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Orthopedic Pediatrics Flashcards

(44 cards)

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1
Q

DDH

A

-developmental dysplasia of the hip

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2
Q

Cause of DDH

A
  • mechanical-positional
  • cultural
  • increased incidence with torticollis
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3
Q

DDH Population

A
  • 70% female
  • first born
  • heredity
  • breech birth
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4
Q

DDH Classifications

A
  • normal
  • subluxable
  • dislocatable
  • subluxed
  • dislocated
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5
Q

DDH Evaluation Instability tests

A
  • Barlow

- Ortolani

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6
Q

Barlow

A
  • dislocates a reduced hip

- hip flexion, adduction with posterior force

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7
Q

Ortolani

A
  • reduces a hip that is out

- flexed hips, abd with distraction

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8
Q

DDH Appearance

A
  • LLD, Galeazzi, Uneven Thigh folds
  • Waddling gait with lordosis
  • limited hip abduction
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9
Q

DDH and limited hip abduction

A
  • Unilateral late diagnosis-difference of 10*

- Bilateral <60*

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10
Q

DDH Diagnostic Imaging

A
  • US: 6-8 weeks
  • Radiographs after 4 months
  • AP, frog leg
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11
Q

DDH Radiograph Eval

A
  • Shenton’s line
  • Hilgenreiner’s Line
  • Perkin’s line
  • Acetabular angle
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12
Q

Shenton’s line

A

inf neck and inf border of sup pubic ramus

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13
Q

Hilgenreiner’s line

A

-horizontal through triradiate cartilages

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14
Q

Perkin’s Line

A
  • perpendicular to hilgenreiner’s line

- intersect lateral acetabular roof

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15
Q

-Acetabular angle

A
  • hilgenreiner’s line at tri radiate to acetabular roof

- <40* significant at birth

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16
Q

DDH Treatment

A
  • <6 months: observation; abduction orthosis

- 6-12 months: orthotics

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17
Q

Pavlik Orthosis

A
  • DDH

- works well if diagnosed under 6 weeks old, bilateral, acetabular angle <35*

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18
Q

Rhino Orthosis

Study These Flashcards
A
  • for older more mobile children
  • hard plastic shell with foam padding
  • hold legs in flexion and abd
19
Q

PT for DDH

Study These Flashcards
A
  • orthosis management
  • ROM
  • strength
  • gross motor skills
20
Q

Talipes Equinovarus

Study These Flashcards
A
  • Club foot

- mild to severe

21
Q

Tx for Mild talipes equinovarus

Study These Flashcards
A
  • serial casting

- (weekly progressions)

22
Q

Tx for severe talipes equinovarus

Study These Flashcards
A
  • surgical correction
  • night splint
  • PT: PROM, strength, gross motor concerns
23
Q

Metatarsus Adductus

Study These Flashcards
A

-forefoot curves medially

24
Q

calcaneovalgus

Study These Flashcards
A
  • forefoot curves laterally
  • hindfoot valgus
  • navicular on floor
  • foot appears dorsiflexed
  • vertical talus (rocker bottom) deformity
25
Arch develops at:
age 3-5
26
Pes Planus
- flat foot - determine cause - WB vs NWB - bilat vs unilat
27
Torticollis Types
- Congential Muscular Torticollis - Benign paroxysmal Torticollis - Torticollis Spasmodica
28
Congenital Muscular Torticollis
- infancy | - CMT
29
Benign Paroxysmal Torticollis
- childhood | - BPT
30
Torticollis Spasmodica
- childhood to adulthood | - cervical dystonia
31
Primary Mm Involved in Torticollis
- SCM - Upper trap - Scalenes - Splenius capitis/cervicis
32
Secondary Mm Involved in Torticollis
- Longissimus - illiocostalis - suboccipital Mm
33
Cause of Torticollis
- abnormal intrauterine posture (space too small) | - injury to SCM during delivery (Mm trauma/compartment syndrome)
34
Direct SCM Trauma
- contracture | - fibrosis
35
Compartment Syndrome (SCM)
- nerve and Mm damage - swelling - fibrosis
36
Associated Conditions of Torticollis
- hip dysplasia - plagiocephaly - progressive facial asymmetry - vision deficits
37
Torticollis
- contralateral head rotation with ipsilateral tilt | - named to side of tilt
38
Torticollis Exam
- Hx - Postural deviations - range/strength - neurologic function - vision - gross motor development - language delays
39
Torticollis Tx
- PROM - Strength - HEP - Shaping Helmets
40
Refractory Torticollis
-little/no improvements after 4-5 months PT AND/OR -over 7-8 months of age
41
Concerns with Refractory Torticollis
- facial asymmetry - plagiocephaly - irreversible contracture - if botulinum toxin injections don't work consider CT scan
42
Surgical Intervention for Torticollis
- when non-responsive to conservative treatment and botox | - age >18-24 months
43
Legg-Calve-Perthes
- self-limiting AVN of femoral head | - boys 3-13>girls
44
causes of Legg-Calve-Perthes
- trauma - vascular anomalies - infection - thrombic incidents

Pediatrics (13 decks)

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