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Peds Ortho Problems Flashcards

(59 cards)

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1
Q

what is responsible for longitudinal growth of long bones?

A

physis (growth plates)

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2
Q

where are ossification centers of child bones?

A

at ends of the long bone

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3
Q

when is ligamentous laxity greatest in children?

A

at infancy

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4
Q

what is trendelenburg gait?

A

excessive swaying of trunk with normal stance

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5
Q

what muscle stabilizes pelvis during stance phase and prevents the pelvis from dropping toward leg in swing phase?

A

gluteus medius

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6
Q

what is antalgic gait?

A

painful limp

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7
Q

what is bilaterally decreased in function with waddling gait? what disease is it seen in?

A

bilateral decrease in fxn of gluteus muscles

seen in muscular dystrophy

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8
Q

cause of acute limping in children?

A

transient synovitis

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9
Q

what is the MCC of hip pain in kids?

A

transient synovitis

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10
Q

what is characteristic of transient synovitis?

A

resolution of sx’s and return of ROM

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11
Q

what is transient synovitis? is there an infection?

A

self-limiting inflammatory condition of hip

THERE IS NO INFECTION

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12
Q

what are sx’s of transient synovitis? ROM of hip?

A

rapid onset limping and refusal to walk/bear weight

ROM of hip limited by pain and spasm

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13
Q

how is hip held in transient synovitis?

A

hip held in flexion

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14
Q

dx of transient synovitis?

A

dx of exclusion

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15
Q

tx of transient synovitis?

A

bed rest until s/s improve

gradually increase activity (NWB lasts 1-2 days)

NSAIDs

***NO ABX b/c NO INFECTION!!!

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16
Q

what MUST you exclude on your ddx of transient synovitis?

A

septic arthritis -> more severe pain

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17
Q

what are 3 causes of chronic limping in children?

A

Apophysitis (Osgood Schlater, Sever’s disease)

Slipped capital femoral epiphysis

Legg Calve Perthes Disease

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18
Q

what is apophysitis?

A

painful inflammation of a bony outgrowth and especially the area of active growth at the end of bone

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19
Q

what are the 2 types of apophysitis?

A

Osgood Schalter and Sever’s disease

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20
Q

what is Osgood Schlater disease?

A

traction of apophysitis in adolescent girls and boys

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21
Q

presentation of Osgood Schlater?

A

pain over tibial tuberosity relieved with rest

prominent tibial tubercles, redness

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22
Q

tx of Osgood Schlater?

A

rest, ice, NSAIDs, reassurance

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23
Q

what is Sever’s disease?

A

apophysitis at insertion of achilles tendon into calcaneus

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24
Q

what is a common cause of Sever’s disease?

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A

repetitive stress from running/jumping on growth plate as foot strikes ground and results in inflammation/pain

25
Sever's disease occurs during what?
growth spurts
26
s/s of Sever's disease?
child/adolescent with heel pain bad enough to cause limp
27
when is Sever's disease usually first noticed?
after sport then during and after and w/new cleats
28
tx of Sever's disease?
RICE and NSAIDs D/C sport if severe enough Symmetric gel heel pads if moderate Achilles stretch
29
what is slipped capital femoral epiphysis?
d/o of proximal femoral physis that leads to slippage of epiphysis relative to femoral neck
30
what is the most common d/o affecting adolescent hips?
slipped capital femoral epiphysis
31
what is the greatest RF of slipped capital femoral epiphysis?
obesity
32
what are the MC sx's of slipped capital femoral epiphysis?
groin and thigh pain
33
what's the gait like for slipped capital femoral epiphysis? hip motion is what?
external rotation or trendelenburg decreased hip motion
34
imaging for slipped capital femoral epiphysis?
AP Hip and Frog Lateral
35
what is the treatment of choice for slipped capital femoral epiphysis?
percutaneous in situ fixation
36
why should you not mixx the dx of slipped capital femoral epiphysis?
b/c abnormal gait and external rotation of leg are permanent
37
what can you have and can you NOT have when fixing peds fx?
you can have angulation BUT NOT rotation
38
complications of peds fx's?
overgrowth, neuromuscular injury, compartment syndrome
39
<10 y/o with femoral fx can overgrow how much?
1-3cm
40
what can result in premature closure of the physis (growth plates)?
growth plate fx's
41
complete closure of physis before it should be closed can result in what? most common in what bones?
limb shortening MC in distal femur and distal/proximal tibia
42
how are growth plate fx's classified?
Salter-Harris
43
what are common sites for physis fx's?
distal radius, tibia, fibula
44
what is Salter-Harris Type 1?
transverse fx through physis S for straight through
45
what is Salter-Harris Type 2?
fx through part of physis and metaphysis A for above
46
what is the MC type of Salter-Harris fx?
Type 2 - fx through part of physis and metaphysis
47
what is Salter-Harris Type 3?
fx through physis and epiphysis into joint (intra-articular) L for lower
48
what is Salter-Harris Type 4?
fx through metaphysis, physis, epiphysis T for through
49
what is Salter-Harris Type 5?
crush injury of physis - not displaced, but damaged by direct compression ER for ERasure of growth plate or cRush
50
what confirms dx of Salter-Harris Type 5?
growth arrest, complete obliteration or diminished physical distance confirms dx
51
what is Toddlers Fx?
minimally/displaced oblique spiral fx of tibia w/out fibula fx
52
supracondylar elbow fx due to?
FOOSH from moderate height into fully extended elbow -> falling from monkey bars posterior displacement of the distal component
53
tx of supracondylar elbow fx?
long-arm cast ORIF
54
tx for nursemaids elbow?
pressure on radial head and gentle supination while flexing the elbow
55
what happens in nursemaids elbow?
radial head is subluxed
56
what is Monteggia Fx dislocation? MOA? Tx?
fx of ulna shaft with anterior dislocation of radial head MOA is secondary to FOOSH Tx is ORIF
57
what is Galeazzi Fx dislocation? MOA?
fx of distal radius with dislocation of the distal radioulnar joint MOA is FOOSH
58
what is intact in Galeazzi Fx?
ulna proximally
59
wha are the anatomic abnormalities of developmental dysplasia of the hip?
hip that is dislocated and irreducible unstable (dislocatable and reducible) dysplastic, but within acetabulum (Femoral head isn't rounded)

Clin Med Peds (10 decks)

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