Children's Orthopaedics Flashcards

1
Q

What is more of a problem, unilateral or bilateral abnormalities?

A

Unilateral

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2
Q

When is deformity significant?

A

If it is likely to persist and cause physical or mental health problems later in life

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3
Q

How does bone grow?

A

Longitudinal from the growth plate by enchondral ossification
Circumferential from the periosteum by appositional growth

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4
Q

What mostly causes damage to the growth plate in childhood?

A

Trampoline

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5
Q

What factors affect the growth plate?

A
Diet/Nutrition
Sunshine, vitamins (Vit D and A)
Injury
Illness
Hormones (Growth Hormone)
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6
Q

What is the normal development for children?

A
1-6 months - loss of primitive reflexes
2 months - head control
6-9 months - sits alone, crawls
9-12 months - few words
8-12 months - stands
14-17 months - walks
24 months - jumps
3 years - walks stairs alone
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7
Q

What can overtreatment cause?

A

Fear of doctors

Feelings of stigmatisation and distress

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8
Q

What are 4 variations of normal alignment?

A

Genu Varum or valgum
Intoeing
Flat feet
Curly toes

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9
Q

What is varum?

A

Bow legged

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10
Q

What is Valgum?

A

Knock kneed

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11
Q

What age in genu varum normal?

A

<2

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12
Q

When may genu varum be abnormal?

A

Unilateral
Serve >2SD?
Short stature
Painful

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13
Q

What can cause pathological genu varum?

A
skeletal dysplasia
Rickets
Tumour
Blounts disease
Trauma
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14
Q

What is blounts disease?

A

Growth arrest of medial tibial physis of unknown aetiology

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15
Q

What is seen on x-ray of blounts disease?

A

Beak like protrusion

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16
Q

What can cause genu valgum?

A

Tumours
RIckets
Neurofibromatosis
Idiopathic

17
Q

When does genu valgum usually occur?

A

3 and 1/2

18
Q

When should genu valgum be referred?

A

If asymmetric
Painful
severs
>8cm intermalleolar distance

19
Q

Three things for intoeign?

A

Femoral neck anteversion
Internial tibial torsion
Metatarsus adductus

20
Q

What position do kids tend to sit on?

A

W position

21
Q

What do kids that sit in the W position tend to have?

A

Femoral anteversion

22
Q

What can femoral neck anteversion cause?

A

Usually no consequence

Can predispose to patellofemoral problems

23
Q

What is metatarsus adductus?

A

Common benign and resolves

Foot bending inwards

24
Q

What do you do when a child presents with intoeing?

A
Define cause
Reassure
Chart/Photograph
Review
Discharge
25
Q

What % of people have flat feet?

A

1 in 5

26
Q

Are we born with flat feet?

A

Yes

27
Q

What is the test for hypermobility?

A

Beighton score

28
Q

What is the treatment for curly toes?

A

Not needed
Majority resolve by 6 years
Splinting or taping ineffective
Consider flexor tenotomy

29
Q

What are the characteristics of anterior knee pain?

A

Females>Males
Adolescent
Localised patellar tenderness
Stairs/squats

30
Q

What should you check for knee pain?

A

HIPS