Paediatric Orthopaedics Flashcards

1
Q

What are the some abnormal features of the lower limb that usually correct with age?

A
  • Overlapping toes
  • Internally rotated feet
  • Flat feet
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2
Q

How do bones grow from the growth plate?

A

Enchondral ossification

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3
Q

How do bones grow from the periosteum?

A

Appositional growth

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4
Q

What are the factors affecting the growth plate?

A
Diet
Sun
Vitamins A and D
Injury
Illness
Hormones - particularly Growth Hormone
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5
Q

How can you tell if short children have a pathological process underlying this?

A

Parents height

Dysmorphic features

Age over 3 - as under 3 growth much more variable and can cross centiles . Nutrition big factor here

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6
Q

What measure defines a child of short stature?

A

Those less than 2 standard deviations under the mean for those of their age

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7
Q

What should a child be able to do at 6-9 months?

A

Sit alone

Crawl

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8
Q

What should a child be able to do at 8-12 months?

A

Stand

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9
Q

What should a child be able to do at 14-17 months?

A

Walk

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10
Q

What should a child be able to do at 24 months?

A

Jump

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11
Q

What should a child be able to do at 3 years?

A

Climb stairs alone

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12
Q

What is Genu Varum?

A

Bow legged

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13
Q

What is Genu valgum?

A

Knock kneed

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14
Q

How does knee alignment vary with age?

A

Newborn and under 2 - genu varum

Peak at 3 and half and then after - genu valgum

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15
Q

What is mean knee alignment for adults?

A

-5 degrees of valgus

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16
Q

When is Genu varum pathological?

A

Unilateral

Severe - greater than 2 SD or 16 degrees from normal

Short stature

Painful

SHOULD BE REFERED

17
Q

What can cause pathological genu varum?

A

Skeletal dysplasia

Rickets

Tumour i.e. enchondroma

Blounts disease

Trauma = physeal injury

18
Q

What is blounts disease?

A

Grwoth arrest at medial tibial physis

? caused by weight overload

19
Q

What is the sign of Blounts disease on X ray?

A

Beak like protrusion

20
Q

When is genu valgum pathological?

A

Asymmetric

Painful

Severe - over 2 SD

21
Q

What are the causes of pathological genu valgum?

A

Tumour

Rickets

Neurofibromatosis

Idiopathic

22
Q

When is surgery considered for genu valgum?

A

If less than 8 cm intermalleolar distance at aged 11

23
Q

What are possible causes of intoeing?

A

Femoral neck anteversion

Internal tibial torsion

Metatarsus adductus

24
Q

What is femoral neck anteversion?

A

Increased pointing if femoral neck anteriorly. Sit in W position

Usually 30-40 degrees at birth but will be 10-15 degrees at maturity

25
What is the treatment of Metatarsus adductus that will not passively correct?
Serial casting at aged 6 -12 months
26
Is flat feet normal at birth?
Yes Medial arch develops as walking strengthens tibialis posterior
27
What are the two types of flat feet?
Flexible or fixed/ rigid
28
What is the cause of flexible flat feet?
Generalised ligamentous laxity Tight gastrocsoleus complex = stretching
29
What is rigid flat feet?
Flat feet caused by bony connection = tarsal coalition
30
What are the features of curly toes?
Common in young children but resolve by 6 years Mostly 3rd and 4th toes
31
How can you tell between fixed and flexible flat foot?
Tip toe test
32
When are orthotics indicated in flexible flat foot?
If it is painful