peds ortho surg Flashcards
1
Q
def. hip dysplasia
A
abnormal dev. of the femoral head and acetabulum
2
Q
spectum of instability (5)
A
- subluxatable
- dislocatable
- subluxated (Reducible)
- dislocated (reducible)
- irreducible
3
Q
5 risk factors for DDH
A
- breech
- fam hx
- female
- 1st born - less room
- swaddled babes
4
Q
nat Hx of DDH
A
- leg length discrepancy
- scoliosis
- ipsilateral knee pain and deformity
- gait abnormal
- low back pain
- degen arth
5
Q
4 clinical tests for DDH
A
- assymetric abduction (should be >45)
- barlow’s (clunk when hips adducted)
- ortolani (clunk when hip abducted and upward)
- galeazzi - shorter thigh segment
6
Q
5 DDH findings in children >3months
A
- instability rare
- limited ROM
- leg lenght disc
- painless limp
- imaging studies
7
Q
2 imaging studies and indications
A
- US
- coronal and trans planes
- high risk bbs - x-rays
- when ossific nucleaus begun
8
Q
what are AAP guidelines for DDH
A
- screen all before discharge
- 2-week exam
- well baby exams until walking
- barlow or ortolani - refer
- imaging at 3-4 weeks for risk factors
- refer if imaging prostive
9
Q
DDH mgmt
A
- pavlik harness up to 6 months
- full time for 6 weeks
- U/s to confrim reduction
- abandon if not better in 3 weeks
- night time for 6 weeks
- effective in majority
- not extra diapers
10
Q
2ry mgmt of DDH
A
- closed reuction with spica cast
- for failure of harness
- older than 6 mo
- adductor tenotomy
11
Q
DDH surgical mgmt
A
- open reduction and casuloraphy
- pevic osteotomy after 18 months
- femoral shrotening in older child
- risk of avasc. necrosis
12
Q
def. clubfoot
A
talipes equines varus
- male>female
- diagnoses prenatally
- fam hx
13
Q
4 idiopathic clubfoot etiologies
A
- mechanical
- neuromucular
- arrested fetal dev.
- inherited
14
Q
4 syndromic causes of clubfoot
A
- spina bifida
- arthrogryposis
- cerebral palsy
- polio
15
Q
5 findings in club foot
A
- hindfoot equinus
- deep posterior crease
- empty soft heel
- hinffoot varus
- midfoot cavus
