Pediatric orthopedics Flashcards
(25 cards)
What is anisomieli?
Means length discrepancies between limbs. Usually used for leg length discrepancy.
What are normal variations in leg length discrepancies?
Discrepancies of 0,5-1,5 cm.
What is measured to determine of there is a leg length discrepancy?
The length from the spina iliaca anterior superior to the medial malleolus (while the patient lies in a supine position).
Besides measurements, how can a leg length discrepancy be determined through clinical examination?
The patient should be standing without bending their knees, and then bend forward so you can see if the sacral plateau is leveled. If the sacral plateau is tilted, plates of known height are placed under the short leg until the sacral plateau is leveled.
What are causes of scoliosis?
Idiopathic (unknown cause).
Neuromuscular scoliosis, e.g. cerebral palsy or Duchenne muscular dystrophy.
Syndrome associated, e.g. achondroplasia, Marfan syndrome, Down syndrome, neurofibromatosis, and osteogenesis imperfecta.
Functional cause, e.g. leg length discrepancy.
What are options for treatment of scoliosis?
Back brace and surgery.
What is talipes equinovarus?
Also known as club foot. It is a birth defect where one or both feet are rotated inward and downward.
What are options for treatment of talipes equinovarus?
Ponseti method (conservative, relies on casting together with manipulation) (recommended treatment in Norway), cutting the Achilles tendon (percutaneous achillestenotomy), and bracing.
Is talipes equinovarus more comon in girls or in boys?
It is more common in boys.
How common is it for talipes equinovarus to be bilateral?
50 % of cases are bilateral.
What are the three main classes of developmental dysplasia of the hip?
Dysplasia, subluxation and luxation.
How is developmental dysplasia of the hip diagnosed?
Clinical examination: Gluteal skinfold, leg lenght discrepancy, and Ortolani and Barlow tests. (Frog tests and adduction test.)
Imaging examination: Ultrasound (or x-ray) will confirm the diagnosis.
How is developmental dysplasia of the hip treated?
Abduction with the help of “Frejkas pute” etc.
Surgery and casting.
Traction and casting.
Is developmental dysplasia of the hip more common in girls or in boys?
It is more common in girls.
What is Calve-Legg-Perthes disease?
It is an avascular, transitory condition in caput femoris of unknown cause.
What are symptoms of Calve-Legg-Perthes disease?
Limping.
Pain in knees and/or hips.
How is Calve-Legg-Perthes disease treated?
Treatment should always be performed by an orthopedist. Running and jumping should be avoided. Physical therapy is an option. Surgery if loss of containment.
What is slipped slipped capital femoral epiphysis?
It is a condition that occurs in teens and pre-teens who are still growing. For reasons that are not well understood, the ball at the head of the femur (thighbone) slips off the neck of the bone in a backwards direction.
Is Calves-Legg-Perthes disease more common in boys or girls?
It is more common in boys.
How is slipped capital femoral epiphysis treated?
It is treated with surgical pin fixation.
What are symptoms of slipped capital epiphysis? What group of children have an especially high risk of slipped capital femoral epiphysis?
Pain in hip or knee.
Overweight/obese children are at high risk.
What is coxitis simplex? What are common symptoms of coxitis simplex?
Also called transient synovitis. It is an inflammatory, self-limiting, irritation in the hip joint. It causes pain, limp and sometimes refusal to bear weight.
What is the most common cause of acute onset limping in children of preschool age?
Coxitis simplex (transient synovitis).
What is the cause of coxitis simplex?
The exact cause is unknown, but the condition is often preceded by a recent viral infection (most commonly an upper respiratory tract infection).
