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Year 2 Loco > 22. Paediatric orthopedics (Robson) > Flashcards

22. Paediatric orthopedics (Robson) Flashcards

1
Q

Flat foot is often described by parents as their child having what?

A

Weak ankles

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2
Q

Flat foot - ankles turn inward or outward?

A

Inward

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3
Q

Flat food - what arch of the foot is missing?

A

Medial longitudinal arch

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4
Q

Two causes of flat food?

A

Muscle imbalance - need physiotherapy

Incorrect shape of the tarsal bones - need shaving

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5
Q

Habitual toe walking normally disappears at what age?

A

Two

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6
Q

Three conditions linked to persistent toe walking?

A

Cerebral palsy
Duchene muscular dystrophy
Other nervous system problems

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7
Q

Toe walking can cause a problem in which muscle group?

A

Planterflexors - hypotonic

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8
Q

Treatment for toe walking? x2

A

Casting foot and ankle for six weeks to stretch the calf muscle

Surgery to release tight calf muscles

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9
Q

Club foot is also known as?

A

Talipes equinovarus

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10
Q

Club foot is more common in males or females?

A

Males

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11
Q

Five risk factors for club foot

A 
Breech presentation
Connective tissue disorders
Oligohydramnios
Edwards syndrome - trisomy 18
Family history
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12
Q

Treatment for club foot is?

A

Ponsetti method

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13
Q

Why is the ponsetti method successful?

A

Baby still has woven bone - can manipulate this

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14
Q

How long does the ponsetti method take?

A

Period of five weeks

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15
Q

Congenital hip dysplasia is more common in males or females?

A

Females

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16
Q

Risk factor for CHD? x2

A

Breech presentation

Scoliosis

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17
Q

Hormone that may be involved in the development of CHD is?

A

Relaxin

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18
Q

How will a baby with CHD present? x2

A

Extra crease around the hip joint at the gluteal aspect when in crawl position

Shorter and externally rotated leg

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19
Q

Two tests to diagnose CHD?

A

Barlow test

Ortolani test

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20
Q

What is the Barlow test?

A

Brings legs from abduction to adduction and push down to see femoral head slip from acetabulum

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21
Q

What is the Ortolani test?

A

Bring legs from adduction out to abduction to see movement of the femoral head

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22
Q

What is the Galeazzi sign in CHD diagnosis?

A

Flex both the knees - leg length discrepancy

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23
Q

Why can x-rays not be used to diagnose CHD?

A

Femoral head is not ossified until about three months SO cannot see it on an x-ray

24
Q

What is used to image CHD?

A

Ultrasound

25
Q

Treatment for CHD?

A

Pavlick harness

26
Q

Relation of head of the femur to Perkin’s line?

A

Head of the femur should be medial to perkins line

27
Q

Relevance of Perkin’s line to CHD?

A

If the head of the femur is lateral to Perkin’s line - CHD

28
Q

Two potential adverse effects of the Pavlick harness?

A

Avascular necrosis

Femoral nerve palsies - temporary

29
Q

Indication for use of the pavlick manouvre?

A

Child less than 6 months old

30
Q

Treatment of CHD over 6 months old?

A

Surgery - open reduction

31
Q

Untreated CHD will present as?

A

Horizontal neck of femur - shortened leg with limited movement

32
Q

What is Perthes’ disease?

A

Self-limiting avascular necrosis fo the femoral head

33
Q

Artery involved in Perthes’ disease?

A

Acetabular branch of the obturator artery

34
Q

Four stages of Perthe’s disease?

A

Necrosis
Fragmentation
Reossification
Remodelling

35
Q

Non-surgical treatment for Perthes’ disease? x3

A

Swimming/cycling to build surrounding muscles
Bed rest
Plaster cast/brace

36
Q

Surgical treatment for Perthes’ disease and indication for use

A

Osteotomy

Older children

37
Q

Purpose of plaster cast/brace in Perthes’ disease treatment?

A

Want to keep the femoral head inside the acetabulum

38
Q

What form of exercise is not recommended for an individual with Perthes’ disease?

A

Running

39
Q

Slipped upper femoral epiphysis SUFE more common in male or female?

A

Male

40
Q

Which hip is most commonly affected in SUFE?

A

Left

41
Q

What is SUFE?

A

Slippage of the epiphyseal growth plate

42
Q

Four risk factors for the development of SUFE?

A

Obesity
Hypothyroidism
Increased/decreased androgens
Trauma

43
Q

What movement cannot be performed at the hip in someone with SUFE?

A

Cannot perform internal rotation

44
Q

Between what years does SUFE tend to occur?

A

10-17

45
Q

What line is drawn to diagnose SUFE?

A

Klein’s line - superior portion of femoral neck

46
Q

Relevance of Klein’s line to diagnose SUFE?

A

Klein’s line should cross at least some portion of femoral head

47
Q

Three treatments for SUFE

A

Rest
Analgesia
Surgery

48
Q

What is Blount’s disease?

A

Compression of the growth plate of the knee

49
Q

Presentation of Blount’s disease?

A

Bow legs

50
Q

What is Osgood-Schlatters disease?

A

Endochondral ossification disturbance fo the knee - self limiting

51
Q

Common cause of Osgood-Schlatters?

A

Underdevelopment of quads

52
Q

Drugs given for treatment of Osgood-Schlatters?

A

NSAIDs

53
Q

What is the acetabular angle?

A

Angle between Hilgenreiner’s line and acetabular index line?

54
Q

Acetabular angle between 0-1 years?

A

<34

55
Q

Acetabular angle between 1-4 years?

A

<28

56
Q

Acetabular angle >4 years?

A

<25

Year 2 Loco (31 decks)

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