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Clin Med Peds > Peds Ortho Problems > Flashcards

Peds Ortho Problems Flashcards

1
Q

what is responsible for longitudinal growth of long bones?

A

physis (growth plates)

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2
Q

where are ossification centers of child bones?

A

at ends of the long bone

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3
Q

when is ligamentous laxity greatest in children?

A

at infancy

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4
Q

what is trendelenburg gait?

A

excessive swaying of trunk with normal stance

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5
Q

what muscle stabilizes pelvis during stance phase and prevents the pelvis from dropping toward leg in swing phase?

A

gluteus medius

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6
Q

what is antalgic gait?

A

painful limp

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7
Q

what is bilaterally decreased in function with waddling gait? what disease is it seen in?

A

bilateral decrease in fxn of gluteus muscles

seen in muscular dystrophy

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8
Q

cause of acute limping in children?

A

transient synovitis

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9
Q

what is the MCC of hip pain in kids?

A

transient synovitis

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10
Q

what is characteristic of transient synovitis?

A

resolution of sx’s and return of ROM

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11
Q

what is transient synovitis? is there an infection?

A

self-limiting inflammatory condition of hip

THERE IS NO INFECTION

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12
Q

what are sx’s of transient synovitis? ROM of hip?

A

rapid onset limping and refusal to walk/bear weight

ROM of hip limited by pain and spasm

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13
Q

how is hip held in transient synovitis?

A

hip held in flexion

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14
Q

dx of transient synovitis?

A

dx of exclusion

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15
Q

tx of transient synovitis?

A

bed rest until s/s improve

gradually increase activity (NWB lasts 1-2 days)

NSAIDs

***NO ABX b/c NO INFECTION!!!

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16
Q

what MUST you exclude on your ddx of transient synovitis?

A

septic arthritis -> more severe pain

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17
Q

what are 3 causes of chronic limping in children?

A

Apophysitis (Osgood Schlater, Sever’s disease)

Slipped capital femoral epiphysis

Legg Calve Perthes Disease

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18
Q

what is apophysitis?

A

painful inflammation of a bony outgrowth and especially the area of active growth at the end of bone

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19
Q

what are the 2 types of apophysitis?

A

Osgood Schalter and Sever’s disease

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20
Q

what is Osgood Schlater disease?

A

traction of apophysitis in adolescent girls and boys

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21
Q

presentation of Osgood Schlater?

A

pain over tibial tuberosity relieved with rest

prominent tibial tubercles, redness

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22
Q

tx of Osgood Schlater?

A

rest, ice, NSAIDs, reassurance

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23
Q

what is Sever’s disease?

A

apophysitis at insertion of achilles tendon into calcaneus

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24
Q

what is a common cause of Sever’s disease?

A

repetitive stress from running/jumping on growth plate as foot strikes ground and results in inflammation/pain

25
Q

Sever’s disease occurs during what?

A

growth spurts

26
Q

s/s of Sever’s disease?

A

child/adolescent with heel pain bad enough to cause limp

27
Q

when is Sever’s disease usually first noticed?

A

after sport then during and after and w/new cleats

28
Q

tx of Sever’s disease?

A

RICE and NSAIDs

D/C sport if severe enough

Symmetric gel heel pads if moderate

Achilles stretch

29
Q

what is slipped capital femoral epiphysis?

A

d/o of proximal femoral physis that leads to slippage of epiphysis relative to femoral neck

30
Q

what is the most common d/o affecting adolescent hips?

A

slipped capital femoral epiphysis

31
Q

what is the greatest RF of slipped capital femoral epiphysis?

A

obesity

32
Q

what are the MC sx’s of slipped capital femoral epiphysis?

A

groin and thigh pain

33
Q

what’s the gait like for slipped capital femoral epiphysis? hip motion is what?

A

external rotation or trendelenburg

decreased hip motion

34
Q

imaging for slipped capital femoral epiphysis?

A

AP Hip and Frog Lateral

35
Q

what is the treatment of choice for slipped capital femoral epiphysis?

A

percutaneous in situ fixation

36
Q

why should you not mixx the dx of slipped capital femoral epiphysis?

A

b/c abnormal gait and external rotation of leg are permanent

37
Q

what can you have and can you NOT have when fixing peds fx?

A

you can have angulation BUT NOT rotation

38
Q

complications of peds fx’s?

A

overgrowth, neuromuscular injury, compartment syndrome

39
Q

<10 y/o with femoral fx can overgrow how much?

A

1-3cm

40
Q

what can result in premature closure of the physis (growth plates)?

A

growth plate fx’s

41
Q

complete closure of physis before it should be closed can result in what? most common in what bones?

A

limb shortening

MC in distal femur and distal/proximal tibia

42
Q

how are growth plate fx’s classified?

A

Salter-Harris

43
Q

what are common sites for physis fx’s?

A

distal radius, tibia, fibula

44
Q

what is Salter-Harris Type 1?

A

transverse fx through physis

S for straight through

45
Q

what is Salter-Harris Type 2?

A

fx through part of physis and metaphysis

A for above

46
Q

what is the MC type of Salter-Harris fx?

A

Type 2 - fx through part of physis and metaphysis

47
Q

what is Salter-Harris Type 3?

A

fx through physis and epiphysis into joint (intra-articular)

L for lower

48
Q

what is Salter-Harris Type 4?

A

fx through metaphysis, physis, epiphysis

T for through

49
Q

what is Salter-Harris Type 5?

A

crush injury of physis - not displaced, but damaged by direct compression

ER for ERasure of growth plate or cRush

50
Q

what confirms dx of Salter-Harris Type 5?

A

growth arrest, complete obliteration or diminished physical distance confirms dx

51
Q

what is Toddlers Fx?

A

minimally/displaced oblique spiral fx of tibia w/out fibula fx

52
Q

supracondylar elbow fx due to?

A

FOOSH from moderate height into fully extended elbow -> falling from monkey bars

posterior displacement of the distal component

53
Q

tx of supracondylar elbow fx?

A

long-arm cast

ORIF

54
Q

tx for nursemaids elbow?

A

pressure on radial head and gentle supination while flexing the elbow

55
Q

what happens in nursemaids elbow?

A

radial head is subluxed

56
Q

what is Monteggia Fx dislocation? MOA? Tx?

A

fx of ulna shaft with anterior dislocation of radial head

MOA is secondary to FOOSH

Tx is ORIF

57
Q

what is Galeazzi Fx dislocation? MOA?

A

fx of distal radius with dislocation of the distal radioulnar joint

MOA is FOOSH

58
Q

what is intact in Galeazzi Fx?

A

ulna proximally

59
Q

wha are the anatomic abnormalities of developmental dysplasia of the hip?

A

hip that is dislocated and irreducible

unstable (dislocatable and reducible)

dysplastic, but within acetabulum (Femoral head isn’t rounded)

Clin Med Peds (10 decks)

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