Ortho

Question 1

Elbow ossification

CRMTOL

Answer 1

Capitellum
Radial head
Medial Epicondyle
Trochlea
Olecranon
Lateral epicondyle

1, 3, 5, 7, 9, 11years

Question 2

Ligaments or epiphyseal plates stronger

Non union ___ in paeds

Commonest site of growth plate fractures

Answer 2

Ligaments stronger- avulsion fractures

Uncommon as periosteum very active

Distal radius and ulnar

Question 3

Salter - Harris 1

Answer 3

Through growth plate

Low risk growth disturbance

Backslab if undisplaced
Closed reduction if displaced

Question 4

Salter Harris 2

Answer 4

Metaphysis and physis

Most common

Low risk growth disturbance
Backslab or closed reduction

Question 5

Salter Harris 3

Answer 5

Epiphysis and physis

Medium risk growth disturbance

ORIF

Question 6

Salter Harris 4

Answer 6

Through all three components

High risk growth disturbance

ORIF

Question 7

Salter Harris 5

Answer 7

Crush

High risk

Usually retrospective diagnosis after growth arrest

Question 8

Monteggia

Answer 8

Ulnar shaft

Dislocation of radial head

Question 9

Galeazzi

Answer 9

Shaft radius
Disruption to radio-ulnar joint

Manipulation under anaesthetic or ORIF

Question 10

Toddlers fracture

Answer 10

Spiral fracture of tibia

9 months to 3 years

Low energy injury
Leads to limp, localised warmth + tenderness
Crawls, avoid weight bearing
XR may be in conclusive

Question 11

Osgood-Schlatter

What
Incidence
Boys or girls
Rx

Answer 11

Inflammation of tibial tubercle
Repeated tensile forces
2% of all growth plate injuries

Boys
Rest m, analgesics

Question 12

Ankle fracture

Usual mechanism
Classified based on
XRs conclusive or inconclusive

Answer 12

Twisting
Conclusive
Salter Harris

Question 13

Distal arthrogryposis

Inheritance 
Affects
\_\_\_ deviation of fingers
Flexion contractions at \_\_\_
Feet anomalies

Answer 13

AD

Hands and feet

Ulnar deviation
MCP and PIPJs

Club foot
Vertical talus

Question 14

Arthrogryposis multiplex congenita

Sensory function….
Aetiologies…
Decreased what in spinal cord

Associations (2)
Facies
IQ
Organs
Hips feet 
Scoliosis

Answer 14

Normal
Neuropathic, myopathic, mixed
Oligohydramnios, intrauterine viral infection
Anterior horn cell

DDH, talipes

Normal
Normal
Normal
C shaped

Question 15

Perthes

Define

Boys or girls
Age
Clinical features
What is most significant indicator of prognosis

Ddx

Answer 15

Deformed femoral head caused by vascular insult. Osteonecrosis if capital femoral epiphysis.

Girls 4:1
4-8, second peak 10-12y

Pain
Reduced ROM
Limp

Skeletal age

Septic hip
Epiphyseal dysplasia
Hypothyroidism

Question 16

Sufe

Defect where

Bilateral in ___%
Features
Rx

Answer 16

Hypertrophic zone of growth plate

25%
Pain hip or knee
Antalgic gait
Externally rotated limb
Decreased internal rotation

Screw fixation of epiphysis

Question 17

Brachial plexus palsy

Incidence
Causes
Presentation
Full recovery in ___ at ___ years

Erbs- which root
Weakness

Answer 17

0.4 per 1,000
Pelvic dystocia, shoulder dystocia, breech (lower cervical roots)

Flail upper limb at birth
Full recovery in 75% by 4 y

C5-6
Shoulder abduction
External rotation
Elbow flexion
Supination