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Ortho Boards > Peadiatrics > Flashcards

Peadiatrics Flashcards

1
Q

What factors are associated with outcomes of a distal femoral fracture

A

SH classification
presence of displacement
open fracture
presence of hardware across the physis

direction of displacement is not associated with outcome

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2
Q

Findings of osteopetrosis

A

Inability to acidify the howship lacunae
AR not compatible with life
AD compatible with life

Rugger jersey spine
multiple fractures
coxa vera (stress fractures)
deafness
blindness 
anemia
frequent infections
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3
Q

Radiographic indicators of both bone forearm fractures following reduction

A

On AP biceps and radial styloid are 180 degrees apart

On Lateral ulnar styloid and coronoid are 180 degrees apart

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4
Q

Complications and concerns following transphyseal distal humerus injury

A

posteromedial displacement
child abuse

closed reduction and splinting
pin if very displaced

Varus
medial condyle AVN
(no risk of tardy ulnar nerve palsy)

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5
Q

Phenotype of diastropic dysplasia

A

defect in sulphate transporter affecting cartilage

cauliflower ear
hitchikers thumb
symphangalisism
kyphosis c-spine

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6
Q

Fracture associated with highest morbidity and mortality

A

spine

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7
Q

Acceptable angulation of a radial neck fracture

A

30 degrees
begin ROM early to prevent stiffness

Percutaneous pinning
Open reduction - associated with stiffness and increased risk of AVN

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8
Q

Reduction technique for radial neck fracture

A

Patterson - extension and supnation
Isralei - flexion and pronation
Compression bandage

K-wire joystick
Metaizeau - retrograde nail across fracture

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9
Q

complications of radial neck fracture

A

stiffness (loss of pronation)
radial head ON
synostosis (open, delayed)
radial head overgrowth (40%)

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10
Q

Multifocal mycobacterial infection

A

Polyarthrosis swelling
elevated ESR
from foreign place

spine (50%), large joints, long bones
subchondral erosions with diffuse osetopenia

treatement with Abx
Surgery for residual constitutional sx

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11
Q

Best predictors of septic hip

A 
Fever
CRP
ESR
Refusal to bear weight
WBC

In that order

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12
Q

Bones with intra-articular metaphyses

A

shoulder
elbow
hip
ankle

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13
Q

Indications for surgical treatment of proximal humerus fracture

A

usually can be treated nonoperativley because of ability to heal and remodel

open
NV
> 45 degrees

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14
Q

Drop in BP intraop myelomeningocele

A

latex allergy

IGE mediated

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15
Q

Risk factors for spina bifida

A

DM2
maternal hyperthermia
valproic acid
folate deficiency

10% have chromosomal abnormality

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16
Q

Level of myelomeningocele at risk for hip dislocation

A

L3-4
(level is the lowest functioning level)
usually confined to wheelchair

L5 is more normal functioning

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17
Q

Procedure to correct calcaneus heel in L5 level

A

posterior transfer of tib ant

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18
Q

Larsen syndrome

A

hyperlaxity, presents with multiple dislocations

at risk for cervical kyphosis

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19
Q

Scoliosis with no curve and assymetric abdominal reflex

A

syrinx

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20
Q

most common cause of malignant back pain

A

leukemia

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21
Q

lower extremity growth

A

Proximal femur - 3mm
Distal Femur - 9mm
Proximal tibia - 6mm

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22
Q

what is the teardrop comprised of

A

quadrilateral surface
cotyloid fossa

normal hip at 18 months
usually not there in untreated DDH

23
Q

Side of congential pseudoarthrosis

A

Right middle

Cosmesis or function at 3-6 years old
Iliac crest graft with ORIF

24
Q

Factor most associated with loss of reduction of forearm fractures

A

Cast index > 0.85

25
Q

Acceptable reduction forearm fracture

A

9yo - 10 deg, 30 deg rotation, 1 cm bayonette

26
Q

What is the most common cause of physical disability in child abuse

A

head injury

27
Q

most common age of child abuse

A
28
Q

acceptable alignment of distal radius fracture

A

> 10 yo - 20 deg ang, 30 deg rotation

closed reduction initially
if inadequate or reduction lost then do closed reduction with pinning

29
Q

Disease associated with olecranon fracture

A

OI

30
Q

What is the most common complication requiring intervention following hip spica treatment for femoral shaft fractures

A

loss of reduction

31
Q

Treatment of anterolateral bowing associated with neurofibromatosis

A

bracing

If fracture then IM device (growing rod)

32
Q

Gauchers mutations

A

glucocerbridase

33
Q

fibrous dysplasia mutation

A

cAMP

34
Q

SLC6A2A sulphate transporter

A

diatrophic dysplasia

35
Q

Morqoio

A

keratin sulphate
proportionate dwarfism
normal intellegence
odontoid hypoplasia

36
Q

Hurlers

A

C1-2 instability

37
Q

Hunters

A

X-linked recessive
metal retardation
clear corneas

38
Q

diatrophic dysplasia

A

cervical kyphosis
cauliflower ears
hitchhikers thumb

39
Q

indications for physeal bar resection

A

20% will require osteotomy as they are unlikley to correct

40
Q

superior lens dislocation

A

marfans

41
Q

inferior lens dislocation

A

homocystinuria

42
Q

dolichostenomelia

A

long limbs associated with marfans

43
Q

SCFE associations

A

left hip
males
hip pain (not knee pain)

44
Q

best radiograph for lateral epicondyle

A

internal oblique

45
Q

long term consequences of brachial plexus palsy

A

glenohumeral dysplasia - due to internal rotation contracture (70%)

elbow contracture - due to overdrive of the biceps

46
Q

prognosis of brachial plexus palsy

A

90% recover with early PT

Good - erbs, biceps activity

Poor:
lack of biceps by 3 months
preganglionic injuries (elevated hemi, rhomboid dys)
horners
C5-7
klupkes
47
Q

Erbs

A

C5-6 - most common

waiter’s tip

Axillary/SS - absent deltoid, teres minor, SS, IS
MC - biceps, BR
intact wrist and hand

48
Q

Klumpke

A

C8-T1 - poor prognosis

Median and ulnar nerve - claw hand

often associated with horners

49
Q

Early brachial plexus treatment

A

Nerve graft

  • flail arm at 1 month
  • horners at 1 month
  • no biceps by 3 months

Nerve transfer
- root avulsion at 3 months

50
Q

Late surgery for brachial plexus

A

Glenohumeral dislocation

  • ORIF with capsuloraphy
  • proximal humerus osteotomy (no glenoid)

Glenohumeral dysplasia

  • lat dorsi transfer - persistant ER with mild dyplasia
  • pec major - 5yo
51
Q

SMN-1

A

spinal motor dystrophy

52
Q

PMP 22

A

CMT

53
Q

myelomeningocele hip dislocation

A

observe

highest risk in L3

54
Q

most common foot deformity with spina bifida

A

clubfoot

Ortho Boards (9 decks)

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