trigger ortho Flashcards
where does the tibial spine attatch to
the ACL!
McCmurray test tests for what
meniscal tears
hyperextension of the knee with concurrent rotation of femur on tibia
tibial spine fracture MOI
tx of non displaced vs displaced tibial spine fracture
- non-displaced: immobilize knee in full extension and orhto referall
- displaced: needs reduction and IMMEDIATE ortho consult
these fractures frequently acocmpany ligament tears, meniscal injuries and patellar dislocations
osteochondral fractures
caused by sudden, forcefull contraction of the quadriceps to a flexed knee
sudden stop from full sprint, landing after jumping
patellar sleeve fracture
quadriceps exceed the strength of the patella
tx for patellar sleeve avulsion fracture
immobilization of knee w ortho surgery referall
as this disease progresses it can cause demineralization and detatchement of bone and overlying cartilage
osteochondritis dissecans
tx for osteochondritis dissecans
immbolization for 3-6 mo.
this diagnosis, if left untreated, can lead to premature arthritis
osteochondritis dissecans
what is the MC reason for inflammatory childhood limp
toxic synovitis
occurs after recent URI
ortho problem that can occur after URI
toxic synovitis
hips and knees effected most!!!
When do you use the Kosher Criteria and what are the kosher criteria
to determine severity of septic arthritis (like in the hip!)
- fevr >101.3
- ESR>40
- WBC>12
- inability to bear weight
How do you treat suspected septic arthritis
I&D of the hip PRN and aspiration of joint fluid
ABX that cover staph Aureus
what is the treatment for metatarsus adductus
- stretching for mild/mod
- Casting for severe
shortened achilles tendon is associated with what diagnosis
clubfoot/ talipes equinovarus
what is the proper term for clubfoot
talipes equinovarus
I just know ima forget this
what is the MC type of clubfoot
congenital (idiopathic)
Ponseti method is used when
Clubfoot
manipulation w serial castings for 4-10 applicaitons
what is the indication for treating tibial torsion
if feet are turned greater than 15 degrees by age 5
if an eaminer can is able to passively correct the deformity into the middle position but no farther what level of metatarsus adductus is this
mild, moderate or severe
moderate
what are the MCC for intoeing in:
- less than 1 yr
- 1-3 yrs
- 3+ yrs
- less than 1 yr = metarsus aDDuctus
- 1-3yrs = internal tibial torsion
- 3+ yrs = femoral anteversion
Femoral derotational osteotomy is a treatment of what
a child w severe dysfunction or deformity caused by femoral anteversion
hip adducted w posteriorly directed pressure is defining what maneuver
barlow maneuver
hip is abducted while lifting the trochanter anteriorly
ortolani maneuver
what are the indications for screening for DDH in an infant
what is the screening method of choice? how does this change once a child reaches 4 months old?
US is method of choice!
- any child w hip instability
- any male/female born breech >34 wks gestation
- FHx of DDH
- any child >4 mo with instability, limp or unstable gait uses xray for screening eval
what is the treatment for a positive:
* ortaloni
* barlow
- ortolani = US, refer to specialist
- barlow = US, observe and follow
treatment of DDH
pain/tenderness to the tibial tubercle w/wo edema
osgood schlatter disease
what is inflamed in osgood schlatter disease
patellar tendon
tx for osgood schlatter dz
ice 20-30 min BID, NSAIDs, stretching quads, PT PRN
benign and self limiting. NO crutches or knee immobilizers!!!
degeneration of cartilage d/t poor alignment of the kneecap
patellofemoral syndrome
who has theatre sign and what is theatre sign
- people w patellofemoral syndrome
- theatre sign = aggravation of syndrome by activity or prolonged sitting w bent knees!!
tx of patellofemoral syndrome
- strengthening quads and hammies
- NSAIDS, Ice, DC activity causing pain.
dx is clinical but you may see it on xray
pt comes in w two months of hip pain that has now developed a limp and he is no longer able to weight bear on his left leg. what is the diagnostic of choice? what is the dianosis and tx?
- xray, US, MRI (just one)
- SCFE
- tx= internal fixation w single cannulated screw placed in center of epiphysis
I feel like this could also be describing legg calve perths disease!
this disease can lead to avascular necrosis of the femoral head
SCFE
can also lead to chondrolysis at the hip joint and osteoarthritis
what is legg-Calve perthes disease
idiopathic necrosis of the hip
Xray of the hip shows joint effusion with widening of joint space and periarticular swelling
legg calve perthes disease
what are indications for bracing or surgery in scoliosis?
- > 20 degrees or progression of >5 degrees
what is a toddlers fracture
spiral fracture of distal 1/2 of the tibia
how do you treat X linked hypophosphatemia
calcitriol, amiloride and HCTZ
mutation of the phosphate regulating gene is the mechanism for which disease
X linked hypophosphatemia
asude from short stature of the lower limbs, what are some other s/s that you would see with x linked hypophosphatemia
- dental abnormalities (delayed with abscesses)
- deafness
- chiari malformation of brian
- calcification of tendons/ligamentts/joints
- craniosyntosis
