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Flashcards in Peadiatrics Deck (54):
1

What factors are associated with outcomes of a distal femoral fracture

SH classification
presence of displacement
open fracture
presence of hardware across the physis

direction of displacement is not associated with outcome

2

Findings of osteopetrosis

Inability to acidify the howship lacunae
AR not compatible with life
AD compatible with life

Rugger jersey spine
multiple fractures
coxa vera (stress fractures)
deafness
blindness
anemia
frequent infections

3

Radiographic indicators of both bone forearm fractures following reduction

On AP biceps and radial styloid are 180 degrees apart

On Lateral ulnar styloid and coronoid are 180 degrees apart

4

Complications and concerns following transphyseal distal humerus injury

posteromedial displacement
child abuse

closed reduction and splinting
pin if very displaced

Varus
medial condyle AVN
(no risk of tardy ulnar nerve palsy)

5

Phenotype of diastropic dysplasia

defect in sulphate transporter affecting cartilage

cauliflower ear
hitchikers thumb
symphangalisism
kyphosis c-spine

6

Fracture associated with highest morbidity and mortality

spine

7

Acceptable angulation of a radial neck fracture

30 degrees
begin ROM early to prevent stiffness

Percutaneous pinning
Open reduction - associated with stiffness and increased risk of AVN

8

Reduction technique for radial neck fracture

Patterson - extension and supnation
Isralei - flexion and pronation
Compression bandage

K-wire joystick
Metaizeau - retrograde nail across fracture

9

complications of radial neck fracture

stiffness (loss of pronation)
radial head ON
synostosis (open, delayed)
radial head overgrowth (40%)

10

Multifocal mycobacterial infection

Polyarthrosis swelling
elevated ESR
from foreign place

spine (50%), large joints, long bones
subchondral erosions with diffuse osetopenia

treatement with Abx
Surgery for residual constitutional sx

11

Best predictors of septic hip

Fever
CRP
ESR
Refusal to bear weight
WBC

In that order

12

Bones with intra-articular metaphyses

shoulder
elbow
hip
ankle

13

Indications for surgical treatment of proximal humerus fracture

usually can be treated nonoperativley because of ability to heal and remodel

open
NV
> 45 degrees

14

Drop in BP intraop myelomeningocele

latex allergy
IGE mediated

15

Risk factors for spina bifida

DM2
maternal hyperthermia
valproic acid
folate deficiency

10% have chromosomal abnormality

16

Level of myelomeningocele at risk for hip dislocation

L3-4
(level is the lowest functioning level)
usually confined to wheelchair

L5 is more normal functioning

17

Procedure to correct calcaneus heel in L5 level

posterior transfer of tib ant

18

Larsen syndrome

hyperlaxity, presents with multiple dislocations

at risk for cervical kyphosis

19

Scoliosis with no curve and assymetric abdominal reflex

syrinx

20

most common cause of malignant back pain

leukemia

21

lower extremity growth

Proximal femur - 3mm
Distal Femur - 9mm
Proximal tibia - 6mm

22

what is the teardrop comprised of

quadrilateral surface
cotyloid fossa

normal hip at 18 months
usually not there in untreated DDH

23

Side of congential pseudoarthrosis

Right middle

Cosmesis or function at 3-6 years old
Iliac crest graft with ORIF

24

Factor most associated with loss of reduction of forearm fractures

Cast index > 0.85

25

Acceptable reduction forearm fracture

9yo - 10 deg, 30 deg rotation, 1 cm bayonette

26

What is the most common cause of physical disability in child abuse

head injury

27

most common age of child abuse

28

acceptable alignment of distal radius fracture

> 10 yo - 20 deg ang, 30 deg rotation

closed reduction initially
if inadequate or reduction lost then do closed reduction with pinning

29

Disease associated with olecranon fracture

OI

30

What is the most common complication requiring intervention following hip spica treatment for femoral shaft fractures

loss of reduction

31

Treatment of anterolateral bowing associated with neurofibromatosis

bracing

If fracture then IM device (growing rod)

32

Gauchers mutations

glucocerbridase

33

fibrous dysplasia mutation

cAMP

34

SLC6A2A sulphate transporter

diatrophic dysplasia

35

Morqoio

keratin sulphate
proportionate dwarfism
normal intellegence
odontoid hypoplasia

36

Hurlers

C1-2 instability

37

Hunters

X-linked recessive
metal retardation
clear corneas

38

diatrophic dysplasia

cervical kyphosis
cauliflower ears
hitchhikers thumb

39

indications for physeal bar resection

20% will require osteotomy as they are unlikley to correct

40

superior lens dislocation

marfans

41

inferior lens dislocation

homocystinuria

42

dolichostenomelia

long limbs associated with marfans

43

SCFE associations

left hip
males
hip pain (not knee pain)

44

best radiograph for lateral epicondyle

internal oblique

45

long term consequences of brachial plexus palsy

glenohumeral dysplasia - due to internal rotation contracture (70%)

elbow contracture - due to overdrive of the biceps

46

prognosis of brachial plexus palsy

90% recover with early PT

Good - erbs, biceps activity

Poor:
lack of biceps by 3 months
preganglionic injuries (elevated hemi, rhomboid dys)
horners
C5-7
klupkes

47

Erbs

C5-6 - most common

waiter's tip

Axillary/SS - absent deltoid, teres minor, SS, IS
MC - biceps, BR
intact wrist and hand

48

Klumpke

C8-T1 - poor prognosis

Median and ulnar nerve - claw hand

often associated with horners

49

Early brachial plexus treatment

Nerve graft
- flail arm at 1 month
- horners at 1 month
- no biceps by 3 months

Nerve transfer
- root avulsion at 3 months

50

Late surgery for brachial plexus

Glenohumeral dislocation
-ORIF with capsuloraphy
- proximal humerus osteotomy (no glenoid)

Glenohumeral dysplasia
- lat dorsi transfer - persistant ER with mild dyplasia
- pec major - 5yo

51

SMN-1

spinal motor dystrophy

52

PMP 22

CMT

53

myelomeningocele hip dislocation

observe
highest risk in L3

54

most common foot deformity with spina bifida

clubfoot