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23 Cards in this Set

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  • Back
What are the four risk factors for myelomeningocele (MM)?
Maternal diabetes
Valproic acid
Folate deficiency
Maternal hyperthermia
Thoracic/high lumbar: What are the functional muscle groups? What functional is the ambulatory function? Low lumbar; What are the functional muscle groups? What is the ambulatory function?
Thoracic/high lumbar: none is functional
No ambulation
Low lumbar: quads, medial hamstrings
Ambulation with crutches and AFOS
High sacral: What are the functional muscle groups?
Quads
Medial hamstrings
Gluts
Low lumbar: What is the ambulatory function?
Ambulation with AFOs only
Low sacral: What are the functional muscle groups? What is the ambulatory function?
Quads
Medial hamstrings
Gluts
Gastrocnemius
Ambulation essentially normal
ls bracing effective?
No
At what age is the risk of curve progression maximal?
<l 5 years
What is the general rate of progression for curves over 40 degrees?
5 degrees/year
What are the two indications for scoliosis surgery in a patient with MM?
Curve >5O degrees
Progressive kyphosis
What is the most common level of MM with associated hip dislocation?
L3/4 (have hip adduction but not hip abduction)
What is the indication for treatment of hip dislocation?
Functioning quadriceps
What is the goal for hip flexion contractures in ambulatory patients?
Maintain <20 degrees
What is the operative indication for if knee flexion contracture?
Over 20 degrees
External tibial torsion leads to what clinical problem?
Increased valgus stress at knee
Therefore, what is the indication for surgery?
Thigh-foot angle greater than 20 degrees
What is the treatment of mild ankle valgus?
Screw hemi-epiphysiodesis
What is the treatment of rigid clubfoot?
Open release
ls triple arthrodesis an option?
No; it is indicated only for severe hindfoot deformity in sensate feet
What is an alternative to triple arthrodesis?
Talectomy may be necessary if insensate
When designing a brace for MM, how many points of pressure are necessary if one joint is spanned? lf two joints?
One joint: three-point pressure
Two joints: four-point pressure
What is the reported effect of intrauterine repair on the risk of hindbrain herniation?
Decreased
What is the reported effect of intrauterine repair on shunt dependence?
Decreased
What is the reported effect of intrauterine repair on functional outcome?
No functional difference