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MSK > Principles of Paediatric Orthopaedics > Flashcards

Principles of Paediatric Orthopaedics Flashcards

1
Q

What are some “manufacturing” defects in infants?

A
  • 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
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2
Q

Name some “packaging” defects in infants?

A
  • 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
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3
Q

What is a defect that can be developmental or “packaging”?

A

•Talipes Equino-varus - club foot

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4
Q

What are some MSK issues that cause concern?

A
  • In toed gait
  • Bow legs
  • Flat feet
  • Curly Toes
  • Late walkers
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5
Q

What is paediatric orthopaedics?

A
  • 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
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6
Q

What is “in toeing”?

A
  • A foot progression angle that is negative - toes point in

* Vast majority improve but not those due to neuromuscular disease

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7
Q

What is “in toeing” often caused by in the newborn?

A

Foot

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8
Q

What is “in toeing” often caused by in the infant?

A

Tibia

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9
Q

What is “in toeing” often caused by in a child of school age?

A

Femur

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10
Q

What is femoral anteversion?

A
  • Developmental norm
  • 40degress at birth
  • 1-2degree decrease pa
  • 80% reach 100 by 16yoa
  • Increased = increased internal rotation of the hips
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11
Q

What is internal tibial torsion?

A

•Increased thigh foot angle
•90% + spontaneously resolve
•No role for splints, wedges, physio etc.
INTERNAL TIBIAL TORSION

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12
Q

What is metatarsus adducts?

A 
•90% resolve by 1y
•Stretching - does no harm
•5% persist to adulthood
•If flexible, no role for splintage
METATARSUS ADDUCTUS
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13
Q

At what age is surgical intervention considered?

A

Secondary school age

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14
Q

Are flat feet normal at birth?

A

Yes

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15
Q

What characterises flexible flat fleet?

A
  • Diminishes with age

* Insoles = No benefit

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16
Q

What characterises flexible flat fleet?

A
  • Diminishes with age
  • Insoles = No benefit (may reduce pain)
  • See in all infants (fat foot and lax ligaments)
  • Many Children have them
  • 15% Adults
  • Commoner with shoes, obese, Ligament laxity
  • In adult soldiers not associated with symptoms
  • Shoes, arch supports, heel cups no influence
17
Q

What characterises stiff flat feet?

A
  • Cannot bring up toe
  • Underlying pathology
  • Very small proportion of all flat feet
18
Q

Which toes are usually affected by curly toe?

A

•3rd, 4th

19
Q

What causes curly toes?

A
  • Strong Family History

* Tightness flexor tendons

20
Q

How are curly toes treated?

A
  • Taping no help in long term
  • Mostly cosmetic problem
  • ¼ improve spontaneously
21
Q

When is a flexor tenotomy considered for curly toes?

A

•After 6 years if causing a functional problem

22
Q

What is the normal walking age?

A
  • 12 months = Mean
  • ‘Normal’ ≠ Mean
  • 50% of children walk later than the mean
  • Concern after 18months - look for underlying neurological problems
23
Q

What are the 5 Ss for paediatric orthopaedic referral?

A
  • Symptoms
  • Symmetry (Really •Asymmetry reason to refer)
  • Stiffness
  • Syndromes
  • Systemic Illness

MSK (28 decks)

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