Abos - Pediatric Ortho Surgery:pediatric Upper Extremity Malformations And Disorders

Front 1

Upper extremity malformations are associated with what parental risk factor?

Back 1

Advanced maternal age

Front 2

Hand formation (limb bud) occurs between which gestational days?

Back 2

Gestational days 26 to 56

Front 3

What is the most common congenital hand anomaly?

Back 3

Syndactyly

Front 4

What is the inheritance?

Back 4

AD

Front 5

What is acrosyndactyly?

Back 5

Digits are only fused distally

Front 6

What two digits are most commonly involved with syndactyly?

Back 6

Long
Ring

Front 7

What is the general rule of thumb for rates of involvement for each digit?

Back 7

5-15-50-30
5% thumb-index
15% index-long
50% long-ring
30% ring-small

Front 8

At what age should syndactyly release generally be performed?

Back 8

1 year

Front 9

With syndactyly surgery, what should never be done?

Back 9

Never release both sides of a digit at the same time

Front 10

For coverage, which type of graft should be used?

Back 10

Full-thickness skin graft (FTSG)

Front 11

What two entities is camptodactyly generally due to?

Back 11

Abnormal lumbrical insertion
Abnormal FDS

Front 12

What is the most common location for camptodactyly?

Back 12

Proxima] interphalangeal (PIP) joint of the small finger

Front 13

What is the preferred treatment?

Back 13

Nonoperative (stretching, etc.)

Front 14

What is the operative treatment?

Back 14

Transfer to the radial lateral band

Front 15

What is the indication for surgery?

Back 15

PIP contracture greater than 60 degrees

Front 16

What is the definition of Kirner’s deformity?

Back 16

Kirner’s is a volar curve of the distal phalanx

Front 17

What is the preferred treatment if an associated delta phalanx is an extra bone?

Back 17

Early excision

Front 18

. . . . is not an extra bone?

Back 18

Opening wedge osteotomy

Front 19

What are the four clinical features of Poland’s syndrome?

Back 19

Unilaterally short fingers
Simple (soft tissue) complete syndactyly
Hand hypoplasia
Absent sternocostal head of
pectoralis major (chest
anomalies)

Front 20

What is the specific deformity that makes the lingers short in Poland’s syndrome?

Back 20

Middle phalanx is short

Front 21

What are the six clinical features of Apert‘s syndrome?

Back 21

Bilateral complex (bony) syndactyly
Common nail
Acrocephaly
Hypertelorism
Craniosynostosis
Retardation
Radiol Club Hand

Front 22

What bone is absent with radial club hand?

Back 22

Radius

Front 23

With what four disorders is radial club hand associated?

Back 23

Holt-Oram (cardiac)
Fanconi’s
TAR (thrombocytopenia with absent radii)
VATER (vertebral defects,
imperforate anus,
tracheoesophageal fistula, radial and renal dysplasia)

Front 24

What does treatment usually consist of?

Back 24

Surgical

Front 25

What other option exists for mild cases of radial club hand?

Back 25

Cast

Front 26

The ulna should not be centralized if what contraindication to operative treatment exists?

Back 26

No elbow motion

Front 27

What is the key feature of the radius in TAR syndrome?

Back 27

No radii bilaterally

Front 28

What is the key feature of the thumbs in TAR syndrome?

Back 28

Normal thumbs

Front 29

What muscular procedure is required for improved outcomes?

Back 29

Excise brachiocarpalis muscle

Front 30

What bone is absent with ulnar club hand?

Back 30

Ulna

Front 31

What is the most common clinical complaint of patients with ulnar club hand?

Back 31

Elbow stiffness

Front 32

What is the general rule for treatment?

Back 32

Conservative treatment

Front 33

Radioulnar synostosis is associated with what group of disorders?

Back 33

Sex chromosome developmental disorders

Front 34

What joint is absent with symphalangism?

Back 34

lnterphalangeal (IP) joint

Front 35

What is the clinical appearance of an affected digit?

Back 35

No skin crease

Front 36

What is the treatment of choice?

Back 36

No treatment is generally required

Front 37

ls preaxial polydactyly sporadic or inherited?

Back 37

Sporadic

Front 38

What is the most common type?

Back 38

Wassell lV (duplicate proximal phalanx)

Front 39

With treatment, which thumb is generally retained? Why?

Back 39

Retain ulnar thumb
To keep the ulnar collateral ligament (UCL) intact

Front 40

ln what situation is the ulnar thumb not retained?

Back 40

Triphalangeal ulnar thumb

Front 41

What is the preferred treatment if one digit is severely affected?

Back 41

Amputation

Front 42

What is the treatment of thumb hypoplasia with an absent carpometacarpal (CMC) joint?

Back 42

Thumb amputation and index pollicization

Front 43

Why?

Back 43

Stable reconstruction cannobe achieved without functional CMC

Front 44

What is Madelung’s deformity?

Back 44

Disruption of radial volar ulnar epiphysis

Front 45

What two clinical abnormalities may result?

Back 45

Excess radial inclination
Excess volar tilt

Front 46

What two things happen to the distal ulna?

Back 46

Subluxes
Enlarges

Front 47

What happens to the carpus?

Back 47

Becomes wedged

Front 48

What happens to the volar ligaments?

Back 48

Hypertrophy

Front 49

What happens to pronation/supination?

Back 49

Supination becomes very limited

Front 50

What is the treatment of painless Madelung’s deformity?

Back 50

None generally required

Front 51

What are the two components of the treatment of painful Madelung’s?

Back 51

Osteotomy of the radius
Distal ulna resection
May need to be corrected in more than one stage

Front 52

Constriction rings are seen with what syndrome?

Back 52

Streeter's dysplasia

Front 53

Why are constriction rings thought to develop?

Back 53

Amniotic fluid rupture

Front 54

How do the feet of affected children classically appear?

Back 54

Clubfeet

Front 55

What radial head morphology is associated with congenital dislocation?

Back 55

Dome-shaped head

Front 56

What are the two treatment options if congenital dislocation is incidentally discovered? What is not a treatment option?

Back 56

Leave alone
Excise
Reduction is not an option

Front 57

What is the consequence of chronic congenital radial head dislocation?

Back 57

Limited flexion and rotation