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Orthopaedics > MSK Paediatrics > Flashcards

MSK Paediatrics Flashcards

1
Q

differentials for limping child 7

A

transient synovitis

septic arthritis/ osteomyelitis

Juvenile idiopathic arthritis

trauma

Development dysplasia of the hips

Perthes disease

Slipped upper femoral epiphysis

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2
Q

presentation of transient synovitis 3
-age
-gender bias

A

acute onset

usually accompanies viral infections
-but child is well or has mild fever

most common in boys, age 2-12

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3
Q

presenation of septic arthritis/osteomyeltis 2

A

unwell child

high fever

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4
Q

presentation of juvenile idiopathic arthritis 1

A

limp but may be painless

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5
Q

whats vital when assessing trauma in limping child

A

history usually diagnostic

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6
Q

presentaion of development dysplasia of the hip 1
-gender bias

A

usually detected in neonates

6x more common in girls

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7
Q

presentation of perthes disease
-age?

A

more common 4-8yo

due to AVN of femoral head

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8
Q

presentatino of slipped upper femoral epiphysis
-age?

A

10-15 yo

displacemnt of femoral head epiphysis postero-inferiorly

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9
Q

most common primary tumours of bone 2

A

osteosarcoma

Ewings

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10
Q

difference between fractures in adults and children 4

A

fracture patterns

time to healing

remodelling

treatment differs

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11
Q

fracture pattern in children compared to adults

A

buckle fractues
plastic deformation
greenstick fractures

-occur in children but not adults

-becuase mechanical property of immature bone is different
-in mechanical terms a child bone is less brittle

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12
Q

time to healing of fractures in children compared to adults

A

femoral fracturs heal in ‘age in years+1’ weeks

physeal fractures heal in 2-3wks

adult fractures heal much slower

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13
Q

remodelling of fractures in children compared to adults

A

proximal humeral fractures remodel well
-rotational deormites of any fracture do not remodel

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14
Q

how does treatment of fractures inchildren differ to adults

A

rational for surgical fracature treatment in adults is often due to complications of immobility (osteoporosis, pressure sores, UTI, DVT, confusion)

these are very rare in children
-thereofre fracture treatment relies more on plaster casts and percutaneous fixation with fine wires

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15
Q

common fractures in child 2

A

distal forearm and wrist injuries

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16
Q

which fracture in children is of particular consideration and why

A

supracondylar distal humeral fracture

-associated with major nerves and blood vessels of the upper arm like the brachial artery and anterior intraosseous

17
Q

why are physes fractures of importance in fractures of children

A

partial growth arrest can occur and result in angular deformity, lower-extremity limb-length discrepancy, incongruity of the joint surface, or a combination of these

18
Q

describe the salter harris classification system

A

used to grade fractures that occur in children and ilvovle the growth plate [70]

19
Q

regarding the salter harris classification system
define type 1

A

transverse fracture thorugh growth plate [70]

20
Q

regarding the salter harris classification system
define type 2

A

fracture through growth plate+ metaphysis but not epiphysis [70]

21
Q

regarding the salter harris classification system
define type 3

A

fracture through growthplate+ epiphyssi but not metaphysis [70]

22
Q

regarding the salter harris classification system
define type 4

A

fracture through growth plate + epiphysis+ metaphysis [70]

23
Q

regarding the salter harris classification system
define type 5

A

compressure gracture of grwoth plate
-results in decreased perceived space between epiphysis and metaphysics on XR [70]

24
Q

define clubfoot

A

talpised equinovarus

-described as inverted (inward turning) and plantar flexed sfoot

usually diagnosed on newborn exam

25
Q

what is the nature of the clubfoot deformity 4

A

use mneonmic CAVE
-Cavus
-Adductus
-Varus
-Equinuus

26
Q

associations for clubfoot 6

A

most commonly idiopathic

assoc:
-spina bifida
-CP
-Edwards syndrome (trisomy 18)
-oligohydramnios
-arthrogryposis

27
Q

diagnosis of clubfoot

A

usually clinical
-deformity not passively correctable

imaging not normally needed

28
Q

management of clubfoot 1

A

now ponseti method preferred over surgery

29
Q

describe the ponseti method for clubfoot 4

A

-manipulation and progressive casting which starts soon after birth
-deformity is usually corrected after 6-10wks
-achilles tentoomy usually required (can be done under LA)
-night time braces applied until 4yo

30
Q

spectrum of nomral conditions in children that are normal variants 3

A

flat foot

in toeing

genu varum/valgus (bow leg, knock knee)

31
Q

red flags for non-accidental injury 3

A

serial bruising

atypical injuries for age of child

inconsistent history

Orthopaedics (15 decks)

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