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