Paediatric Orthopaedics · NEET PG Preparation Orthopaedics
A 6-year-old boy presents with a 2-month history of painless limp and restricted movements of the right hip, particularly abduction and internal rota…
Practice question from Paediatric Orthopaedics (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
hard · MCQ · Q-C84567
A 6-year-old boy presents with a 2-month history of painless limp and restricted movements of the right hip, particularly abduction and internal rotation. Radiography shows sclerosis, fragmentation, and flattening of the right femoral head. Bone scintigraphy confirms avascular necrosis of the femoral epiphysis. What is the primary therapeutic goal in the management of this patient?
- A.Immediate open reduction and internal fixation with dynamic hip screw
- B.Containment of the femoral head within the acetabulum to prevent deformationCorrect answer
- C.Complete bed rest with bilateral skeletal traction until complete re-ossification
- D.High-dose oral bisphosphonates to reverse epiphyseal resorption
Solution
The child has Legg-Calve-Perthes disease (idiopathic avascular necrosis of the femoral head). The primary treatment goal is 'containment'—keeping the softened femoral head deep within the true acetabulum so that the acetabulum acts as a mold, preventing collapse and subsequent coxa magna or hinge abduction. Containment can be achieved by bracing or surgical osteotomies (femoral or pelvic).
More from Paediatric Orthopaedics
- A 3-year-old child is brought by his parents with a painless limp. Examination reveals a positive Trendelenburg sign on the right side, lim…
- An 18-month-old child is brought to the orthopaedics outpatient department with bilateral intoeing and bowing of the legs. On examination,…
- A 12-year-old obese boy presents with a 3-week history of a dull, aching left hip pain radiating to the knee, with no history of trauma. He…
- A newborn infant is evaluated for foot deformities. The right foot exhibits severe equinus at the ankle, varus of the hindfoot, adduction o…
Practise more Orthopaedics
Sign up free for adaptive practice on this chapter, with instant feedback and hints on every question.
Start practising freeFree to start · No credit card needed