Paediatric Orthopaedics

Question 1

What does DDH stand for?

Answer 1

Developmental Dysplasia of the HIp

Question 2

Risk factor for DDH

Answer 2

First born, 
Oligohydramnios, 
Breech, 
Family history,
Other lower limb deformities

Question 3

Clinical signs of DDH

Answer 3

Ortolani’s sign,
Barlow’s sign,
Piston Motion sign

Question 4

<3 month management of DDH?

Answer 4

Splint

Question 5

3month to 1 year management of DDH?

Answer 5

Closed reduction,

Spica cast

Question 6

> 1 year DDH treatment?

Answer 6

Open reduction,

Capsule reefing

Question 7

> 18 months DDH treatment?

Answer 7

Open reduction with femoral shortening and pre-acetabular osteotomy

Question 8

What does LCP stand for?

Answer 8

Legg-Calve_Perthes Disease

Question 9

Presentation of Legg-Calve-Perthes Disease?

Answer 9

Short stature,
Limp,
Knee pain on exercise,
Stiff hip joint

Question 10

What is Legg-Calve-Perthes disease?

Answer 10

Avascular necrosis of proximal femoral head

Question 11

What are the phases of LCP?

Answer 11

1- avascular necrosis,
2- Fragmentation- revvascularisation,
3- reossification
4-Residual deformity

Question 12

Unilateral differential for LCP

Answer 12

Septic hip,
JIA,
SCFE,
Lymphoma

Question 13

Bilateral differential of LCP?

Answer 13

Hypothyroid,
Sickle,
Epiphyseal dysplasia

Question 14

Treatment of LCP?

Answer 14

Hip motion maintained,
Analgesia,
Restrict painful activities,
Osteotomy (>7years)

Question 15

What is SCFE?

Answer 15

Slipped capital femoral epiphysis

Question 16

Risk factors for SCFE?

Answer 16

9-14 year old male,
Overweight,
Endocrine abnormality

Question 17

Classifications of SUFE?

Answer 17

Acute vs chronic

Stable vs unstable

Question 18

Difference between stable and unstable SUFE?

Answer 18

Unstable to weight bear and has a poor prognosis

Question 19

SCFE presentation?

Answer 19

Pain in hip or knee,
Externally rotated posture and gait,
Reduced internal rotation

Question 20

Investigation for SCFE?

Answer 20

Xray

Question 21

In SCFE what is measured on the xray?

Answer 21

Width of femoral neck on AP

Question 22

Mild, moderate and severe femoral neck widths of SCFE?

Answer 22

Mild <1/3
Moderate 1/3-1/2
Severe >1/2

Question 23

Pathology of SCFE?

Answer 23

Displacement through hypertrophic zone,

Metaphysis moves anterior and proximal

Question 24

Treatment of SCFE?

Answer 24

Surgery

Pinned

Question 25

Complication outcomes of SCFE?

Answer 25

``` Avascular necrosis, Chomdrolysis, Deformity, Early osteoarthritis, Limb length discrepancy, Impingement ```

Question 26

Which SCFE has a higher risk of AVN, stable or unstable?

Answer 26

Unstable

Question 27

What line is drawn on Xray between pelvis and femur, to help diagnosis SCFE?

Answer 27

Klein

Question 28

What is Trethowan sign?

Answer 28

When the klein line is above the femoral head | Sign of SUFE