Paediatric Orthropaedics Flashcards
When is tip toe walking normal
Up to. 3
What is club foot
Congenital deformity of the tarsal bones
What is rocker bottom
Feet are out the ways ( opposite to club foot)
What are the red flags for leg pain
Asymmetry Persisting limp Not thriving Pain worsening Sudden Good localisation
Whay is osteochondrititis dissecans
Bone underneath cartilage dies - bone and cartilage can break off and the fragment can get stuck and cause constant pain
What are the children Hip disorders
Development dysplasia of the hip (DDH) Slipped upper femoral epiphysis ( SUFE) Perthes Septic arthritis Transient synovitis
What side is more affect in DDH and what gender
Females and L
IX of DDH
Barlow : middle finger on femoral head and push down).. posterior dislocation
Ortolani: abduction with upward lift to relocate
US < 3 months
X-ray > 3 months
Treatment of DDH
Pavlik harness until US is normal
What is SUFE
Femoral head starts to slip from the socket
Think of ice cream, ice cream starts to slip
Boys
Ix of SUFE
Limp, short limb, loss of internal rotation
X-ray
What happens if its a complete slip in SUFE
Avascular necrosis = need hip replacement
Treatment of SUFE
Mild - pin in situ and prophylactic screw on the other side
Severe : open procedure
Avascular necrosis - hip replacement
What is transient synovitis
Inflammation of the synovium, often secondary to viral illness
Presentation of transient synovitis
History of viral illness
LIMP and hip / groin pain
May referred pain to knee
Hip is flexed, externally rotated
What is perthes disease
Avascular necrosis of the hip
Idiopathic
Does blood supply return in perthes
Yes but can rake a while :(
Treatment of perthes disease
Restriction of activities
Physio
NSAIDs
What is septic arthritis of the hip
Intra - articular infection of the hip joint
SURGICAL EMERGENCY
Symptoms of septic arthritis
Short duration
Unable to weight bear and hip / groin pain
Hip lying flexed / externally rotated
Severe hip pain on passive movement
Usually pyrexial but May be haemodynamically stable
Ix of septic arthritis
Blood tests, ESR, CRP, FBC
Blood cultures
Kochers criteria
X-ray to rule out other
Treatment of septic arthritis
OPEN SURGICAL WASH OUT
IV antibodies before cultures taken
