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Children's Orthopaedics Flashcards

(55 cards)

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1
Q

What is the steps involved in Cerebral palsy progression?

A
  • Brain injury
  • Increased tone
  • Abnormal posture
  • Contracture
  • Bony deformity
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2
Q

What is the migration index?

A
  • gives % of hip ball out of socket, then gives the % risk factor for dislocation
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3
Q

What is the GMFCS score?

A
  • Cerebral palsy

- Score 1-5 at risk children

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4
Q

In the gait cycle what percentage is swing and what percentage is stance?

A
  • stance = 60%

- swing = 40%

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5
Q

What is ambulation?

A
  • Walking
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6
Q

What is dependant on for normal walking?

A

-An appropriate and adequate force acting via a rigid lever of appropriate length on a stable joint

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7
Q

What are the prorities of normal gait?

A
  • Stability in stance
  • Clearance in swing
  • Pre-position of foot in terminal swing
  • Adequate step length
  • Conservation of energy
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8
Q

What are the main orthopaedic complications with CP?

A
  • Hip dislocation
  • Scoliosis
  • Gait
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9
Q

Causes of CP CNS insult?

A
  • In utero (2nd or 3rd trimester)
  • Prematurity birth
  • Very few obstetrics
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10
Q

Muscle dystrophy in males?

A
  • Duchenne muscle dystrophy
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11
Q

In club foot what region of the foot is in contact with the ground?

A
  • Dorsum of the foot
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12
Q

CAVE nmenonic for deformity of club foot?

A

o Cavus
o Adduct
o Varus
o Equinus

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13
Q

Rockerbottom vs clubfoot?

A
  • Club foot towards midline

- Rockerbottom laterally

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14
Q

Leg pain red flags

A
  • Asymmetry
  • Good localisation
  • Short history
  • Persisting limp
  • Not thriving
  • Pain worsening
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15
Q

Treatment of clubfoot?

A
  • Boots and bar (bracing)
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16
Q

Knee pain means what examination should be done?

A
  • Hip examination

- referred pain

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17
Q

HSMN stands for?

A
  • Hereditary sensory and motor neuropathy
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18
Q

What may be seen in HSMN in the foot?

A
  • High arched foot

- foot weakness

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19
Q

Why are babies USS of their hips?

A
  • To assess for developmental dysplasia
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20
Q

What are specific hip tests in babies?

A

o Barlow’s

o Ortolani

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21
Q

What are you checking for when inspecting a babie’s hips?

A

o Asymmetry
o Loss of knee height
o Crease asymmetry
o Less abduction in flexion

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22
Q

How is Barlow’s test preformed?

A

-Adduction with downward pressure

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23
Q

Risk factors for developmental dysplasia?

Study These Flashcards
A 
o	Females
o	Breech (foot first)
o	Family history
o	Oligohydramnios (low level of amniotic fluid)
o	Moulded baby 
o	First born
o	Weight >4kg
24
Q

How is Ortolani’s exam performed?

Study These Flashcards
A

-Clunk towards the midline

25
Treatment of early DDH?
- Pavlik Harness - 23-24hrs per day for 12 weeks - Hips are abducted and flexed
26
Treatment of late DDH?
- Age > 3months - Surgery o CR spica o OR spica - Will not get a normal hip
27
What is Antalgic gait
- painful limp
28
Symptoms of SCFE – Slipped Capital Femoral Epiphysis
o Short o Externally rotated o Loss of internal rotation o Loss of deep flexion
29
Tip toe walking may be normal variation up to what age?
- 3 years
30
Tip toes walking may be a sign of?
- Cerebral Palsy
31
What is SCFE/SUFE?
- Ball of the hip (epiphysis) starts to flip off the growth plate (physis)
32
Transient synovitis may occur after what?
- viral infection
33
What position may a child lie in with transient synovitis?
- lie with the hip flexed and externally rotated
34
What must you rule out in a possible case of transient synovitis?
- Septic arthritis
35
What does septic arthritis lead to?
- destruction of the joint
36
What may be the presenting features of septic arthritis in paediatrics?
- severe pain - lie with hip flexed and externally rotated - severe pain - struggle to walk - high fever
37
What is the treatment of septic arthritis?
- surgical drainage | - antibiotics
38
What criteria is used in septic arthritis?
- Kocher's criteria
39
DDH vs SCFE/SUFE
- DDH - born with, not painful | - SCFE/SUFE - acquired, painful, teenage years
40
What is Perthes disease?
- Avascular necrosis of the hip
41
What forms at the apical ectodermal ridge?
- Hand development
42
What gene may be affected that leads to hand deformities?
- Sonic Hedgehog gene
43
What hip is most commonly affected in DDH?
- the left hip
44
Define cavus
- foot has a very high arch | - seen in CP
45
Define equinus
- Lacks the flexibility to bring the toes closer to the leg
46
What is another term for osteogenesis imperfecta
- Brittle bones disease
47
What gene is affected in osteogenesis imperfecta
- defect of the maturation and organisation of type 1 collagen
48
What are some symptoms of osteogenesis imperfecta
- Multiple fragility fractures - short stature - blue sclerae - loss of hearing
49
What gene is affected in Marfan's syndrome?
- Fibrillin gene
50
What are the symptoms of Marfan's syndrome?
- tall stature - out of proportion long limbs - laxity
51
What is abnormally formed in Ehlers-Danlos syndrome?
- abnormal elastin and collagen formation
52
What gene is defected in Duchenne muscular dystrophy?
- Dystrophin gene (calcium transport)
53
Explain varus gait?
- angulation of the distal segments of a bone or joint towards the midline
54
Explain valgus gait?
- angulation of the distal segments of a bone or joint away for the midline
55
What is the treatment for talipes equinovarus (clubfoot)
-Ponseti technique splints

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