Paediatric Orthopaedics Flashcards
What does DDH stand for?
Developmental Dysplasia of the HIp
Risk factor for DDH
First born, Oligohydramnios, Breech, Family history, Other lower limb deformities
Clinical signs of DDH
Ortolani’s sign,
Barlow’s sign,
Piston Motion sign
<3 month management of DDH?
Splint
3month to 1 year management of DDH?
Closed reduction,
Spica cast
> 1 year DDH treatment?
Open reduction,
Capsule reefing
> 18 months DDH treatment?
Open reduction with femoral shortening and pre-acetabular osteotomy
What does LCP stand for?
Legg-Calve_Perthes Disease
Presentation of Legg-Calve-Perthes Disease?
Short stature,
Limp,
Knee pain on exercise,
Stiff hip joint
What is Legg-Calve-Perthes disease?
Avascular necrosis of proximal femoral head
What are the phases of LCP?
1- avascular necrosis,
2- Fragmentation- revvascularisation,
3- reossification
4-Residual deformity
Unilateral differential for LCP
Septic hip,
JIA,
SCFE,
Lymphoma
Bilateral differential of LCP?
Hypothyroid,
Sickle,
Epiphyseal dysplasia
Treatment of LCP?
Hip motion maintained,
Analgesia,
Restrict painful activities,
Osteotomy (>7years)
What is SCFE?
Slipped capital femoral epiphysis
Risk factors for SCFE?
9-14 year old male,
Overweight,
Endocrine abnormality
Classifications of SUFE?
Acute vs chronic
Stable vs unstable
Difference between stable and unstable SUFE?
Unstable to weight bear and has a poor prognosis
SCFE presentation?
Pain in hip or knee,
Externally rotated posture and gait,
Reduced internal rotation
Investigation for SCFE?
Xray
In SCFE what is measured on the xray?
Width of femoral neck on AP
Mild, moderate and severe femoral neck widths of SCFE?
Mild <1/3
Moderate 1/3-1/2
Severe >1/2
Pathology of SCFE?
Displacement through hypertrophic zone,
Metaphysis moves anterior and proximal
Treatment of SCFE?
Surgery
Pinned
Complication outcomes of SCFE?
Avascular necrosis, Chomdrolysis, Deformity, Early osteoarthritis, Limb length discrepancy, Impingement
Which SCFE has a higher risk of AVN, stable or unstable?
Unstable
What line is drawn on Xray between pelvis and femur, to help diagnosis SCFE?
Klein
What is Trethowan sign?
When the klein line is above the femoral head
Sign of SUFE
