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