Principles of Paediatric Orthopaedic Flashcards
What is paediatric orthopaedic?
Concentrates on the study of diseases and injuries affecting individuals with immature musculoskeletal systems and how these pathologies are managed
What does paediatric orthopaedic include?
Fracture treatment
Management of orthopaedic conditions unique to childhood
Conditions that are affected by development and growth
MSK variants that cause concern
What are manufacturing defects of infant abnormalities?
Spinal bifida
Proximal femoral focal deficiency
TAR syndrome
Thalidomide
Congenital scoliosis
What are some packaging defects in infant abnormalities?
Metatarsus adductus
Infantile postural scoliosis
Plagiocephaly
Congenital torticollis
What a condition that could be both manufacturing and packaging defect?
Talipes Equino-varus
What are MSK issues which cause parents concern?
Toed gait, bow legs, flat feet, curly toes and late walkers
What is causing in toeing in children?
New born - foot (metatarsus abductus)
Infant - tibia
School age - femur (femoral anteversion)
What is femoral anteversion?
Usually at birth 40 degree angle
Improves by 1-2 degrees a year so should improve with growth
Developmental norm
What is internal tibial torsion?
Increased thigh foot angle
90% spontaneously resolve
No role of splints, wedges or physio
Does metatarsus adductus need treatment?
90% spontaneously resolve
If flexible, no role for splintage
What is bowing in coronal plane?
Bent legs
Mostly physiological
Treat rarely
If symmetrical and getting better then just watch and wait
Describe flexible flat feet
Normal at birth
Diminished with age
Insoles are no benefit
What is the natural history of painless mobile flat feet?
Seen in all infants and 15% adults
Commoner with shoes, obese and ligament laxity
Shoes, arch supports and heel cups have no influence
Describe curly toes
Usually 3rd and 4th toes
Strong FH
Tightness in flexor tendons
Mostly cosmetic problem
What is walking age?
12 months - mean
50% walk later than 12 months
