Pediatric Orthopaedic Secrets, 3e

Front matter......Page 1
Copyright\r......Page 3
Acknowledgment......Page 4
Top 100 Secrets......Page 14
How do the limb buds develop?......Page 22
What are the two kinds of growth plates?......Page 23
Where does a growth plate fail when it is fractured?......Page 24
Bibliography......Page 25
Why is it important to use the term developmental and not congenital when referring to hip dysplasia?......Page 26
Name three orthopaedic disorders that are caused by genetic abnormalities.......Page 27
Why is it important to differentiate deformations from dysplasias?......Page 28
What is apoptosis? What is the etiology?......Page 29
What does the Hueter-Volkmann law have to do with the etiology of progressive adolescent genu varum?......Page 30
What diagnostic tests are useful in acute osteomyelitis and septic arthritis?......Page 31
What are the local findings in systemic-onset JRA?......Page 32
What are the laboratory findings in a child with acute leukemia?......Page 33
What clinical tools and skills are helpful in making the diagnosis of abuse and in instituting treatment?......Page 34
Bibliography......Page 35
Are there different kinds of amplified musculoskeletal pain?......Page 36
What do you mean by belle indiffeacuterence?......Page 37
What are other signs of fibromyalgia?......Page 38
Are these children depressed?......Page 39
How do you treat children with hypervigilance?......Page 40
Bibliography......Page 41
What is the injected substance that lights up on a bone scan? On a white blood cell labeled scan?......Page 42
What tissues are dark or have low-signal intensity on T2-weighted images?......Page 43
Bibliography......Page 44
What are kinetics?......Page 45
What are typical uses for gait analysis?......Page 46
Are gait data always reliable, or are there possible sources of error?......Page 47
Bibliography......Page 48
How do I instill confidence in the child\'s family?......Page 49
What do you do if a complication occurs?......Page 50
Bibliography......Page 51
How do you handle parents and patients that live a long distance away when significant treatment is necessary or a problem arises?......Page 52
What situations can arise with divorced or separated parents?......Page 53
Key Points: The Physician-Parent Relationship......Page 54
Bibliography......Page 55
Who can help with ADLs?......Page 57
What about role models and self-esteem? They don\'t teach that in medical school!......Page 58
What is the Americans with Disabilities Act (ADA)?......Page 59
How can I avoid saying things that will offend people who have differences?......Page 60
Websites......Page 61
What are the main anesthesia risks for a patient undergoing surgery?......Page 63
Bottom line: In which groups of children with a URI should routine surgery definitely be canceled?......Page 64
What criteria are used to assess the need for blood transfusion in children?......Page 65
What are the coexisting organ system dysfunctions in these groups of patients?......Page 66
What radiologic examinations are important?......Page 67
How is acute pain assessed in children?......Page 68
What methods are used in the management of pediatric acute pain?......Page 69
Who are high-risk patients for latex allergy?......Page 71
How is an anaphylactic reaction managed?......Page 72
Bibliography......Page 73
A 13-year-old boy with an unstable (acute) slipped capital femoral epiphysis (SCFE) had a hip joint hematoma aspiration and closed reduction with single-screw fixation. What do.........Page 74
A 7-year-old boy with a displaced fracture of the distal radius and ulna is treated by closed reduction and application of a well-molded splint using intravenous conscious sedation. What.........Page 75
An 11-year-old boy had a resection of a calcaneonavicular tarsal coalition with interposition of the extensor digitorum brevis muscle. The anesthesiologist bellieves that postoperative popliteal.........Page 76
A 10-year-old boy has a temperature of 38.6degC on the second postoperative day after an elastic nailing of a femur fracture. How should this be evaluated?......Page 77
A 6-year-old boy had a closed reduction and percutaneous pinning for a supracondylar humerus fracture. At a follow-up appointment 4 weeks sfter the operation, the pins are removed.........Page 78
A 12-year-old boy had a plantar release with a plantar-based opening wedge osteotomy of the medial cuneiform to correct a pes cavus deformity. The anesthesiologist believes that epidural.........Page 79
Bibliography......Page 80
What is the composition of casting material?......Page 81
When casts are used to treat fractures, are there special guidelines?......Page 82
What should you remember at all times about a cast?......Page 83
Does traveling with a cast require special care?......Page 84
Bibliography......Page 85
What are the uses for orthoses?......Page 86
Key Points: Orthoses......Page 87
Bibliography......Page 88
What does physical therapy have to do with children\'s orthopaedics?......Page 89
You have a child who could use a wheelchair. Who should be asked for advice?......Page 90
What other kinds of exercises are there for children?......Page 91
What are the indicators for occupational therapy referral of a school student?......Page 92
What are some other terms you are likely to see on a therapist\'s report that you may not understand?......Page 93
What is the role of biofeedback in children?......Page 94
Websites......Page 95
What is cervical spine pseudosubluxation?......Page 96
Do children maintain their body temperature as effectively as adults?......Page 97
Do children\'s fractures heal faster than fractures in adults?......Page 98
Do fractures that involve the physes have any effect on growth?......Page 99
Bibliography......Page 100
What are the features of a good shoe?......Page 101
Do shoe wedges or inserts help with intoeing or out-toeing?......Page 102
What should I do if families insist on some treatment?......Page 103
Bibliography......Page 104
What are the precautions during joint aspiration or injection?......Page 105
What is the approach for finger joint aspiration?......Page 106
Key Points: Joint Aspiration and Injection......Page 107
Bibliography......Page 108
What is the anatomic basis of this classification?......Page 109
How are these fractures treated?......Page 110
What are the major complications of physeal growth-plate fractures?......Page 111
Bibliography......Page 112
What is the epidemiology of bicycle trauma in North America?......Page 113
When, where, and how are restraint systems used?......Page 114
What areas of prevention must take top priority in preventing spinal cord injuries in children?......Page 115
Why are all-terrain vehicles such a major hazard to inexperienced childhood riders?......Page 116
How can this injury be prevented in high-level adolescent athletes?......Page 117
How can the increasing epidemic of gunshot trauma in children be minimized and prevented?......Page 118
How can injuries from horseback riding be minimized?......Page 119
Bibliography......Page 120
What key elements of the history must be noted to avoid missing a case of child abuse?......Page 121
What are the priorities of the emergency department evaluation?......Page 122
How does the physiologic response to trauma differ in children versus adults?......Page 123
Are there any other essential radiographic examinations needed for children with cervical spinal injury aside from plain radiographs?......Page 124
Should ketamine be used in the emergency room?......Page 125
What can be done to provide sedation and pain relief for outpatient fracture management?......Page 126
What are some secrets to decreasing anxiety in traumatized children?......Page 127
Bibliography......Page 128
A 7-month-old child presents to the emergency room with a history of falling off a couch, and radiographs are interpreted as indicating a dislocation of the elbow. What.........Page 129
A 12-year-old girl presents with a displaced midshaft fracture of both bones of the forearm. After closed reduction and application of a short-arm cast, when.........Page 130
A 6-year-old boy steps on a nail while wearing tennis shoes and sustains a puncture wound to the planter aspect of the foot. Ten days later, he presents to the emergency room with.........Page 131
A 7-year-old boy undergoes retrograde titanium elastic nail fixation for a transverse midshaft fracture. Approximately 3 weels later, as rehabilitation is begun, the boy complains of.........Page 132
Bibliography......Page 133
No one can be 100% sure that abuse has occurred, so why should I become involved?......Page 134
What physical findings point toward abuse?......Page 135
What confirmation should be sought on radiographs?......Page 136
How can you confront the parents with your suspicions and still maintain a trusting relationship with the family?......Page 137
Key Points: Child Abuse......Page 138
Bibliography......Page 139
After an adequate airway and satisfactory oxygenation and ventilation are confirmed or established, what steps need to be taken to ensure sufficient fluid resuscitation?......Page 141
What is the most common injury pattern in children following polytrauma?......Page 142
What types of thoracic injuries occur in the pediatric polytrauma victim?......Page 143
What is the most appropriate radiographic evaluation for suspected cervical spine injury?......Page 144
What is the significance of open fractures in the child with polytrauma?......Page 145
Bibliography......Page 146
Which factors help predict the outcome of ankle fractures in children?......Page 147
How are fractures about the ankle managed?......Page 148
What are the most common fractures of the foot?......Page 149
How frequent are fractures of the talus? How are they managed in children?......Page 150
What is stubbed-toe osteomyelitis?......Page 151
Bibliography......Page 152
What is the differential diagnosis for an acute hemarthrosis of the knee in a child?......Page 153
What are the management options for an isolated intrasubstance tear of the ACL in a skeletally immature child? In a skeletally immature child? In a skeletally mature child?......Page 154
What are the presenting symptoms and findings with a discoid meniscus?......Page 155
What are the principles of surgical treatment of osteochondritis dissecans of the knee?......Page 156
Bibliography......Page 157
What is a common deformity after treatment of proximal tibial fractures in children? What are its causes?......Page 158
What are the operative stabilization options that can be used in children with tibial fractures?......Page 159
What is a floating knee? How is it treated?......Page 160
Bibliography......Page 161
What is the first consideration in treatment of a femoral fracture?......Page 162
In what position should the broken leg be placed?......Page 163
What is the most significant complication associated with reamed intermedullary nailing?......Page 164
How much shortening or over-riding can be accepted?......Page 165
Bibliography......Page 166
What is a greenstick fracture?......Page 167
What fractures require reduction?......Page 168
Should the forearm be placed in pronation, in a neutral position, or in supination in the cast or splint?......Page 169
What should be done after cast removal for a child\'s wrist or forearm fracture?......Page 171
Bibliography......Page 172
How are hip fractures in children classified?......Page 173
How are hip fractures in children treated?......Page 174
What surgical technique tips are helpful in the management of hip fractures in children?......Page 175
How are pelvic fractures in children different from those in adults?......Page 176
What type of imaging is useful?......Page 177
Bibliography......Page 178
How should a lateral cervical spine radiograph be evaluated?......Page 180
When are advanced imaging studies (i.e., a computed tomography [CT] scan or magnetic resonance imaging [MRI]) indicated?......Page 181
What structure damage results in atlantoaxial instability?......Page 182
How do odontoid fractures in children differ from those in adults?......Page 183
Bibliography......Page 184
What is a Seymour\'s fracture?......Page 185
How are phalangeal neck fractures treated?......Page 186
What is the most appropriate postoperative program for a young child following flexor tendon repair?......Page 187
What are the indications for digital replantation in pediatric patients?......Page 188
Bibliography......Page 189
What are the indications for surgery in clavicle fractures?......Page 190
How much displacement is acceptable in a proximal humerus physeal fracture, and why?......Page 191
What is Sprengel\'s deformity?......Page 192
What is scapulothoracic dissociation?......Page 193
Bibliography......Page 194
What are the bones most commonly injured around the elbow in children?......Page 195
Extension supracondylar fractures are classified into three subtypes. How is this classification used in determining the method of treatment?......Page 196
What is the most common risk associated with the insertion of a pin medially in the distal supracondylar fragment to stabilize the fracture after the reduction has been obtained?......Page 197
What is the most common complication with supracondylar fractures?......Page 198
Does a cubitus varus deformity produce any significant disability or functional impairment?......Page 199
How does the mechanism of injury in this fracture differ from that of a supracondylar fracture?......Page 200
Does the stage of displacement affect the usual treatment of these injuries?......Page 201
What is the more common injury involving the distal humerus in infants and small children?......Page 202
What is the most common mechanism for fractures of the entire distal humeral physis in infants?......Page 203
How common is injury to the medial condyle in children?......Page 204
What is the result of not recognizing or treating correctly a fracture of the medial condyle?......Page 205
What is the most commonly injured epicondyle around the elbow?......Page 206
What is the most common complication associated with avulsion of the medial epicondyle?......Page 207
What are the usually accepted methods of treatment for fractures of the radial neck?......Page 208
What are the common mechanisms responsible for fractures of the olecranon in children?......Page 209
Does Monteggia\'s fracture-dislocation injury occur only as a single pattern?......Page 210
What is probably the most frequent iatrogenic complication associated with Monteggia\'s fracture?......Page 211
In what direction does the proximal radioulnar segment displace in elbow dislocations in children?......Page 212
You are often asked to evaluate the lateral projection of a radiograph of an injured elbow to see whether there is a positive fat pad sign. What does this term mean?......Page 213
Bibliography......Page 215
In preparticipation screening evaluations, what component is the most sensitive for identifying individuals at significant risk for injury from sports participation?......Page 216
How much salt replacement is needed in fluids?......Page 217
Key Points: Youth Sports and Related Injuries......Page 218
How do stingers and burners occur?......Page 219
What are the most common injuries in the immature skeleton in young runners?......Page 220
Can one-eyed athletes participate in sports?......Page 221
Bibliography......Page 222
What is the implication of having a compression-type femoral neck fracture?......Page 223
How does one make the diagnosis of a stress fracture?......Page 224
What are the most common locations of stress fractures in children?......Page 225
Do stress fractures occur in the spine? What are some causes?......Page 226
Do stress fractures occur in growth plates?......Page 227
Bibliography......Page 228
How are AC joint injuries classified?......Page 229
What is a sternoclavicular (SC) joint injury?......Page 230
What are the causes of traumatic instability?......Page 231
What is impingement syndrome?......Page 232
How should impingement be treated?......Page 233
What is little leaguer\'s elbow?......Page 234
What factors should be considered in the evaluation of the elbow of a young athlete?......Page 235
What is Panner\'s disease (i.e., osteochondrosis)? How is it treated?......Page 236
Bibliography......Page 237
Besides avulsion fractures, which two serious injuries of the hip and pelvis are most often associated with sports injuries?......Page 238
What is the clinical presentation of SCFE?......Page 239
What portion of the meniscus has a blood supply that aids in the healing process, either spontaneously or with surgical repair?......Page 240
Name the two most common ways for a patient with symptomatic medial plica to present.......Page 241
Can the ACL be safely reconstructed in a skeletally immature person?......Page 242
What physical examination finding best differentiates a physeal fracture of the distal fibula from an ankle sprain?......Page 243
What other fractures are typically associated with inversion injuries of the foot and ankle?......Page 244
Bibliography......Page 245
How do you assess a patient with LLD?......Page 246
What are the causes of LLD?......Page 247
What is the Galeazzi sign?......Page 248
What are the limitations of a shoe lift?......Page 249
What work-up should a patient with hemihypertrophy undergo?......Page 250
How is a bone lengthened?......Page 251
What can the patient and the parents do to ensure success?......Page 252
Bibliography......Page 253
Why is taking a good history important?......Page 254
What is a flexible flatfoot with a shortened tendo Achillis?......Page 255
What condition can cause pain in the midfoot?......Page 256
What is an accessory navicular bone?......Page 257
What are other unusual causes of foot pain?......Page 258
Bibliography......Page 259
How do I examine a child for leg aches?......Page 260
Do medications help in the treatment of leg aches?......Page 261
Bibliography......Page 262
What is equinus gait?......Page 263
How do I use observational gait analysis?......Page 264
Key Points: Limping......Page 265
What are the most common causes of a limp in a child of 10-15 years of age?......Page 266
Bibliography......Page 270
How is the deformity documented?......Page 271
When is surgery indicated?......Page 272
What are the disadvantages of corrective osteotomies?......Page 273
What is the difficulty with fusion of the MP joint?......Page 274
Bibliography......Page 275
What is the background of the conditions that cause intoeing?......Page 276
What are the pitfalls of diagnosis?......Page 277
Does intoeing ever persist and cause disability?......Page 278
Do sprinters intoe?......Page 279
What is tibial torsion?......Page 280
What are the clinical features of MFT?......Page 281
How is MFT corrected surgically?......Page 282
What is the torsional malalignment syndrome (TMS)?......Page 283
Bibliography......Page 284
What are the physical findings?......Page 285
Are laboratory studies useful?......Page 286
What about hemiepiphysiodesis?......Page 287
Key Points: Bowlegs and Knock Knees......Page 288
What is guided growth?......Page 289
Bibliography......Page 290
What is an overriding fifth toe?......Page 291
What is the treatment of subungual exostosis?......Page 292
What are claw toes?......Page 293
What is polydactyly?......Page 294
What is syndactyly?......Page 295
What are the contributing preventable causes?......Page 296
Bibliography......Page 297
What instructions should be given to the family?......Page 298
Bibliography......Page 299
What causes metatarsus adductus?......Page 300
How does the condition differ from talipes equinovarus and skewfoot?......Page 301
Bibliography......Page 302
When should a magnetic resonance imaging (MRI) scan be ordered?......Page 303
What are common presenting complaints in patients with Osgood-Schlatter disease?......Page 304
Key Points: Knee Pain......Page 305
What is the treatment for adolescent anterior knee pain?......Page 306
Bibliography......Page 307
Can clubfoot be diagnosed prenatally?......Page 308
How long is bracing necessary?......Page 309
What information is important to communicate to the family up front?......Page 310
Bibliography......Page 311
How do you differentiate the types of flatfoot on clinical examination?......Page 312
Are there other benefits from the use of orthoses?......Page 313
What are the treatment principles for the rigid flatfoot?......Page 314
Bibliography......Page 315
In acute dislocation of the patella in a child, what is the appropriate treatment?......Page 316
What common conditions produce referred pain to the knee in children?......Page 317
What is an apprehension test?......Page 318
What imaging studies are most helpful in the evaluation of patellar pain and malalignment?......Page 319
What characterizes congenital dislocation of the patella?......Page 320
Bibliography......Page 321
What are typical presenting complaints?......Page 322
What other studies should be performed?......Page 323
What are the principles of operative management?......Page 324
Bibliography......Page 325
What are the main conditions in the differential diagnosis?......Page 326
How many degrees of ankle dorsiflexion are needed for a normal gait (i.e., heel-toe walking)?......Page 327
Is there a neurodevelopmental problem associated in a child with ITW?......Page 328
Bibliography......Page 329
How often does one see hyperextended knees at birth?......Page 330
What imaging methods are used?......Page 331
What should be done with knees that cannot be reduced by conservative treatment?......Page 332
Bibliography......Page 333
How do I differentiate clinically physiologic tibia vara from other diseases with bowing legs?......Page 335
How does imaging help to differentiate physiologic bowing from Blount disease?......Page 336
What is the natural history of Blount disease?......Page 337
Is there another technique to be used in initial cases?......Page 338
Bibliography......Page 339
What diseases are frequently associated with CPT?......Page 340
Are there important limitations for the use of these classifications?......Page 341
What are the other surgical options?......Page 342
What is the present status of CPT treatment?......Page 343
Bibliography......Page 344
Is slipping of the epiphysis due to a traumatic event?......Page 345
What imaging studies should be ordered in SCFE? What is seen on these studies?......Page 346
When is realignment osteotomy indicated?......Page 347
Does the development of avascular necrosis require early reconstructive surgery?......Page 348
Bibliography......Page 349
What other investigations are helpful in the evaluation of hip pain?......Page 350
Do age and sex influence the pathologies that present with hip pain?......Page 351
What is the most sensitive indicator of pathology in patients with hip pain?......Page 352
How do you distinguish septic arthritis from transient synovitis?......Page 353
What is the usual time frame for recovery?......Page 354
Is aspiration of the hip beneficial?......Page 355
When should plain radiographs be ordered?......Page 356
When should diskitis be suspected?......Page 357
What treatment is needed for diskitis?......Page 358
What treatment is needed for spondylolisthesis?......Page 359
Bibliography......Page 360
What is the Ortolani maneuver? What is its significance in the evaluation of DDH?......Page 361
What other physical findings may aid in the identification of a dislocated hip, especially in an older child or in a teratologic dislocation if the Ortolani Maneuver is negative?......Page 362
What is the Pavlik harness?......Page 363
What is the treatment for the 6- to 24-month-old child newly diagnosed with DDH?......Page 364
Name and briefly describe indications and techniques for the Pemberton, Steel, Ganz, Chiari, and Shelf procedures used in the treatment of DDH.......Page 365
What is the natural history of untreated DDH?......Page 366
Bibliography......Page 367
How do I make the diagnosis?......Page 369
How is the natural history influenced by the age at onset?......Page 370
Can the other hip become involved?......Page 371
Bibliography......Page 372
What is the genetic predisposition for scoliosis?......Page 373
Can one predict the natural history of curve progression for any individual’patient?......Page 374
What are the treatment options for idiopathic scoliosis?......Page 375
What does the surgery for scoliosis involve?......Page 376
Bibliography......Page 377
How do I measure kyphosis and lordosis?......Page 378
What is the three-column spine concept?......Page 379
What is Scheuermann\'s disease?......Page 380
How do I manage a teenager with Scheuermann\'s disease?......Page 382
How does lumbar hyperlordosis relate to contractures about the hip joint?......Page 383
In a conscious patient with neck pain, what is a radiographic feature of a whiplash injury?......Page 384
What are the pitfalls in common practice when assessing the sagittal balance of a child?......Page 385
Bibliography......Page 386
What other types of physical examination are required in the patient with torticollis?......Page 387
What is the treatment of torticollis due to congenital anomalies of the cervical spine?......Page 388
Bibliography......Page 389
What initial investigation should be performed for a neonate who presents with a motionless or paralytic upper limb?......Page 390
When should microsurgical treatment be considered in NBPP?......Page 391
In patients with upper-root brachial plexus (i.e., Erb\'s) palsy, which upper limb muscles are affected?......Page 392
Bibliography......Page 393
What other clinical conditions can compromise the room available for the spinal cord at C1 and C2?......Page 394
When and how often should one order x-rays of the cervical spine in the patient with Down syndrome?......Page 395
What is the medical importance of Klippel-Feil syndrome?......Page 396
What is the significance of absence of the clavicle?......Page 397
What are the classic clinical findings in Sprengel\'s deformity?......Page 398
What is the omovertebral bone?......Page 399
Bibliography......Page 400
What are the elements of CRPS?......Page 401
How do you approach the toddler with a limp arm?......Page 402
What is the best way to manage a painful wrist ganglion in a child?......Page 403
How should I approach a patient with pain along the ulnar side of the wrist?......Page 404
An active youth presents with shoulder pain and trouble abducting or flexing the shoulder. Does this indicate impingement syndrome or a rotator cuff tea?......Page 405
Bibliography......Page 406
Are there pediatric age groups at risk for certain tumors?......Page 407
What is staging of musculoskeletal tumors?......Page 408
Key Points: Initial Evaluation of Musculoskeletal Tumors in Children......Page 409
Bibliography......Page 410
What other organ systems are commonly affected in patients with congenital hand anomalies?......Page 411
What is the difference between camptodactyly and clinodactyly?......Page 412
What are the treatment options for thumb hypoplasia?......Page 413
What is the most common type of congenital upper-limb amputation?......Page 414
Bibliography......Page 415
What is the underlying problem?......Page 416
What is Kirner\'s deformity?......Page 417
What is a ganglion cyst?......Page 418
What causes Madelung\'s deformity?......Page 419
Bibliography......Page 420
What pathologic features distinguish an ABC from a simple bone cyst?......Page 421
Describe the typical clinical presentation, principal pathologic features, diagnostic radiographic features, and treatment of an osteochondroma.......Page 422
Describe the typical clinical presentation and appropriate initial evaluation of a patient presenting with an apparent eosinophilic granuloma.......Page 423
Key Points: Bone Tumors......Page 424
What are the classic histologic findings in osteofibrous dysplasia? How do they differ from fibrous dysplasia?......Page 425
Bibliography......Page 426
What are the deep spaces of the hand? What is their significance in hand infections?......Page 427
What is the best way to decompress FTS?......Page 428
What unusual infections can be seen in an infant\'s hand?......Page 429
What is a collar-button abscess?......Page 430
Bibliography......Page 431
What is juvenile chronic arthritis?......Page 432
How frequently does a patient with JRA need to see an ophthalmologist?......Page 433
What blood tests should I order for a child with arthritis?......Page 434
What laboratory tests are indicated for children on nonsteroidal medication?......Page 435
What tests are useful on the synovial fluid that is aspirated?......Page 436
What are the tip-offs in distinguishing leukemia from JRA?......Page 437
Bibliography......Page 438
What are the different types of benign lesions of soft tissue in children?......Page 439
What should be asked regarding the history?......Page 440
Which type of imaging is useful?......Page 441
Who should manage the malignant lesions?......Page 442
What are the complications?......Page 443
Bibliography......Page 444
How does osteomyelitis in children differ from that observed in adults?......Page 445
What determines the natural history of untreated disease?......Page 446
What are the clinical features of the different categories of disease?......Page 447
What laboratory studies should be obtained?......Page 448
What other conditions may be confused with osteomyelitis?......Page 449
What are the indications for surgical treatment?......Page 450
Who should manage the problem?......Page 451
Bibliography......Page 452
What studies should one obtain in the work-up of septic arthritis?......Page 453
Is ultrasonography helpful?......Page 454
What are the clinical and laboratory guidelines for differentiating toxic synovitis from acute septic arthritis?......Page 455
What is the surest method of decompressing and debriding a septic joint?......Page 457
What is definitive treatment for GC septic arthritis?......Page 458
Bibliography......Page 459
Which are the most frequent atypical pathogens infecting children\'s bones?......Page 460
How should we study a patient with a suspected atypical bone infection?......Page 461
What is Lyme disease?......Page 462
What mycobacterial infections can be found in osteoarticular disease?......Page 463
What is the most recently proved medical treatment for TB?......Page 464
What microbiologic study detects mycobacteria?......Page 465
Acknowledgments......Page 466
How is the poliomyelitis virus spread?......Page 467
What sort of problems would you expect a child to have as a result of muscle weakness?......Page 468
What muscles do you need to keep your knee from giving way when you are walking?......Page 469
How does muscle weakness of poliomyelitis result in deformity?......Page 470
Who should be treating a child with the residua of poliomyelitis?......Page 471
Do you find that parental attitudes and social attitudes toward children with poliomyelitis are different from those toward some other chronic diseases of Childhood?......Page 472
Bibliography......Page 473
How is CP classified by motor disorder type?......Page 474
Who are involved in the care of children with CP?......Page 475
What is the upper motor neuron syndrome (UMN)?......Page 476
What is the role of oral medications for spastic hypertonia?......Page 477
What are neurolytic blocks?......Page 478
Is there a unified treatment or cure for CP?......Page 479
What are the gait problems seen in children with hemiplegia?......Page 480
Is there a role for multilevel surgery in spastic hemiplegia?......Page 481
What is the role of spasticity management in spastic diplegia?......Page 482
What is meant by single-level surgery and multilevel surgery?......Page 483
When are casts required after multilevel surgery?......Page 484
What is meant by screening for spastic hip disease (SHD)?......Page 485
Is a cast necessary after hip surgery in children with CP?......Page 486
What are the principles of scoliosis surgery in CP?......Page 487
Bibliography......Page 488
What is the incidence?......Page 489
What is the early treatment?......Page 490
What is the significance of sensory loss?......Page 491
Is arthrodesis indicated?......Page 492
What is the importance of posture?......Page 493
Are fractures common?......Page 494
Why are some of these children obese?......Page 495
Bibliography......Page 496
How early should these children be seen by a pediatric orthopaedist?......Page 497
Is there an indication for surgery for these cases?......Page 498
In general, what is the role of amputation and prosthetic fitting (i.e., prosthetic reconstruction surgery)?......Page 499
What functional result can be expected in a child with a unilateral through-knee or above-knee amputation?......Page 500
Is a child with a traumatic amputation different?......Page 501
How do I classify CFD?......Page 502
What other congenital anomalies are associated with CFD?......Page 503
What is the best level for lengthening the femur in CFD?......Page 504
How do I classify FH?......Page 505
What are the specific complications of tibial lengthening in FH?......Page 507
How is TH classified?......Page 508
Bibliography......Page 509
What is the molecular basis of Duchenne\'s and Becker\'s muscular dystrophy?......Page 511
What are the clinical signs of DMD?......Page 512
What is Gowers\' maneuver? What does it indicate?......Page 513
If one suspects muscular dystrophy based on clinical findings, what laboratory studies can be used to confirm the diagnosis?......Page 514
What is dermatomyositis?......Page 515
How does joint contracture affect the ability to ambulate?......Page 516
Once spinal fusions are done, what particular orthopaedic needs require attention?......Page 517
What are the side effects of corticosteroid administration?......Page 518
Are other medications beneficial to DMD patients?......Page 519
Bibliography......Page 520
Describe the topographic classification of arthrogryposis multiplex congenita.......Page 521
What procedures are beneficial in the correction of an elbow extension contracture?......Page 522
Describe the management of unilateral teratologic hip dislocation.......Page 523
Key Points: Arthrogryposis Multiplex Congenita......Page 524
Bibliography......Page 525
How do we classify syndromes?......Page 526
What skeletal abnormalities are present in orthopaedic syndromes?......Page 527
Bibliography......Page 528
How are children measured?......Page 529
Why is the ratio between trunk length and limb length important?......Page 530
How are children with short stature treated?......Page 531
Why is skeletal elongation controversial?......Page 532
Bibliography......Page 533
Define collagen.......Page 534
Describe the four principal type II collagenopathies. Give the characteristic features of this group of disorders.......Page 535
Define fibroblast growth factor receptor (FGFR). Name three osteochondrodysplasias caused by FGFR mutations.......Page 536
By what sclerosing bone dysplasia is the French impressionist painter H. M. R. de Toulouse-Lautrec Monfa said to have been affected? Describe the clinical and.........Page 537
Define type IX collagen Give three characteristic features of the osteochondrodysplasia for which a mutation in its gene is responsible.......Page 538
Define cartilage oligomeric matrix protein (COMP). Give three characteristic features of the osteochondrodysplasia for which a mutation in its gene is responsible.......Page 539
Give three characteristic spinal deformities in achondroplasia.......Page 540
Bibliography......Page 541
What are the criteria for diagnosis?......Page 542
What are the clinical features?......Page 543
What spinal deformities are associated with neurofibromatosis?......Page 544
What tibial disorders are seen?......Page 545
What type of imaging is useful?......Page 546
Who should manage the problem?......Page 547
Bibliography......Page 548
How are the various forms classified?......Page 549
What is the natural history?......Page 550
Key Points: Osteogenesis Imperfecta......Page 551
What are the indications for straightening and rodding the long bones?......Page 552
What is basilar invagination?......Page 553
Are patients with OI prone to chronic pain?......Page 554
Bibliography......Page 555
What is the pathophysiology of the bone disease in these metabolic disorders?......Page 556
How much do I have to know about calcium, vitamin D, and phosphorus metabolism to be able to effectively manage the orthopaedic needs of these patients?......Page 557
What are the clinical features of rickets?......Page 558
What findings can be seen on the plain radiographs?......Page 559
After orthopaedic treatment of rachitic deformities, what can I tell the parents about the prognosis and the risk of recurrence?......Page 560
What is the cause of the epiphyseal slipping in this disease?......Page 561
How are the orthopaedic problems associated with anticonvulsants managed?......Page 562
Acknowledgments......Page 563
Bibliography......Page 564
What are the physical findings of minor hemarthrosis?......Page 565
What are the indications for synovectomy?......Page 566
How are iliopsoas hemorrhage and hemarthrosis of the hip joint differentiated?......Page 567
What is the ethnic distribution of the gene for HgS? What is the resultant incidence of SC anemia?......Page 568
Describe the most common cause and site of extremity pain in SC anemia.......Page 569
Why is it difficult to differentiate bone infarction from osteomyelitis?......Page 570
How can the spine be involved in sickle patients?......Page 571
How common is cerebral infarction in SC anemia?......Page 572
What is the rate of premature physeal closure in thalassemia?......Page 573
What are the typical skeletal changes seen in Gaucher\'s disease?......Page 574
Where does osteonecrosis usually occur in Gaucher\'s disease? How is it treated?......Page 575
What are the common sites of soft tissue involvement, and what is the prognostic significance?......Page 576
What are the ways to differentiate between the mature lesions of Langerhans cell histiocytosis and subacute or chronic osteomyelitis?......Page 577
What are the musculoskeletal features of leukemia?......Page 578
Key Points: Hematologic Disorders......Page 579
Bibliography......Page 580
Index......Page 583