Pediatric surgery and orthopedic Flashcards
A child is always using abnormal sitting habits (W-Setting), what is the effect on the bones?
Answer: Internal Femoral Torsion (Femoral Anteversion), it’s the most common cause of intoeing > 2 years of age
Management: Observation, takes 1-3 years to resolve. Surgery only if significant at > 10 years of age.
( long scenario) Child brought by his father in wheelchair complaining of knee swelling and history of falling on his knee. What is the best investigation ?
A. Joint Aspiration.
B. X-ray.
Answer: B
plain radiograph of the affected joint should be performed to rule out fractures, periostitis, avascular necrosis, bone tumors, and bone dysplasias.
Pediatric blunt trauma with duodenal coiled spring sign. what will you do?
Answer: Duodenal hematoma
important clues to the diagnosis include the history of upper abdominal trauma, persistent vomiting, and air-fluid levels in both the stomach and duodenum (the so called double bubble) in a plain erect abdominal x ray film.
If doubt still exists, contrast study of the upper gastrointestinal tract will show partial to complete obstruction of the duodenum, with a “stacked coins” or “coiled spring” appearance caused by oedematous mucosal folds proximal and distal to the point of maximum obstruction
In the pediatric age group, duodenal injury from a blunt, abdominal trauma resulting in an intramural hematoma is rare. This case illustrates the characteristic delayed presentation of a duodenal hematoma following a blunt injury from a motor vehicle accident and the associated sequelae of delayed pancreatitis .
Total parenteral nutrition and gastric decompression provide an effective conservative treatment of the gastric outlet obstruction associated with this injury. Surgical intervention is only reserved for those patients who continue to show the clinical and radiological signs of complete high obstruction despite conservative management
For more details, See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3088392/
Child history of hip pain x-ray of hip shows effusion What is the next step of management? a-Aspiration
b-Antibiotic
c-US
Answer:A
