peds ortho Sx

Question 1

high risk position for developmental dysplasia of the hip DDH

Answer 1

swaddling

when hips adducted and extended

Question 2

natural history of DDH can lead to

Answer 2

degenerative arthritis

Question 3

Clinical screening for DDH

4 points

Answer 3

1) limited hip abduction (45 deg or less)
2) clunk of dislocation
3) clunk of reduction
4) shorter thigh segment

Question 4

what is barlow’s sign

Answer 4

Clunk of dislocation

Hip slips out when adducted and a posterior force is applied

Question 5

what is ortolani’s sign

Answer 5

Clunk of reduction

- hip is out at rest, reduces with a clunk

Question 6

Galeazzi’s sign

Answer 6

shorter thigh segment

Question 7

up to 6 months of age what is the management of DDH

Answer 7

• pavlick harness - guided reduction

Question 8

when do you abandon the pavlick harness?

Answer 8

if the hip is not reduced in 3 weeks=

Question 9

What are the complications of the harness?

Answer 9

Avascular necrosis of the hip

femoral nerve palsy

Question 10

If the pavlick harness fails then perform and the child is > 6 months of age

Answer 10

closed reduction with spica cast