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MD 3 - Paeds > Orthopaedic > Flashcards

Flashcards in Orthopaedic Deck (47):
1

most common age for transient synovitis

3-8 years

2

mechanism of action for a supracondylar #

FOOSH with hyperextension at the elbow

3

which deformity can result from an incorrectly managed supraconylar #

cubits varus

4

most common Dx of limp in:
- Pre-school
- primary school
- adolescence

preschool - transient synovitis
primary school - Perthes disease
adolescence - SUFE

5

asymmetrical pigeon toeing is indicative of

a spiral fracture in toddlers

6

which conditions MUST you rule out in a children with a limp

malignancy
infection - septic arthritis/osteomyelitis
NAI

7

complications of no treatment of DDH

pain
early high OA
limp
difficulty walking

8

when should tests on the hips be performed in children

birth
1,2,4, 8 weeks
4, 8 months

9

how do you diagnose SUFE

XRay

10

what are the tests used for looking for DDH in a child >4 weeks

- decreased abduction
- skin creases
- thigh length discrepancy
- Knee height discrepancy

11

empirical AB choice for septic arthritis/osteomyelitis

Flucloxacillin

12

risk factors for DDH

- breach delivery
- oligohydramnios
- C. section
- FHx
- Congenital abnormalities (especially foot abnormalities)
- first-born
- female
- large baby

13

clinical presentation of transient synovitis

- limp
- unilateral hip or groin pain
- history of recent URTI
- otherwise well child

14

clinical presentation of perthes disease

- limp, especially after exercise
- mild or intermittent pain in anterior thigh (but classically described as a painless limp)

15

treatment of a Toddler's fracture

needs to treatment - heals spontaneously

16

what is perthes disease

idiopathic avascular necrosis of the capital femoral epiphysis resulting from compromise of the blood supply

17

what causes DDH

failure of the hip joint to develop normally --> dislocation of the hip

18

most common mechanism of action leading to a Monteggia fracture-dislocation

FOOSH with hyperpronation or hyperextension of the forearm

19

fancy name for flat feet

pes planus

20

what is transient synovitis

transient inflammation of the synovium of the hip

21

what are the tests used for looking for DDH in a child

Barlow - (downwards)
Otolani - (abduction)

22

DDx for limping/non-weight bearing child of age 1-4

DDH
toddler's #
Transient synovitis of the hip - most common
child abuse

23

how long is the typical oral AB course for septic arthritis/osteomyelitis (after completion of IV therapy)

3 weeks if uncomplicated

24

what is sitting in a W position indicative of

inset hips

25

common risk factors for SUFE

- OBESITY
- boys>girls
- L>R

26

most common bacterial causes of septic arthritis/osteomyelitis

staph aureus
group A b-haemolytic strep
haemophilus influenza

27

DDx for limping/non-weight bearing child of age 4-10 years

transient synovitis of the hip
Perthes disease

28

treatment of transient synovitis

heat and massage
ibuprofen

29

what is the difference in pain onset between osteomyelitis and septic arthritis

osteomyelitis is usually a subacute onset, whereas SA is acute

30

what is a Toddler's fracture

type of # of the tibial shaft that occurs in young ambulatory children
- spiral or oblique undisplaced # of the distal shaft of the tibia with an intact fibula

31

common age of patients with SUFE

late childhood/early adolescence

32

what is the difference between a greenstick fracture and a torus fracture

greenstick - fracture is on the outside corner of the bend
torus - fracture is on the inside corner of the bend

33

mechanism of action of a Toddler's fracture

twisting injury

34

what does SUFE stand for

slipped upper femoral epiphysis

35

what is the tip toe test

- diagnoses flat feet
- when child on tip toes, the long flexor and extensor muscles are recruited in the foot and an arch appears

36

what signs on examination point you towards transient synovitis

- decreased range of hip movement - especially internal rotation
- may be tender to palpation

37

age range for perthes disease

2-12
majority 4-8

38

principles of management of perthes disease

minimal weight bearing and protection of the joint (maintain the femur abducted and internally rotated using a brace or surgery

39

what signs on examination point you towards perthes disease

- restricted hip motion, especially in abduction and internal rotation
- proximal thigh atrophy

40

DDx for limping/non-weight bearing child of age >10

- slipped upper femoral epiphysis
- overuse syndromes/stress fractures

41

diagnosis of DDH is done by which imaging

US - if 6 months

42

management of DDH

- abduction splint - worn until the dysplastic acetabulum is radiologically and clinically normal
- surgery may be needed in a child who is diagnosed later in life

43

what causes Volkmann's ischaemic contracture and what is a common # it results from

disruption to the brachial artery --> necrosis of the muscles of the forearm
- commonly results from a supracondylar # with forward displacement of the metaphysis

44

pathological causes of flat feet

hypermobility syndromes
CP

45

principles of management of SUFE

SURGERY - immediate internal fixation in-situ

46

what features on examination point you towards SUFE

- hip appears externally rotated and shortened
- decreased hip movement, especially internal rotation

47

potential complications of untreated SUFE

chondrolysis of the hip
avascular necrosis