Principles of Paediatric Orthopaedics Flashcards
What are the different group of infant abnormalities?
- manufacturing defects
- packaging defects
- could be either
What are examples of manufacturing defects?
- spina bifida
- proximal femoral focal deficiency
- TAR syndrome
- thalidomide (medication)
- congenital scoliosis
What are examples of packaging defects?
- metatarsus adductus
- infantile postural scoliosis
- plagiocephaly
- congenital torticollis
What is an example of both a manufacturing defect and packaging defect?
Talipes equino-varus
What are 5 MSK issues that precipitate a lot of referrals?
- in toed gait
- bow legs
- flat feet
- curly toes
- late walkers
What are the 3 principle reasons for in toed gait?
newborn problems in foot
- metatarsus adductus
- 90% resolve by 1 year
infant problem with tibia
- internal tibial torsion, increased thigh foot angle
- 90% resolve spontaneously, no role for splints, wedges, physio
school age problem with femur
- femoral anteversion
- normal is 40 degrees at birth, decreases 1-2 degrees per year to adult amount of 10 degrees by 16 years
What is the treatment for in toed gait?
- most improve, but no improvement in time in neuromuscular disease
- never operate before 10 years
In in-toed gait, do the toes point medially or laterally?
Medially (inwards)
What is the treatment for bow legs?
This is common and resolves over time most of the time, rarely is treated
Infants legs are normally varus or valgus?
varus
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What is flat feet?
where medial longitudinal arch is not evident when the child stands
What is the treatment of flat feet?
Normal at birth and usually diminishes with age, insoles have no benefit
What are the 2 kinds of flat feet?
Mobile flat foot
- when do Jack’s test (raise big toe) arch forms
Stiff flat foot
- underlying pathological cause
- very rare
What is the aetiology of curly toes?
Usually 3rd or 4th toe with family history
Due to tightness of flexor tendons
What is the treatment of curly toes?
Mostly cosmetic problem, 25% improve spontaneously
If functional problem treat with flexor tenotomy if over 6 years
Which toes are usually affected by curly toes?
Usually 3rd or 4th toe
What is the mean walking age?
12 months is the mean, remember mean is not normal as 50% of children walk later than the mean
What are the 5 S’s of when to refer to paediatric orthopaedics?
- symptoms
- symmetry (really asymmetry reason to refer)
- stiffness
- syndromes
- systemic illness