Children's Orthopaedics Flashcards
(41 cards)
List 3 characteristics of bone in children
- Less dense and more porous than adult bones (bend, buckle)
- Thicker periosteum: more rapid healing
- Remodeling
List 4 possible causes of fractures in infants
- rare
- birth trauma
- child abuse
- osteogenesis imperfecta
What is a greenstick fracture and where is it most commonly seen?
Why do these occur in children?
break occurs through the periosteum on one side of the bone while only bowing or buckling on the other side. Seen most frequently in forearm
Occur in children because their bones are more flexible (can bend or buckle)
List the catagories of the Salter Harris classification
List 4 treatments for ‘immobilisation’ of a fracture
- cast
- traction
- bedrest
- brace
List 4 causes of a ‘limp’ in a child (there is heaps!)
List 4 important hip conditions in children we MUST identify
List 4 other differentials for a painful hip
- Sepsis
- Leg Calve Perthes Disease
- SUFE (slipped upper femoral epiphysis)
- DDH (clicky hips)
- synovitis
- Juvenile Arthritis
- septic arthritis
- blood disorders
Give the pathophysiology of ????
Transphysial blood vessels Seive like arrangements Immunity
List 4 investigations used to diagnose hip pathologies in children?
What is Kocher’s Criteria and give the parameters
Tool used in the differentiation of septic arthritis from transient synovitis in the child with a painful hip.
- Fever
- Raised Inflammatory Markers (WCC / ESR / CRP)
- Hip Effusion on ultrasound scan
- Aspiration?
- Radiological Features
How do we manage septic arthritis in a child
What is Leg-Calve-Perthes Disease
Idiopathic avascular necrosis of femoral head, commonly presents between 5–7 with insidious onset of hip pain that may cause child to limp
Give the common presentation of Perthes disease
Painful limp, localised to the groin (may be reffered to the antero-medial thigh or knee region)
It has an Insidious onset and is activity-related + relieved by rest
State and explain the classification system for Perthes disease?
Herring (Lateral Pillar) Classification
- A <50 %
- B >50%
- C Whole head
- B / C Age at presentation
List 4 Prognostic Factors of Perthes
- Age of onset
- Extent of epiphyseal involvement
- Range of movement
- Femoral Metaphyseal Involvement (at risk)
- Acetabular Congruity
- Type of treatment (?)
- Stage at treatment initiation (?)
List 4 broad management options for Perthes and incl pros/cons of each
What does SUFE stand for and what is it
Slipped Upper (Capital) Femoral Epiphysis
List 4 risk factors for SUFE
- obesity
- hypothyroidism
- hereditary factors
- post radiation
- weakened physeal plate
List 2 presentations of SUFE that can be identified without an X-ray
Pain (at thigh or knee)
Gait (antalgic)
List the 4 types of slip, SUFE can present with
- Pre–Slip
- Acute (Unstable) Slip 10%
- Chronic (Stable) Slip
- Acute on Chronic
How can SUFE be classified and how does treatment differ for each?
- Mild < 30% ➞ Fix in situ
- Moderate 30-70% ➞ Fix in situ/ Osteotomy
- Severe >70% ➞ Osteotomy
Give 4 causes of Clicky / Hypermobile Joints
What is DDH (D(C)DH)
Developmental (congenital) Dislocation of Hip
How may DDH present during different stages of life
