MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Orthopedic disorders can be - correct answers ✅Congenital
Acquired/trauma
Infectious
Club Foot - correct answers ✅1-2 per 1000 live births
*Males more affected*
Involves both the bony structures and soft tissues
Club Food: Causes - correct answers ✅Intrauterine positioning
Neuromuscular or vascular problem
Genetics
Club Foot: Interventions - correct answers ✅Manipulation and serial
casting immediately
The more rigid the higher likelihood surgery will be necessary
Surgery is performed between 3-12m
,MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Developmental Dysplasia of the Hip (DDH) - correct answers
✅Encompasses a variety of hip abnormalities:
Acetabular dysplasia - abnormal development leading to instability
Subluxation - incomplete dislocation
Dislocations - femoral head has no contact with the acetabulum
DDH: Predisposing Factors - correct answers ✅5 F's:
Female
Family hx in 20% of cases
Frank breech birth
First born
Left hip involvement (3x more often than the right)
DDH: Clinical Manifestations: Infant - correct answers ✅Shortened limb on
affected side
Restricted abduction of hip on affected side
Unequal gluteal folds when infant is prone
Positive Ortolani test
,MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Positive Barlow test
Many resolve by 2m of age
DDH: Clinical Manifestations: Older Infant and Child - correct answers
✅Affected leg shorter than the other
Positive Trandelenburg sign (while bearing weight on the affected side the
pelvis tilts downward)
Limp
May walk on toes on one side
Marked lordosis and waddling gait if bilateral dislocations
DDH: Treatment: 0-6m - correct answers ✅Pavlik harness to maintain
*abduction and flexion*
Typically worn all day - only removed for bath time
Every 1-2wks the child is brought in for evaluation and the harness is
readjusted
DDH: Treatment: 6-18m - correct answers ✅Closed reduction under
general anesthesia
, MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Hip spica cast for 2-3m
Hip Spica cast can be difficult at this age because of diapering - cover around
cast and perineal area is waterproof
Cast care:
Frequent assessments
Frequent ROM exercises with unaffected extremities
Pay attention to skin integrity around diaper area or around edges of cast
Teach parents to turn frequently to prevent pressure ulcers
Special car seats are available to use when baby in a hip spica cast
DDH: Treatment: >18m - correct answers ✅Open surgical reduction - pelvic
and/or femoral osteotomy
Very difficult after 4yrs of age
Slipped Capital Femoral Epiphysis (SCFE) - correct answers ✅Occurs during
maximal pubertal growth spurt
Males - age 13-15
Females - age 11-13
Update 2023) Verified Solutions (GRADED A+)
Orthopedic disorders can be - correct answers ✅Congenital
Acquired/trauma
Infectious
Club Foot - correct answers ✅1-2 per 1000 live births
*Males more affected*
Involves both the bony structures and soft tissues
Club Food: Causes - correct answers ✅Intrauterine positioning
Neuromuscular or vascular problem
Genetics
Club Foot: Interventions - correct answers ✅Manipulation and serial
casting immediately
The more rigid the higher likelihood surgery will be necessary
Surgery is performed between 3-12m
,MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Developmental Dysplasia of the Hip (DDH) - correct answers
✅Encompasses a variety of hip abnormalities:
Acetabular dysplasia - abnormal development leading to instability
Subluxation - incomplete dislocation
Dislocations - femoral head has no contact with the acetabulum
DDH: Predisposing Factors - correct answers ✅5 F's:
Female
Family hx in 20% of cases
Frank breech birth
First born
Left hip involvement (3x more often than the right)
DDH: Clinical Manifestations: Infant - correct answers ✅Shortened limb on
affected side
Restricted abduction of hip on affected side
Unequal gluteal folds when infant is prone
Positive Ortolani test
,MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Positive Barlow test
Many resolve by 2m of age
DDH: Clinical Manifestations: Older Infant and Child - correct answers
✅Affected leg shorter than the other
Positive Trandelenburg sign (while bearing weight on the affected side the
pelvis tilts downward)
Limp
May walk on toes on one side
Marked lordosis and waddling gait if bilateral dislocations
DDH: Treatment: 0-6m - correct answers ✅Pavlik harness to maintain
*abduction and flexion*
Typically worn all day - only removed for bath time
Every 1-2wks the child is brought in for evaluation and the harness is
readjusted
DDH: Treatment: 6-18m - correct answers ✅Closed reduction under
general anesthesia
, MCN 374 Exam III Questions and Answers (Latest
Update 2023) Verified Solutions (GRADED A+)
Hip spica cast for 2-3m
Hip Spica cast can be difficult at this age because of diapering - cover around
cast and perineal area is waterproof
Cast care:
Frequent assessments
Frequent ROM exercises with unaffected extremities
Pay attention to skin integrity around diaper area or around edges of cast
Teach parents to turn frequently to prevent pressure ulcers
Special car seats are available to use when baby in a hip spica cast
DDH: Treatment: >18m - correct answers ✅Open surgical reduction - pelvic
and/or femoral osteotomy
Very difficult after 4yrs of age
Slipped Capital Femoral Epiphysis (SCFE) - correct answers ✅Occurs during
maximal pubertal growth spurt
Males - age 13-15
Females - age 11-13
