Peds Ortho Flashcards
Describe the disease that fits this picture: 6-7 year old boy who starts falling, early fatigue, calfs are enlarged
Duchenne’s muscular dystrophy
What is the most common congenital hand deformity
syndactyly = webbed fingers
managenent of polydactyly
XR - can ligate ulnar digit
risk factors for developmental dysplasia of the hip
girls, first born child, breech position in third trimester, oligohydramnios
management of developmental dysplasia of hip
harness splinting for first 6 months
management of club foot?
serial casting followed by heel cord release and nighttime bracing
Bone tumor at physis of long bones (knee and shoulder)
Osteosarcoma
most common childhood bone cancer
Long bone tumor, onset in teenage years
ewing’s sarcoma
second most common childhood bone cancer
What is the most common congenital foot deformity?
Metatarsus adductus
- 85%-90% resolve by one year
What is the most common cause of intoeing?
Internal tibial torsion: patella facing forward and feet intoeing
- 90% resolve by age 8
Name this finding: patella facing forward and feet intoeing
Internal tibial torsion
- 90% resolve by age 8
Name this finding: both knees and feet pointing inward
Femoral anteversion
- tendency to sit in a W position
- 80% improve by age 9-10
- surgery at age 9-10 if more severe
What is transient synovitis and when should you consider septic hip?
- Hip pain after infection
- non weight bearing
- ibuprofen to shorten course
- obtain XR to rule out bony process
- consider septic hip if febrile, elevated ESR, CRP, WBC
What is slipped capital femoral epiphysis and how to you manage it?
- slipped femoral head at the epiphysis
- occurs 11-16 yo, male, obese
- obtain XR
- surgical referral should be immediate
What is osteochondritis dissecans and what is initial management?
- Occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen.
- initial management is observation and reduction in activity
What is traction apophysitis
- overuse injury where excessive pull by a large tendon causes damage to the unfused apophysis to which it is attached.
- ex: osgood-schlater
- Treatment is often ice, stretching, rest
What is little league elbow and how do you manage it?
- seen in teen baseball players
- progressive medial elbow pain, diminished throwing speed and distance
- refrain from throwing for 3-6 weeks until pain free, then progressively increase.
What is osgood-schlatter’s and how do you treat it?
- anterior knee pain
- traction apophotisits caused by patellar tendon
- tenderness at tibial tuberosity
- add quad and hip flexor stretches
What is sever’s and how do you treat it?
- posterior heel pain and tenderness at calcaneus
- traction apophotisits caused by achilles tendon
- add heel lifts
What are growing pains and how do you manage them?
- benign nocturnal limb pains of childhood
- deep cramping pain that awakens from sleep
- resolves by morning with no limb
- management: reassurance, heat, massage, warm baths, decrease exercise to non-aggravating levels, mild analgesics
In adolescent scoliosis, what is management for the following cobb angle?
< 30 degrees
Observation and resial radiographs q6 months until physeal closure
In adolescent scoliosis, what is management for the following cobb angle?
30-40 degrees
Bracing
In adolescent scoliosis, what is management for the following cobb angle?
> 40 degrees
Surgery
