Pediatrics Flashcards
Brachial plexus palsy typically manifests as what?
Internal shoulder rotation (results in glenoid hypoplasia), flexion of elbow and wrist
90% of cases will resolve without intervention
What carries a poor prognosis in brachial plexus injury?
No biceps function at 6 months
Horner syndrome
What innervates the teres major?
Lower scapular nerve (C5-C7)
What innervates the latissimus muscle?
Thoracodorsal nerve (C6-C8)
What is the name for undescended scapula?
Sprengel deformity
What is the name for unilateral chest wall hypoplasia?
Poland syndrome (Can have hypoplasia of the hand and forearm, hand deformities)
What are the three possible causes of pediatric in-toeing?
- Metatarsus adductus
- Internal tibial torsion
- Femoral anteversion
What exam finding favors tibial torsion?
Thigh foot angle <-10 degrees (normal is 0-20)
How much does each area contribute to growth per year?
Distal femur 9 mm
Proximal tibia 6 mm
Proximal femur 3 mm
How do I treat a LLD of 2 cm?
Shoe lifts if at maturity
What are the risk factors for DDH?
Breech, positive family history, female, firstborn
When can I use ultrasound for DDH?
Up until 4-6 months
What is the normal alpha angle on hip ultrasound for infants?
60 degrees
What is the normal acetabular index on xrays?
Less than 25 degrees
AIN innervates what three muscles?
FPL
PQ
Radial half of the FDP
What nerve is commonly injured with flexion type SCH?
Ulnar nerve
How old should I consider an open reduction for dislocated hips?
18 months to 3 years
How old shoulder I consider an osteotomy for dislocated hips?
3 to 8 years
For dislocated hips, what osteotomy is available for growth plates are closed?
Ganz and Chiari procedures
Excessive flexion in a pavlik harness can cause what palsy?
Femoral nerve palsy
How long should I give a pavlik harness to reduce a hip?
3 weeks tops
What are the treatments for the following Coxa Vara:
1. Hilgenreiner epiphseal angle <45 deg
2. HE 45-60 deg
3. HE>60
- Will resolve
- close observation
- Surgery (subtroch valgus osteotomy)
When do I consider surgery for Perthes disease?
Skeletal maturity (over the age of 8) with lateral pillar groups (B or B/C)
When should I consider an endocrine work up for SCFE?
Patient less than 10 years old
Whats included in Kochers criteria?
T>101.3
Elevated ESR
Refusal to bear weight
WBC > 12
What joints do not have intraarticular metaphysis?
Hip, Knee, Ankle, Elbow
When can I treat osteomyelitis with only atbx?
If there is no subperiosteal abscess or abscess within the bone
genu varum in children turns into genu valgum by what age?
2.5 years
When is surgery indicated for infantile blounts disease? (0-4 years)
Patient over 3 years at stage II or stage III (Langenshlold classification)