Pediatric Orthopedic Conditions

Question 1

When the head of femur is directed anteriorly

Answer 1

anteversion

in-toeing

Question 2

When the head of femur is directed posteriorly

Answer 2

retroversion

out-toeing

Question 3

negative foot angle is associated with wich hip angle torsion

Answer 3

in-toeing associated with anterversion

Question 4

positive foot angle is associated with wich hip angle torsion

Answer 4

out-toeing (+) with retroversion

Question 5

what is the normal foot pregression angle?

Answer 5

-3 to +20

Question 6

name angle

Answer 6

Foot Progression Angle

Question 7

The foot progression angle includes wich other torsional segments?

Answer 7

torsion of the hip, tibia, and forefoot

Question 8

hip torsion is the relationship between

Answer 8

femoral neck and shaft of femur

Question 9

typical progression of hip rotation

Answer 9

1. Infants have anteversion + ER contractures
2. Resolve by 5-6 yr becomes more apparent

Question 10

Thigh Foot Axis is a measure of….

Answer 10

tibial torsion

Question 11

typical progression of Thigh Foot Axis

Answer 11

1. Infants: IR -30 to -20
2. Spontaneous de-rotation with growth and walking

Question 12

Treatment of Thigh Foot Axis (tibial torsion) required if natural resolution
does not happen

Answer 12

• Friedman Counter Strap
• Derotation strap
• Dennis Browne bar (picture)

Question 13

Answer 13

Metatarsus (forefoot) Adductus

Question 14

Most common positional deformity in infants:

Answer 14

Metatarsus (forefoot) Adductus

Question 15

when the foreffot is curved laterally is called?

Answer 15

Calcaneovalgus

Question 16

Treatment of calcaneovalgus and matatarsus (forefoot) adductus

Answer 16

• matatarsus (forefoot) adductus: corrective shoes, joint manipulation, serial casting
• calcaneovalgus: none, resolves naturally

Question 17

progression of knee alignment

Answer 17

• Newborn: peak varum
• 1-2 yr: straight
• 2-4 yr: peak valgum
• 4-16 yr: approaching sex specific norm

Question 18

the 2 lower extremity rotational profiles are:

Answer 18

• In-toeing: femoral anteversion, tibial internal torsion, metatarsus adductus.
• Out-toeing: contracture of hip external rotators, tibial external torsion, calcaneovalgus.

Question 19

General “looseness” or “instability” of the hip joint

Answer 19

Developmental Dysplasia of the Hip

Question 20

name sign

Answer 20

Galeazzi Sign

seen in developmental dysplasia

Question 21

Barlow and Ortolani test for developmental dysplasia:

Answer 21

• Barlow: will dislocate the hip (hip started reduced)
• Ortolani: will reduce the hip (hips started dislocated)

Question 22

what is the main intervention for developmental dysplasia for children under 6 mo

Answer 22

Pavlick Harness

Question 23

what is the main intervention for developmental dysplasia for children 6-12 mo

Answer 23

closed reduction and abduction orthosis

Question 24

what is the main intervention for developmental dysplasia for children over 12 mo

Answer 24

surgery

Question 25

Avascular necrosis of the ossific nucleus of the femoral head

Answer 25

**Legg Calve Perthes Disease (LCPD)** cause not known

Question 26

treatment of Legg Calve Perthes Disease

Answer 26

* usually resolve spontaneously * Wide variety of treatment * Scotish wide brace (picture) * derotational osteonomy

Question 27

usual population of Legg Calve Perthes disease

Answer 27

* active boys between 5-10 y/o * with learning disabilities * 2nd hand smoke at home

Question 28

Answer 28

**Slipped Capital Femoral Ephiphysis (SCFE)**

Question 29

casues of Slipped Capital Femoral Ephiphysis (SCFE)

Answer 29

* significant trauma * chronic slip (obesity)

Question 30

treatment for Slipped Capital Femoral Ephiphysis (SCFE)

Answer 30

pinning surgery

Question 31

presentation of Slipped Capital Femoral Ephiphysis (SCFE)

Answer 31

* hip ER * hips moves passivelly into ER with hip FLX * 50% cases are bilateral

Question 32

Answer 32

**Blount's Disease (infantile tibia vara)**

Question 33

intervention for **Blount's Disease (infantile tibia vara)**

Answer 33

* KAFO 23h per day * Sx

Question 34

what lenght difference is considered the normal range in leg lenght discrepancies?

Answer 34

a discrepancy of **less than 2.5 cm**

Question 35

impairment in leg length discrepancies include

Answer 35

* pelvic obliquity, spinal alignment * increase energy expenditure

Question 36

leg lenght measurement

Answer 36

* ASIS to lateral malleolous * Umbillicus to heel pad

Question 37

treatment of leg lenght discrepancies

Answer 37

* shoe lift * or surgery

Question 38

Answer 38

Club Foot, Talipes Equinovarus

Question 39

Answer 39

Cobb angle

Question 40

Cobb angle \> 10 =

Answer 40

scoliosis diagnosis

Question 41

structural scoliosis

Answer 41

* vertabrae rotate towards convex side * cannot be corrected

Question 42

non structural scoliosis

Answer 42

* usually non progressive * corrects with side bend towards convex side

Question 43

in scoliosis, the direction of the curve is named after the

Answer 43

convex side

Question 44

types of scoliosis

Answer 44

1. **Congenital:** anomalous vertebral development, _may not progress_ 2. **Neuromuscular:** C types curves, SCI, _may progress_ 3. **Idiopathic:** infantile, juvenile, **adolescent**

Question 45

80% of all idiopathic scoliosis cases are...

Answer 45

**Adolescent Idiopathic Scoliosis (AIS)** more in females

Question 46

progression of scoliosis is defined as

Answer 46

a cobb angle change of \>5 deg on **two consecutive exams**

Question 47

scoliosis, non-surgical treatment in angles of

Answer 47

\<40

Question 48

the main goal of surgical intervention for scoliosis

Answer 48

to halt the progression

Question 49

congenital joint contractures in two or more areas of the body, genrally not genetically based

Answer 49

**Arthrogryposis** Multiplex Congenita (AMC)

Question 50

a group of genetic disorders that mainly affect the bones. It results in bones that break easily.

Answer 50

Osteogenesis Imperfecta