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Pediatric Orthopedics
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21
Anatomy
Professional
02/11/2011

Additional Anatomy Flashcards

 


 

Cards

Term

 

 

 

Clubfoot

Definition

-Talipes Equinovarus

-Boys : Girls     2:1


All components must be present for diagnosis


Cause unknown


Some genetic

Differential diagnosis

  Idiopathic vs Positional

  Idiopathic vs Neuromuscular

Treatment:

Manipulation / Casting

Surgery

Term

 

 

 

Clubfoot After Surgery

Definition

-Continued monitoring
-↓ Foot / calf size
-Noticeable if unilateral
-Troy Akimen had clubfoot
-Kristi Yamguchi had clubfoot

Term




Metatarsus Adductus

 

Definition

Flexibility = Correction

Differential diagnosis:

  Clubfoot

  Overactive abductor hallucis

  Internal tibial torsion

Treatment

  Parental education

  cast/straight last shoes

Term

 

 

 

Flatfoot

Definition

-Pes Plano Valgus
Absent longitudinal arch

Flexible Vs Rigid

No treatment for Flexible

Term

 

 

 

In-toeing, Out-toeing

Definition

-By age 7-8 child should have normal foot progression angle which is slight out-toeing (external rotation)
-Prior to age 7-8 in-toeing most common due to internal tibial torsion or femoral anteversion.
-Persistence of rotational deformities due to failure of these to spontaneously correct.

80% professional athletes intoe

90% correct spontaneously 

Term

 

 

 

Genu Valgum

Definition

-Knock Knees


-Normal 2-4 years of age


-Excessive Valgus


99% Spontaneously 


Persistent in:

Rickets

Multiple epiphyseal
Pseudoachondroplasia

Term

 

 

 

Genu Varum

Definition

Bow Legs


-Normal variant newborn


-Spontaneous correction age 2-3


-Treatment: Education


[image]Genu Varum
-Persistent > Age 3
-Severe
-Rule out Blounts

         Rickets

Term




Developmental dysplasia of the hip

Definition

(DDH)
Spectrum of hip disease
 -Radiographic only
 -Subluxation
 -Dislocation
 -Non-reducible dislocation

Term

 

 

 

DDH- Congenital Dislocation

Definition

-Left hip predominance
-Female – male (5:1)
-Breech birth
-First born

Click vs. clunk

Term

 

 

 

DDH-Diagnosis

(BOGA)

Definition

-Barlow Test

-Ortolani Test

-Galeazzi Test

-Abduction Test

Term

 

 

 

DDH-Treatment

Definition

-Treatment
-Early intervention
< 6 months of age
-Pavlik Harness
-Cause AVN
-Brachial plexus injury
-Femoral nerve palsy
-Skin lesions
Pavlik Failure
Age >6 months
Closed       Reduction under general                anesthesia
Open 

Term




Legg-Perthes

[image]

Definition

-Idiopathic necrosis of femoral head
-Age range 2 – 12 (1° 4-8)
-Male : Female 4:1
-Unilateral 90%

Term

 

 

 

Legg-Perthes
Clinical Symptoms

Definition

-Limp

-Ipsilateral Knee Pain

-Painful Internal Rotation


Treatment:

 

Containment of femoral head in acetabulum

 

Bracing (not currently recommended)

 

Surgery

Term

 

 

 

Legg-Perthes Differential Diagnosis

Definition

Differential diagnosis
-Septic arthritis
-Transient synovitis
-Epiphyseal dysplasia
-SCFE

Term




[image]Slipped Capital Femoral Epiphysis 

Definition

SCFE


-Frequently present with knee pain/gait disturbance
-Age 8-12 (older than typical LCP)
-Associated with obesity
-endocrine disorder possible
-Pain, external rotation deformity of hip
-AP/LAT x-ray diagnostic

Treatment – Surgical pinning

Term

 

 

 

Osteomyelitis 

Definition

-Infection in bone
-Usually bacterial
-Usually 2° to hematogenous spread
-Metaphyseal location
Symptoms:
Pain, Swelling ,Tenderness ,Pseudoparalysis (refusal to move   extremity)

Lab   ↑ Temperature

  CBC - ↑WBC

            ↑ ESR

            ↑C-reactive protein

Term

 

 

 

Osteomyelitis Treatment

Definition
[image]Treatment
Aspiration of involved area
Culture and sensitivity
Appropriate antibiotics
Occasional surgical drainage
Term

 

 

 

Osteomyelitis Organisms

Definition

[image]Organisms
-Staphylococcus – most common
-Streptococeus – neonates
-I.Influenzae – 6 month - 4 years
-Puncture wounds - pseudomonas

Term

 

 

 

Septic Arthritis 

Definition

-Hematogenous seeding
-Direct extension from adjacent osteomyelitis
Diagonsis
Joint Aspiration
Differential diagnosis
Transient Synovitis (Viral)
JRA
Treatment

Aspiration and antibiotics

  Hip – Surgical drainage and antibiotics

Term

 

 

 

Scoliosis 

Definition

Greater than 10 degrees

 

Causes

 

Idiopathic

Congenital 

Neuromuscular

 

Term

 

 

 

Fractures

Definition

[image]Physeal fractures may result in Residual deformity 2° to interference with normal growth
lSalter Harris

    Classification

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