Principles of Paediatric Orthopaedics Flashcards
What are some “manufacturing” defects in infants?
- Spina Bifida - spinal cord exposed on outer skin
- Proximal femoral focal deficiency - parts of femur are missing
- TAR (thrombocytopenia with absent radius) Syndrome
- Thalidomide
- Congenital scoliosis
Name some “packaging” defects in infants?
- Metatarsus Adductus
- Infantile postural scoliosis
- Plagiocephaly - rarely needs intervention
- Congenital Torticolis - potentially a vascular issue, rarely requires surgery
- These defects can often be fixed once pressure removed out of womb
What is a defect that can be developmental or “packaging”?
•Talipes Equino-varus - club foot
What are some MSK issues that cause concern?
- In toed gait
- Bow legs
- Flat feet
- Curly Toes
- Late walkers
What is paediatric orthopaedics?
- The part of Orthopaedics that concentrates on the study of diseases and injuries affecting individuals with immature musculoskeletal systems and how these pathologies can be managed
- Fracture Treatment
- Management of orthopaedic conditions unique to childhood
- Management of conditions that are affected by development and growth
- MSK variants that cause concern
What is “in toeing”?
- A foot progression angle that is negative - toes point in
* Vast majority improve but not those due to neuromuscular disease
What is “in toeing” often caused by in the newborn?
Foot
What is “in toeing” often caused by in the infant?
Tibia
What is “in toeing” often caused by in a child of school age?
Femur
What is femoral anteversion?
- Developmental norm
- 40degress at birth
- 1-2degree decrease pa
- 80% reach 100 by 16yoa
- Increased = increased internal rotation of the hips
What is internal tibial torsion?
•Increased thigh foot angle
•90% + spontaneously resolve
•No role for splints, wedges, physio etc.
INTERNAL TIBIAL TORSION
What is metatarsus adducts?
•90% resolve by 1y •Stretching - does no harm •5% persist to adulthood •If flexible, no role for splintage METATARSUS ADDUCTUS
At what age is surgical intervention considered?
Secondary school age
Are flat feet normal at birth?
Yes
What characterises flexible flat fleet?
- Diminishes with age
* Insoles = No benefit
