ASSIGNMENT 2:

PAEDIATRIC ORTHOPAEDICS

1. A 3-day old infant is referred to you with the diagnosis of clubfoot. (Chapter 228)

a. What are the four characteristic components of this deformity?

C – Midfoot cavus
A – Adductus of forefoot
V – Varus of hindfoot
E – Equinus of hindfoot

b. Name 2 associated conditions need to be excluded?

 Genovarum


c. What is the best treatment method according to available evidence? Briefly describe this treatment
method
Poncineti technique

2. A baby is born in the peripheral hospital where you work and you are tasked with examining the infant.
(Chapter 222)

a. What orthopaedic condition must be examined for?

Developmental dysplasia of hip( DDH)

b. Describe how you will examine the child, specifically describing the Ortolani and Barlow
manoeuvre.
Barlow: knee and hip flexion, affected leg adduction,, feel for clunking sound( assess
dislocatability of hip joint)
Ortalani: knee and hip flexion at 90 degrees, affected leg abduction, palpate clunking
sound(assesss reducibility of hip joint)

3. A 13-yr old boy presents to you with knee pain after a fall. He is still able to bear weight on the limb.
General examination reveals a Fröhlich-type appearance (Obesity and underdeveloped genitalia).
Orthopaedic examination reveals shortening and external rotation of the left leg. (Chapter 221)

a. What is the likely diagnosis?

Sliiping Capital Femoral Epiphysis

b. What X-rays will you obtain and how will you confirm the diagnosis on these X-rays?
AP and Frog-view x-ray
AP x-ray: display kleins line and disrupted shenton’s line
c. How will you manage this patient? Any specific instructions to the patient?