Free Test MCQs/SBAs Paediatric Orthopaedics

Best Answer: D
A Pavlik harness usually is indicated for children younger than 6 months of age. Hip abduction bracing can be used in older children, but it is usually used for patients with dysplasia and not dislocation. Although closed reduction can be used in children 6 to 24 months of age, it must be concentrically reduced. A dye pool of at least 7 mm results from a nonconcentric reduction. Open reduction is commonly needed for children older than 18 months of age, and femoral shortening or pelvic osteotomy is usually decided upon at the time of surgery. Observation will result in suboptimal outcomes.

Best Answer: D
All other statements are correct. D is False - since simple manipulation and splinting form the initial management. Limb lengthening of Achilles tendon and medial tendons come later in the management.

Best Answer : B .
The figure shows an individual with Poland's Syndrome, as demonstrated by the absent sternoclavicular head of the pectorals major. Syndactyly and symbrachydactyly is often seen.

Best answer : A .
The features on the x-ray shows loss of vertebral body height anteriorly or posteriorly indicating Vertebra Plana which is defined as a vertebral body that has lost almost its entire height anteriorly and posteriorly. Vertebra plana can be caused by Eosinophilic granuloma and avascular necrosis. Vertebra plana is an affliction of childhood: it usually appears between 6 and 12 years of age. The most frequent clinical symptoms are thoracolumbar pain, short-segment kyphosis and loss of interest in playing. Radiologically, the flattening of the anterior part of the vertebral body is seen.

Best answer : D .
This radiograph shows two fractures in different stages of healing. Note the old femur fracture at the top of the field. No evidence of decreased cortical thickness, diaphyseal thinning, or bowing to suggest OI. The physis of the distal femur and proximal femur show no signs of rickets. The presence of fractures rather than periosteal reaction make Caffey’s disease unlikely. The fractures in scurvy are more commonly located in the physis. The diagnosis of nonaccidental injury should be made only after performing a thorough patient history and physical examination.

Best answer: D .
Congenital dislocation of the patella is present from birth and diagnosed in childhood. It is not reducible with the knee in extension. Essential elements include contracture of the iliotibial band, vastus lateralis, hypoplasia of the vastus medialis, lateral insertion of the patellar tendon, decreased size of the patella, flexion contracture and valgus alignment of the knee, and hypoplasia of the patellar sulcus. Operative treatment is usually successful, and the success rate is increased with early surgery.

Best answer: D .
The patient has a displaced intra-articular tibial tuberosity fracture; therefore, the treatment of choice is open reduction and internal fixation. Periosteum is often interposed between the fracture fragments and prevents satisfactory closed reduction. Fortunately, most patients with this injury are close to skeletal maturity and therefore, growth arrest and recurvatum are unusual. Non displaced fractures can be treated with a cast, but displaced fractures are best treated with open reduction and internal fixation. Intra-articular fractures can disrupt the joint surface and are sometimes associated with a meniscal tear; therefore, arthroscopy may be needed at the time of open reduction and internal fixation.