Pediatric Orthopedics

Question 1

Version

Answer 1

Twist relative to coronal midline, often referred relative to the hip. Ex: femoral anteversion or acetabular retroversion.

Question 2

What causes metatarsus adductus?

Answer 2

Feet being bent over the leg in utero

Question 3

When / how should metatarsus adductus be treated?

Answer 3

If it is rigid and causes problems w/ shoes.

Treat w/ casting or surgery.

Question 4

When / how should internal rotation of tibia be treated?

Answer 4

Only do surgery if it creates a functional problem. Bracing does NOT work.

Question 5

Do braces help for femoral anteversion?

Answer 5

No

Question 6

Miserable malalignment syndrome

Answer 6

Anterior knee pain due to femoral anteversion + external tibial torsion

Question 7

Blount disease
Pathophysiology
Population
Treatment

Answer 7

• Severe tibia vara (varus of tibia) → compression of medial tibia → prevents physeal growth on medial side → further varus.
• More common in early walkers and kids who are larger when start walking.
• Try to unload pressure on midline. Use brace to take pressure off medial plate to aid in growth to straighten out.
• Guided growth is used if caught before kid is done growing. Bracing does not work in adolescence.

Question 8

2 causes of Rickets

Answer 8

Low Vit D and renal disease

Question 9

2 tests for diagnosing scoliosis

Answer 9

• Adams forward bending test: shows elevation of ribs on one side.
• Cobb Angle – Scoliosis is defined as curve >10 degrees.

Question 10

Treating scoliosis

Answer 10

• TLSO: thoraco-lumbar-sacral orthosis = brace. Use if curve is >20-25 degrees.
• Can’t make curves better w/ braces, but prevent worsening. Reduces need for surgery by 50%
• Surgery for severe cases.

Question 11

Risk of untreated scoliosis

Answer 11

Risk of CV / respiratory compromise w/ curve >40 degrees.

Question 12

Clubfoot
Other name
4 components

Answer 12

Talipes equinovarus

Cavus (high arch), adduction, varus, and equines (foot forced down due to tight Achilles)