Paediatric Orthopaedics

Question 1

What type of knees do children at birth normally have?

Answer 1

varus knees (bow legs)

Question 2

At what age to varus knees become naturally aligned?

Answer 2

around 14 months

Question 3

What does a valgus deformity look like?

Answer 3

knock knee

Question 4

When is the abnormality of intoeing normally exaggerated?

Answer 4

running

Question 5

What can give the appearance of in toeing?

Answer 5

excess femoral neck anteversion

Question 6

Are flat feet normal?

Answer 6

yes, part of normal variation

Question 7

Flat feet can be mobile or fixed, which test determines this?

Answer 7

Jack test

Question 8

What type of flat feet is abnormal and why?

Answer 8

fixed, rigid

underlying bone abnormality (tarsal coalition)

Question 9

Which toe is most commonly affected in curly toe?

Answer 9

fifth

Question 10

What is Developmental Dysplasia of the Hip?

Answer 10

dislocation or subluxation of femoral head during perinatal period affecting hip joint development

Question 11

Is DDH more common in boys or girls?

Answer 11

girls

Question 12

Is DDH more common in left or right hip?

Answer 12

left

Question 13

If untreated, what is the acetabulum like in DDH?

Answer 13

shallow

Question 14

What are signs of DDH?

Answer 14

shortening, assymetrical skin creases at groin, click or clunk on maneuvres

Question 15

Name the commonest cause of hip pain in childhood.

Answer 15

Transient synovitis

Question 16

What is transient synovitis?

Answer 16

inflammation of synovium of joint - most commonly hip

Question 17

When does transient synovitis tend to occur?

Answer 17

2-10 yrs

Question 18

Are boys more commonly affected or girls in transient synovitis?

Answer 18

boys

Question 19

What is Perthes Disease?

Answer 19

osteochondritis of femoral head, more common in boys

Question 20

What do affected children present with in Perthes Disease?

Answer 20

pain and limp, mostly unilateral

Question 21

What is SUFE?

Answer 21

slipped upper femoral epiphysis, mainly affects overweight pre pubertal adolescent boys

Question 22

What is the predominant clinical sign of SUFE?

Answer 22

loss of internal rotation of hip

Question 23

Treatment of SUFE?

Answer 23

urgent surgery to pin femoral head (to prevent further slippage)

Question 24

What is Jumper’s knee?

Answer 24

patellar tendonitis

Question 25

Most often adolescent knee pain is self limiting, what may be needed if pain is resistant?

Answer 25

surgery to shift forces on the patella

Question 26

What is clubfoot?

Answer 26

Talipes Equinovarus - congenital foot deformity. treatable with early splintage (ponseti technique)

Question 27

Hallux valgus can occur when?

Answer 27

often in late teens, has strong family history