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Flashcards in Orthopedics Deck (30):
1

By what point should infants triple their birth weight?

1 year

2

Treatment of developmental dysplasia of the hip

<6 months Pavlik harness (holds hips flexed)

3

Legg-Calve-Perthes disease

Noted ages 4-8yo; limited internal rotation, avascular necrosis of femoral head.

4

SCFE

Dehiscence of capital femoral growth plate, proximal femoral neck migrates anteriorly and laterally. Internal rotation limited and child limps. Management is surgical!

5

Treatment of clubfoot

ponseti casting

6

What are the Ottawa ankle rules?

An Ankle x ray is required only if: Any pain in the malleolar zone AND 1.) bony tenderness along distal 6cm of posterior edge of tibia or tip of medial malleolus OR 2.) Bony tenderness along the distal 6cm of posterioir edge of fibula or top of lateral malleolus OR 3.) Inability to bear weight in the ED for 4 steps.

7

What is the most likely cause of death for patient with achondroplasia?

Cervicomedullary junction compression.

8

Congenital torticollis

An infant with head tilited to one side, a mass in the sternocleidomastoid muscle and or facial asymmetry. Treated with daily stretching and physical therapy - if no improvement in one year - needs surgery

9

Paroxysmal torticollis

Migrain variant seen in infants - repeated attacks of head tilting, last for only a few minutes at a time. No intervention necessary

10

Which side is developmental dysplasia of the hip more common?

left

11

How do you diagnose DDH?

ultrasound - after 4 months can see on x ray

12

What is the Barlow exam?

Adduction with downward pressure

13

What is the Ortolani exam?

attempt to relocated a dislocated femoral head

14

Other physical findings of DDH

May have asymm gluteal folds, later on waddling gait or leg length deformity

15

Risk factors for DDH?

first born, female, breech delivery, family history

16

What degree of scoliosis needs treatment?

> 25 degrees and still more growth to be had - should brace. If > 40 should have surgery

17

What is the normal degree of kyphosis in the spine?

20-40 degrees

18

Caffey Disease

Infantile cortical hyperostosis. Occurs during first 6 months of life, swelling of bone shafts, only involves cortical bone, not periosteum.

19

The patient falls back on a posteriorly rotated abducted arm

Anterior humeral dislocation

20

Pain over distal clavicle with a prominence over area of point tenderness

Acromioclavicular injury

21

Bowlegged fancy name

Genu Varus

22

Knock-kneed fancy name

Genu valgus

23

When does genu varus need intervention

When persists past 2, or unilateral

24

Salter harris type 1

Separation of epiphysis and metaphysis. Fracture right through physis. X rays may be negative - diagnose clinically. needs casting for 2-3 weeks

25

Salter Harris type 2

physis and metaphysis, closed reduction 3-6 weeks

26

Salter Harris type 3

through growth plate and epiphysis (worse than type 2 bc goes through growth plate.

27

Salter Harris type 4

crack through metaphysis, physis, growth plate, epiphysis - needs OR reduction

28

Salter Harris type 5

compression fracture causing microvascular compromise - may have poor growth later

29

Scaphoid fracture

pain in snuffbox - often x ray is normal

30

position of leg with SCFE

extended and externally rotated