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39 Cards in this Set

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  • Back
What is the expected alignment ofthe knees in a child less than 18 months of age?
Genu varum
. . . 18 to 36 months of age?
Genu valgum
. . . over 36 months of age?
Physiologic valgus
In general, conditions that present early result in what direction of knee deformity?
Excess varus
Conditions that present later result in what direction of knee deformity?
Excess valgus
What condition is the exception to this rule?
Adolescent Blount‘s (late presenting, but varus)
What is the most common nondysplastic cause of genu varum?
Blount’s disease
(Infantile Blount’s Disease) What age group is affected?
O to 4 years
What are the three typical characteristics of affected children?
Obese
Ambulate before 1 year of age
Internal tibial torsion
How is Drennan’s angle measured?
Draw first line through metaphyseal beaks
Draw second line along longitudinal tibial axis
Measure angle between intersecting lines
What is the normal range for Drennan’s angle?
<12 degrees
What values are considered abnormal?
>16 degrees
What classincation system is used for infantile Blount's disease?
Langenskiold
Stages V and Vl are characterized by the presence of what?
Metaphyseal-epiphyseal bridge
What is the treatment for early, unilateral involvement?
Bracing
What are the two indications for surgery?
No response to bracing
>3 years old
What does surgical treatment generally involve?
Valgus producing osteotomy
What is the surgical treatment for stages V and Vl?
Epiphysiolysis
How does the severity of adolescent Blount’s compare with that of infantile Blount’s?
Less severe than infantile Blount’s
What patient population particularly at risk?
Obese children
Is adolescent Blount’s more often unilateral or bilateral?
Unilateral
What is the treatment if growth potential remains?
Lateral proximal tibia/fibula epiphysiodesis
How many months of remaining growth are necessary to consider epiphysiodesis?
15 months
What is the treatment if no growth potential remains?
Valgus opotential steotomy with or without lengthening
What measure of genu valgum is acceptable in children aged 2 to 6?
<15 degrees
What is the most common cause of bilateral pathologic genu valgum?
Renal osteodystrophy
What is the treatment if growth potential remains?
Medial physeal stapling
What are the two indications for surgery for genu valgum?
>10 years old
>10 cm between medial malleoli
What are the two components of the nonoperative treatment for congenital knee dislocation?
Serial casting
Reduction
What is the indication for surgery?
<30 degrees of motion after 3 months of casting
What two steps does surgical treatment include?
V-Y lengthening
Collateral release
What is the usual location of a Baker’s cyst?
Posteromedial (interval between medial gastrocnemius and
semimembranosus)
What is the general treatment?
Observation
How do pediatric Baker’s cysts compare with those of adults?
In children not associated with intraarticular pathology (unlike adults)
What is the key radiographic view for diagnosing knee OCD?
Tunnel view
What is the treatment for stable OCD lesions if relatively asymptomatic?
Activity restriction
What are the two components of the treatment for stable OCD lesions if symptoms are significant?
NWB
Immobilization
What is the treatment for stable OCD lesions if resolution with nonoperative treatment is incomplete?
Retrograde drilling
What are the two components of the treatment for unstable OCD lesions with subchondral bone attached to fragment?
Drill bed
Replace fragment