scoliosis

Osteogenesis Imperfecta

Incidence

 

Spinal deformities are found in 20% to 80% of patients with OI

 

Risk factors

 

Severe disease with nonambulatory status

 

Progression

 

Scoliosis in OI may progress after skeletal maturity 

- may be related to weakened osteoporotic bone 

 

Management

 

Non operative

 

Bracing

 

Poor results

Scoliosis

Epidemiology

 

Scoliosis 10 to 15 x more common in patients with spastic quadriplegia than spastic diplegia

 

Typically

- spastic quadriplegic patient

- long C shaped curve

- lumbar apex

- progressive past maturity

- pelvic obliquity / dislocated or subluxed hips

- can extend into cervical spine

- high risk of respiratory compromise

 

Issues

 

Sitting in wheelchair

Hygiene

Leg Length Discrepancy

Issue

 

Most common reason for litigation against orthopaedic surgeons in THR

Usually from lengthening

 

Complications of LLD

 

1.  Nerve palsy

 

Sciatic nerve - tolerate average 4.4cm lengthening

 

Common peroneal nerve - tolerate average 2.7 cm lengthening

 

Lengthen by up to 15-20% of the resting nerve length

- but in reality is unknown and multifactorial

Syringomyelia

Definition

 

Progressive and  chronic disorder associated with cord cavitation & gliosis

 

Effects

 

Muscle wasting

Dissociate anaesthesia

Scoliosis

Neuropathic arthropathy

 

Epidemiology

 

M > F

No familial tendency

 

Aetiology

 

1. Idiopathic

 

Osteoid Osteoma

Definition

 

Benign, bone-forming neoplasm

- characterized by a small nidus of neoplastic tissue

- surrounded by a wide zone of mature, reactive bone

 

Epidemiology

 

10% of benign bone tumours

Age 5-25

M:F 2:1

 

Aetiology

 

Unknown

- thought may be glomus tumour of bone

 

Pain secondary to prostaglandin production