Children's Orthopaedics - Normal Growth and Development Flashcards Preview

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Flashcards in Children's Orthopaedics - Normal Growth and Development Deck (33):
1

What is appositional growth of bone?

This is outward growth of bone causing increases in bone thickness

2

Which factors can affect bone growth?

  • Vitamins D and A
  • Diet
  • Injury
  • Illness
  • Hormones (e.g. GH)

3

What is the medical term for bow-leggedness?

Genu varum

4

At what age is genu varum considered normal?

< 2 years

5

When would genu varum be condiered abnormal?

  • > 16º from mean
  • The patient has short stature
  • It is painful

6

What can cause genu varum?

  • Skeletal dysplasia
  • Rickets
  • Tumour
  • Blount's disease
  • Trauma

7

What is Blount's disease?

There is growth arrest of the proximal medial tibial physis

8

What is the characteristic sign of Blount's disease on X-ray?

Beak-like protrusion

9

What can cause genu valgum?

  • Tumours
  • Rickets
  • Neurofibromatosis
  • Idiopathic

10

When is genu valgum considered normal?

The incidence peaks at age 3.5

11

When would you refer a patient with genu valgum?

  • It is asymmetrical
  • It is painful
  • It is severely abnormal (>2SD)

12

Intoeing can be related to what 3 things?

  1. Femoral neck anteversion
  2. Internal tibial torsion
  3. Metatarsus adductus

13

In femoral neck anteversion, where does the femoral neck point?

Anteriorly

14

Does femoral neck anteversion have consequence normally?

No

15

What can femoral neck anteversion predispose to?

Patellofemoral problems

16

Internal tibial torsion normally occurs in which age group of patients?

Toddlers

17

When do most cases of internal tibial torsion resolve by?

6 years

18

What is the treatment for internal tibial torsion?

Surgery

Only when very severe

(braces and orthotics are useless)

19

Describe metatarsus adductus?

The metatarsals are adducted

This is a benign, common and self-limiting condition

20

Metatarsal adductus can be treated by what if necessary?

Serial casting

21

Flat feet are common.

True or false?

True

22

Why do flat feet normally not remain in adulthood?

There is usually medial arch development as the posterior tibialis strengthens

23

What are the two types of flat footedness?

  1. Flexible
  2. Fixed

24

How can you tell the differnece between flexible and fixed flat footedness?

Flexible flat footedness returns to normal on tip toes

25

What may be the causes of flexible flat footedness?

  1. Ligamentous laxity
  2. Tightness of the gastrosoleus complex

26

What may be the cause of fixed flat footedness and what is the potential treatment?

Tarsal coalition (bone fusion)

Surgery (when painful)

27

Which toes does curly toes normally affect?

3rd or 4th

28

How may curly toes be treated of they are severe or do not resolve by 6 years?

Flexor tendonotomy

29

Anterior knee pain is common in which age groups?

Adolescents

30

People with anterior knee pain may be predisposed to what?

Arthritis posterior to the patella

31

What must be check in anterior knee pain cases?

The hips

(issues here can be the cause)

32

What is the treatment for anterior knee pain?

Usually physiotherapy

33

When is anterior knee pain exacerbated?

Stairs and squats

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