical history and has had no previous musculoskeletal problems. During the preceding week, he was commenced on antibiotic therapy for an infection and has been taking it for the past seven days. Which antibiotic was he likely to have started?

benzylpenicillin 
ciprofloxacin 
clarithromycin 
doxycycline 
nitrofurantoin

Answer 8

ciprofloxacin

Ciprofloxacin is the likely causative medication with new onset achilles tendon disorders; tendinitis and tendon rupture is a key side effect of which to be aware