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Flashcards in Paediatric Ortho Deck (34):
1

What is talipes?

a deformity in whic hthe foot is twisted out of normal position

2

What is the difference between varus and valgus?

varus is when there is displacement of part of a limb towards the midline whereas valgus is part of a limb away from the midline

3

What is spina bifida?

an incomplete vertebral arch

4

What is spina bifida occulta?

if the incompete vertebral arch is covered by skin

5

What is the difference between meningocoele and meningomyelocele?

meningocoele is a herniation through a bony defect of dura and arachnoid whereas with the meningomyelocele the cord is involved too

6

What is important about the level of defect of spine in spina bifida?

the higher the defect on the spine, the most severe the complications

7

What are the prerequisites for normal gait?

stability in stance; sufficient foot clearance (ots of muscles) and joints involved; appropriate swing phase prepositioning of the foot ( put foot on the grounD); adequate step length and energy conservation

8

What is an antalgic limp?

source of pain is in the limb so walking is done in a way to minimise stance phase and decrese time on painful imb

9

What is a positive trendelemberg?

hips are not aligned when one foot is off the groun

10

What does a postive trendenlenberg indicate

adductor insuffiency; defective fulcrum or defective lever

11

What are causes of tip toe gait?

habitual; structural and neurological

12

What is habitual tip toe gait?

when someone just gets int othe way of walking like that for no otehr reason

13

What can cause structural tip toe gait?

a tight achilles

14

What can cause a neurological tip toe gait?

spasticity; spina bifida; cerebral palsy; muscualr dystrophy

15

What is spasticity?

veolcity dependent increase in tone- contraction doesnt stop as no central inhibition

16

What is cerebral palsy?

inclusive term that describes a group of non-progressive disorders in which disease of the brain causes an impairment of motor function

17

What occurss with the neurological injury?

loss of normal motor development; maintenance of primitive reflexes; loss of selective motor control ; weakness; injury to blaance mechanism and abnormal tone

18

What are the topographical types of cerebral palsy?

hemiplegia (unilateral); diplegia (bilaterLal: total body involvemtn

19

How does a brain injury result in bone deformity?

injury leads to increased tone and so abnormal posture which leads to contracture and bone deformity

20

Why do diplegics with CP walk with in-toeing?

their hips are internally rotated as their hip is still at 40 degres and in order ot walk they ahve to rotate their hip round

21

What are the risk factors for developmental dysplasi of the hip?

breech position; family history; other MSK anomalies

22

What is the ortolani manoeuvre?

attempt to reloacte a discolated hip by abductiontry to lift up the femoral head and reloacte it in the acetabulum- positive if a palpable clunk

23

What is the barlow manoeuvre?

when you attempt to sublux or dislocate an unstable hip by adduction

24

What is the imaging of choice for DDH?

ultrasound

25

What is the treatment for early diagnosed DDH?

a Pavlik harness

26

What is perthes disease?

idiopathic avascular necrosis which causes osteochondritis

27

Who gets perthes disease?

M:F 4:1; ages 4-8

28

What is SUFE?

slipped upper femoral epiphysis- displacement of the growth plate with the epiphysis always slipping down and back

29

What is seen on x-ray with SUFE

a line drawn along the superior edge of the femoral neck does not intersect the femoral head- which it should

30

Who gets SUFE?

10-16years; M:F 2:1; much more common in the obese

31

What is the treatment of SUFE?

stabilisisation acorss the physis

32

How does SUFE presnet?

an adolescent with limping and pain in the groin; ant. thigh or knee

33

What is the most common cause of hip pain in children?

transient synovitis of the hip

34

What must always be ruled out in a child with hip pain?

septic arthritis