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Flashcards in Pediatric Orthopedic Diseases Deck (65)
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1

Pediatric Diseases

Legg-Calve-Perthes disease
Slipped capital femoral epiphysis (SCFE)
Club foot
Metatarsus adductus
Genu varum
Genu valgus
Developmental dysplasia of the hip
Osgood-Schlatter disease
Septic Arthritis

2

Define Legg-Calve-Perthes Disease

Idiopathic osteonecrosis of the femoral head in children

3

Epidemiology of Legg-Calve-Perthes Disease

4-8
Boys > Girls

4

Clinical Presentation of Legg-Calve-Perthess Disease

Prolonged limp or waddling gait
Pain in the thigh, groin, or knee
Delay in bone age
Short stature

5

Diagnosis of Legg-Calve-Perthess Disease

AP & lateral view of hip
Wrist/hand films for bone age
AP with hip abduction to determine containment
Technetium-99m bone scan
MRI

6

Etiology of Legg-Calve-Perthess Disease

Anterolateral portion of head
Ascending lateral cervical vessels from medial femoral circumflex artery
Circulation less developed in 3-10 year old boys

7

Prognosis of Legg-Calve-Perthes Disease

Favorable
Function well despite poor radiographs
Develop arthritis eventually

8

Goals of Treatment of Legg-Perthes-Calve Disease

Reduce pain
Improve function
Minimize femoral head deformity

9

Treatment of Legg-Perthes-Calve Disease

Revascularization
Traction
Bed rest
Surgery

10

Define Slipped Capital Femoral Epiphysis

Disorder in which the epiphysis becomes posterior displaced on the femoral neck

11

Sequelae of Slipped Capital Femoral Epiphysis

Osteoarthritis
Chondrolysis
AVN

12

Epidemiology of SCFE

Boys: 10-17
Girls: 8-15
Male > Female (2:1)

13

Clinical Findings of SCFE

Abrupt onset of anterior hip, groin, medial thigh, & knee pain
Acute: symptoms less than 3 weeks
Chronic: symptoms 3+ weeks
Antalgic gait with external rotation

14

Imaging Studies for SCFE

AP & lateral radiographs

15

AP Radiograph Findings Pre-Slip

Slight widening & fuzzy irregularity of physis

16

Lateral Radiograph Findings

Percent epiphyseal displacement
Lateral head/shaft angle

17

Etiology of SCFE

Hypothyroidism
Hyogonadism
Parathyroid adenoma with GH abnormality

18

Treatment of SCFE

Stabilize slipping process
Achieve premature closure of physics
Single screw fixation

19

Characteristics of Club Foot

Plantar flexion of ankle
Inversion of heel
High arch at midst
Adduction of forefoot

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Epidemiology of Club Foot

Idiopathic
Males > Females (2:1)

21

Clinical Presentation of Club Foot

Look like could walk on top of foot
Plantar flexion most severe
High arch (difficult to see)
Forefoot adduction

22

Tests for Club Foot

Rule out neuromuscular disorders (CP, MD)
X-rays (usually not needed)

23

Treatment of Club Foot

Manipulation
Casting
2-4 months
Surgery if failure of conservative treatment
Surgery: lengthens tendons & ligaments

24

Prognosis of Club Foot

Good
Run & play afterwards

25

Describe Metatarsus Adductus (Pigeon Toe)

Medial deviation of the forefoot

26

Exam in Metatarsus Adductus (Pigeon Toe)

Convex lateral border of foot with palpable prominence of 5th metatarsal
Hindfoot in neutral
Normal dorsiflexion

27

Diagnostics in Metatarsus Adductus (Pigeon Toe)

Serial photocopies
Heel bisector line
Subjective

28

Treatment of Metatarsus Adducts (Pigeon Toe)

Supine sleeping position
Start at 6 months
Serial casting (severe)

29

Genu Varum

Tibia adducted in relation to femur
Straigthens: 12-18 months
After 30-36 months: bracing or surgery

30

Genur Valgus "Knock Knees"

Tibia abducted in relation to femur
Treatment: observation