Pediatrics

Question 0

Salter harris- describe and treatment

Answer 0

I- widen; conservative
II- into metaphysis; reduce/cast, maybe surgery
III- into epiphysis, growth affected; surgery
IV- through metaphysis and epiphysis, growth affected; surgical
V- crush; growth affected; conservative

Question 1

Growth rates?

Answer 1

girls 14, boys 16
9mm/yr femoral
6mm/yr tibia

Question 2

Most common salter harris fx

Answer 2

II- into metaphysis

Question 3

radius remodeling rate?

Answer 3

10 degrees per year; more deformity is acceppted near wrist

Question 4

risk factors for hip dysplasia

Answer 4

4F- first born, female, frank breech positioning, family history

Question 5

hip dysplasia tests

Answer 5

3mo- barlow test (adduct leg and push at knees); ortolani is revese

Question 6

Barlow test

Answer 6

hip dysplasia

Question 7

ortolani test

Answer 7

hip dysplasia

Question 8

hip dysplasia signs

Answer 8

uneven limbs

hyperlordosis, waddling gait, trandelenburg lurch

Question 9

pavlik harness

Answer 9

hip dysplasia for <6mo

Question 10

When does in-toeing become concern?

Answer 10

8yr

Question 11

Metatarsuss adductus- signs

Answer 11

in-toeing at feet <1yr

• flexibility reflects severity
• foot progression angle (footprint to midline)
• foot morphology (heel bisector line) (2/3 is normal) (c look)

Question 12

Internal tibial torsion- signs

Answer 12

in-toeing, leg, 1-3yrs

-thigh foot angle (5internal –>10 external degrees at 8yr)

Question 13

Femoral anteversion-signs

Answer 13

hip, 3yr +, in-toeing

• femoral neck/transcondylar axis angle (40–> 20 at 8yr)
• assess internation rotation (W shape)

Question 14

Scoliosis- dimensions

Answer 14

lateral curves

rotations

Question 15

Types of scoliosis

Answer 15

congenital, idiopathic (AIS), neuromuscular, neurofibramatosis

Question 16

AIS- features, tests, treatment

Answer 16

L thoracic curves
Adams forward bend test
surgery if >50 degrees

Question 17

Achondroplasia: genetics and descrie

Answer 17

autosomal dominant

affects proliferative zone, but intramembbranous ossification is normal

Question 18

achondroplasia radiograph findings

Answer 18

inverted v knees (femur)
champagne pelvis
small sciatic notch

Question 19

achondroplasia vertebral complications

Answer 19

lumbar spinal stenosis

foramen magnum stenosis (apnea, weakness, hypotonia, resp difficulty)

Question 20

Osteogenesis imperfecta- clinical presentation

Answer 20

bone fragility, deformitiies
ligament laxity
thin skin
blue sclerae
brown blue soft teeth

Question 21

Osteogenesis imperfecta treatment

Answer 21

BP therapy

osteotomies, fixation

Question 22

child abuse fx

Answer 22

metaphyseal corner fx
epiphyseal separation
spine compression fx
procecss avulsion