Flashcards in Pediatric Orthopedics Deck (12):
Twist relative to coronal midline, often referred relative to the hip. Ex: femoral anteversion or acetabular retroversion.
What causes metatarsus adductus?
Feet being bent over the leg in utero
When / how should metatarsus adductus be treated?
If it is rigid and causes problems w/ shoes.
Treat w/ casting or surgery.
When / how should internal rotation of tibia be treated?
Only do surgery if it creates a functional problem. Bracing does NOT work.
Do braces help for femoral anteversion?
Miserable malalignment syndrome
Anterior knee pain due to femoral anteversion + external tibial torsion
•Severe tibia vara (varus of tibia) → compression of medial tibia → prevents physeal growth on medial side → further varus.
•More common in early walkers and kids who are larger when start walking.
•Try to unload pressure on midline. Use brace to take pressure off medial plate to aid in growth to straighten out.
•Guided growth is used if caught before kid is done growing. Bracing does not work in adolescence.
2 causes of Rickets
Low Vit D and renal disease
2 tests for diagnosing scoliosis
•Adams forward bending test: shows elevation of ribs on one side.
•Cobb Angle – Scoliosis is defined as curve >10 degrees.
•TLSO: thoraco-lumbar-sacral orthosis = brace. Use if curve is >20-25 degrees.
•Can’t make curves better w/ braces, but prevent worsening. Reduces need for surgery by 50%
•Surgery for severe cases.
Risk of untreated scoliosis
Risk of CV / respiratory compromise w/ curve >40 degrees.