Paediatrics Orthopaedic Topics
Children's orthopaedic conditions. 176 evidence-informed references covering conditions, classifications, management and high-yield exam notes for FRCS (Tr&Orth), FRACS, EBOT and ABOS preparation.
All Paediatrics topics (176)
- Accessory NavicularA comprehensive guide to the Accessory Navicular (Os Tibiale Externum), including classification, clinical presentation, and management strategies (Kidner Procedure).
- AchondroplasiaComprehensive guide to Achondroplasia covering orthopaedic manifestations including spinal stenosis, limb deformity, and management principles.
- Adolescent Idiopathic ScoliosisComprehensive guide to adolescent idiopathic scoliosis - Lenke classification, bracing protocols, surgical indications, posterior spinal fusion for Orthopaedic exam
- Apert SyndromeComprehensive guide to Apert syndrome covering FGFR2 genetics, the complex hand and foot syndactyly, Upton classification, and staged surgical reconstruction.
- ArthrogryposisComprehensive guide to Arthrogryposis Multiplex Congenita (AMC) - Classification, orthopaedic manifestations, and management.
- Atlantoaxial InstabilityComprehensive guide to atlantoaxial instability - C1-C2 pathology, Down syndrome association, ADI measurement, surgical stabilization and fusion techniques for orthopaedic exam
- Beckwith-Wiedemann SyndromeFellowship-level guide to Beckwith-Wiedemann syndrome (BWS) - an imprinting/overgrowth disorder (11p15 region) featuring macrosomia, macroglossia, abdominal wall defects, hyperinsulinism and a predisposition to embryonal tumours (especially Wilms tumour) - focusing on the orthopaedic relevance of lateralised overgrowth/hemihypertrophy, the resulting limb-length discrepancy, the mandatory tumour surveillance, and management of the discrepancy by epiphysiodesis or lengthening.
- Bladder Exstrophy (Pelvic Manifestations)Orthopaedic guide to the pelvic ring abnormality in bladder exstrophy - pubic diastasis, iliac external rotation, the role of osteotomy in closure, immobilisation, and long-term gait and hip outcomes.
- Blount Disease (Tibia Vara)Comprehensive Orthopaedic exam guide to Blount disease including Langenskiöld classification, infantile vs adolescent forms, metaphyseal-diaphyseal angle measurement, bracing protocols, and surgical management strategies including proximal tibial osteotomy and guided growth techniques.
- Brachial Plexus Birth PalsyComprehensive guide to Brachial Plexus Birth Palsy (BPBP) - Erb's, Klumpke's, Narakas Classification, and Surgical Management.
- Caffey DiseaseComprehensive exam-ready guide to Caffey Disease (Infantile Cortical Hyperostosis) - diagnosis, pathophysiology, differential diagnosis, management, and outcomes for orthopaedic fellowship examination preparation
- Calcaneovalgus FootComprehensive guide to Calcaneovalgus Foot (talipes calcaneovalgus) for the orthopaedic exam. Covers the dorsiflexed-everted postural newborn foot, differentiation from congenital vertical talus and posteromedial bowing of the tibia, the DDH association, and management.
- Camptomelic DysplasiaFellowship-level guide to camptomelic (campomelic) dysplasia - a rare, often lethal skeletal dysplasia caused by SOX9 mutation, defined by congenital BOWING (camptomelia) of the long bones (especially the tibia/femur), a small thorax with respiratory compromise, and sex reversal (XY females) - covering the characteristic anterior tibial bowing with a skin dimple, the laryngotracheomalacia/respiratory threat, the associated anomalies, and the largely supportive/palliative management.
- Camurati-Engelmann DiseaseComprehensive guide to Camurati-Engelmann disease (progressive diaphyseal dysplasia): TGFB1 pathophysiology, symmetric diaphyseal hyperostosis, limb pain and waddling gait, radiographic features, corticosteroid and losartan management, and exam differentials.
- Caudal Regression Syndrome (Sacral Agenesis)Comprehensive orthopaedic guide to caudal regression syndrome / sacral agenesis covering the Renshaw classification, spinopelvic instability, lower-limb deformities, and management.
- Causes of Limb Length DiscrepancyPattern and differential page for limb length discrepancy in children: measuring true versus apparent shortening, discriminating congenital, growth arrest, overgrowth and neuromuscular causes.
- Cavus Foot (Pediatric)Comprehensive guide to pediatric cavus foot deformity including etiology, Coleman block test, conservative and surgical management, and differentiation from adult cavovarus
- Cerebral PalsyComprehensive guide to Cerebral Palsy management - GMFCS classification, Hip Surveillance, Gait Analysis, and Multilevel Surgery.
- Cerebral Palsy Gait and SEMLSComprehensive orthopaedic guide to cerebral palsy gait assessment, gait pattern classification, lever-arm dysfunction, instrumented gait analysis, and single-event multilevel surgery.
- Cerebral Palsy Hip SurveillanceComprehensive orthopaedic guide to cerebral palsy hip surveillance, GMFCS risk, Reimers migration percentage, hip abduction, AP pelvis monitoring, adductor-psoas release, VDRO, pelvic osteotomy, salvage surgery and family counselling.
- Charcot-Marie-Tooth DiseaseComprehensive guide to Charcot-Marie-Tooth Disease (CMT), covering classification, cavus foot deformity, and surgical management principles.
- Chondrodysplasia PunctataFellowship-level guide to chondrodysplasia punctata (CDP) - a heterogeneous group of skeletal dysplasias whose radiographic hallmark in infancy is stippled (punctate) epiphyseal/peri-articular calcification - covering the main forms (rhizomelic CDP, X-linked Conradi-Hunermann, the X-linked recessive/brachytelephalangic type, and secondary/teratogenic causes such as warfarin embryopathy and maternal autoimmune disease), the orthopaedic sequelae (rhizomelic limb shortening, asymmetric limb-length discrepancy, scoliosis, cataracts), and management.
- Chondrolysis of the Hip (Idiopathic and Post-SCFE)Fellowship-level guide to chondrolysis of the hip - rapid loss of articular cartilage with concentric joint-space narrowing, stiffness and pain in adolescents: the idiopathic form (a diagnosis of exclusion with normal inflammatory markers, diagnosed early on MRI) and chondrolysis complicating slipped capital femoral epiphysis (especially with pin/implant penetration), plus its management spectrum from anti-inflammatory/physiotherapy to salvage.
- Chronic Nonbacterial Osteomyelitis and CRMOAdvanced orthopaedic guide to chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis, including clinical presentation, imaging, differential diagnosis, biopsy indications, treatment escalation, orthopaedic role and complications.
- Cleidocranial DysostosisComprehensive coverage of cleidocranial dysostosis (cleidocranial dysplasia) including RUNX2 (CBFA1) deficiency, absent or hypoplastic clavicles, delayed cranial ossification with Wormian bones, dental and skeletal anomalies, and orthopaedic management for fellowship examination preparation
- Clubfoot (Congenital Talipes Equinovarus)Comprehensive guide to clubfoot - Ponseti method, pathoanatomy, classification, treatment, casting technique, tenotomy, bracing, and recurrence management for orthopaedic exam
- Congenital Constriction Bands (Amniotic Band Syndrome)Comprehensive guide to congenital constriction bands - amniotic band syndrome, classification, clinical features, treatment, and differentiation from other congenital limb deformities
- Congenital Dislocation of the KneeComprehensive guide to congenital dislocation of the knee (CDK), including Tarek grading, associated conditions (DDH, clubfoot, arthrogryposis, Larsen syndrome), serial casting, and quadricepsplasty for resistant cases.
- Congenital Dislocation of the PatellaComprehensive guide to congenital fixed lateral patellar dislocation from birth, including differentiation from habitual dislocation, associated deformities, and extensive lateral release with realignment strategies.
- Congenital Hand Anomalies OverviewComprehensive orthopaedic guide to congenital hand differences, including assessment, Oberg-Manske-Tonkin classification, syndactyly, polydactyly, thumb hypoplasia, symbrachydactyly, cleft hand, timing of surgery, complications and counselling.
- Congenital KyphosisA comprehensive guide to Congenital Kyphosis, covering Winter classification, neurological risks, and surgical management with emphasis on early intervention.
- Congenital Lower Limb Deficiency OverviewComprehensive orthopaedic guide to congenital lower limb deficiency, including congenital femoral deficiency, fibular hemimelia, tibial hemimelia, limb length prediction, joint stability, foot reconstructability, lengthening, prosthetic pathways, amputation options and family counselling.
- Congenital Pseudarthrosis of the ClavicleFellowship-level guide to congenital pseudarthrosis of the clavicle: a rare painless failure of fusion of the clavicular ossification centres presenting as a mobile mid-clavicular lump, almost always RIGHT-sided and (unlike congenital pseudarthrosis of the tibia) NOT associated with neurofibromatosis - covering the distinction from a birth fracture and cleidocranial dysplasia, and the observation-versus-surgery management.
- Congenital Pseudarthrosis of the TibiaComprehensive guide to congenital pseudarthrosis of the tibia, including NF1 association, Crawford classification, anterolateral bowing progression, and surgical strategies for this recalcitrant nonunion.
- Congenital ScoliosisComprehensive guide to congenital scoliosis - failure of formation vs segmentation, VACTERL screening, natural history, and surgical management strategies
- Congenital Vertical TalusComprehensive guide to Congenital Vertical Talus (CVT) - The 'Rocker Bottom Foot' causes, diagnosis, and management.
- Coxa VaraComprehensive guide to Congenital and Acquired Coxa Vara - Diagnosis, HE Angle, and Valgus Osteotomy
- Cozen FractureComprehensive guide to Cozen fracture (proximal tibial metaphyseal fracture in children), including post-traumatic valgus deformity, natural history, and the critical principle of avoiding premature corrective osteotomy.
- Curly ToesComprehensive guide to curly toes - pediatric toe deformity, flexor tenotomy, age-appropriate treatment, and differentiation from other lesser toe deformities
- DDH Treatment OptionsComprehensive guide to developmental dysplasia of the hip (DDH) treatment - age-based management from Pavlik harness to open reduction and osteotomies, AVN prevention, and outcomes
- Developmental Dysplasia of the Hip (DDH)Comprehensive guide to DDH - screening, diagnosis, and treatment
- Diastrophic DysplasiaComprehensive guide to diastrophic dysplasia - an autosomal recessive short-limbed skeletal dysplasia due to SLC26A2 sulfate transporter mutations, featuring hitchhiker thumb, cauliflower ear, rigid clubfoot, cervical kyphosis, and progressive scoliosis.
- Discoid Lateral MeniscusComprehensive guide to discoid lateral meniscus in children and adolescents: Watanabe and Ahn classifications, snapping knee presentation, MRI criteria, and arthroscopic saucerisation with or without stabilisation.
- Distal Femoral Physeal InjuriesA comprehensive guide to Distal Femoral Physeal Injuries, covering the unique risks of this growth plate, management principles, and long-term surveillance.
- Distal Tibial Physeal InjuriesA comprehensive guide to Distal Tibial Physeal Injuries, including standard Salter-Harris patterns and transitional fractures (Tillaux and Triplane).
- Down Syndrome OrthopaedicComprehensive guide to orthopaedic manifestations in Down Syndrome including atlantoaxial instability, hip dysplasia, and foot deformities.
- Duchenne Muscular DystrophyComprehensive guide to Duchenne Muscular Dystrophy - Orthopaedic manifestations, scoliosis management, and fracture considerations.
- Early Onset Scoliosis (EOS)A comprehensive guide to Early Onset Scoliosis, covering the C-EOS classification, Mehta (Rib-Vertebral Angle Difference), and growth-friendly management strategies.
- Ehlers-Danlos SyndromeComprehensive guide to orthopaedic manifestations of Ehlers-Danlos Syndrome including joint instability, dislocations, and management principles.
- Facioscapulohumeral Muscular Dystrophy (FSHD)Fellowship-level guide to facioscapulohumeral muscular dystrophy (FSHD): the third most common muscular dystrophy with a descending facioscapulohumeral pattern of weakness, the 4q35 D4Z4 / DUX4 genetic basis, the orthopaedic problem of scapular winging, and the role, technique, outcomes and complications of scapulothoracic arthrodesis (with preserved deltoid) within multidisciplinary care.
- Familial Dysautonomia (Riley-Day) - Orthopaedic FeaturesFellowship-level guide to the orthopaedic features of familial dysautonomia (Riley-Day syndrome, hereditary sensory and autonomic neuropathy type III) - an autosomal-recessive disorder (Ashkenazi Jewish, ELP1/IKBKAP) of autonomic dysfunction and reduced pain/temperature sensation - covering the resulting neuropathic (insensate) orthopaedic problems shared with other insensate states: Charcot (neuropathic) joints, painless/unrecognised fractures, scoliosis, osteomyelitis/septic arthritis and self-injury - and the management principle of early diagnosis, protection and patient/family education.
- Fibrodysplasia (Myositis) Ossificans Progressiva (FOP)Fellowship-level guide to fibrodysplasia ossificans progressiva: an ultra-rare autosomal dominant ACVR1 (ALK2) disorder causing progressive heterotopic ossification that turns soft tissue into bone, recognised at birth by malformed great toes, with flares triggered by trauma - so biopsy, intramuscular injections and surgery are contraindicated; covering the genetics/pathophysiology (Activin A), clinical course, diagnosis and supportive management (palovarotene).
- Fibular HemimeliaComprehensive guide to fibular hemimelia - Achterman-Kalamchi and Birch classifications, treatment decision (Syme amputation vs reconstruction), limb length discrepancy management, and outcomes
- Flexible Flatfoot (Pediatric)Fellowship-level guide to paediatric flexible flatfoot (pes planovalgus): natural history, examination, imaging, deformity-specific reconstruction and evidence-based counselling.
- Frayed MetaphysisPattern and differential for the frayed, cupped or splayed metaphysis on paediatric radiographs — rickets, metaphyseal dysplasias, infection, leukaemia and non-accidental injury discriminated.
- Friedreich AtaxiaComprehensive guide to Friedreich Ataxia covering scoliosis, foot deformity, and cardiomyopathy management in this hereditary ataxia.
- Gaucher DiseaseComprehensive guide to orthopaedic manifestations of Gaucher Disease including bone crises, AVN, pathological fractures, and management for Orthopaedic examination.
- Generalised Ligamentous LaxityPattern and differential for the hypermobile child: Beighton scoring, discriminating features of Marfan, Ehlers-Danlos, Loeys-Dietz, Down and osteogenesis imperfecta, and next tests.
- Genu Valgum and Genu Varum in ChildrenComprehensive guide to pediatric angular knee deformities - physiological vs pathological, Blount disease, rickets, hemiepiphysiodesis, and guided growth
- Goldenhar SyndromeOculo-auriculo-vertebral spectrum with hemifacial microsomia, epibulbar dermoids and ear anomalies, and its orthopaedic burden of cervical spine anomalies, scoliosis, radial deficiency and anaesthetic airway risk.
- Guided Growth and Angular Deformity CorrectionComprehensive orthopaedic guide to paediatric guided growth, angular deformity analysis, mechanical axis deviation, LDFA, MPTA, hemiepiphysiodesis, genu valgum, genu varum, rebound and osteotomy indications.
- Gymnast's Wrist (Distal Radial Physeal Stress Injury)Exam-focused guide to gymnast's wrist: repetitive compressive loading of the distal radial physis in young athletes, presenting with dorsal wrist pain. Covers the pathomechanics (compressive microtrauma to the open physis), radiographic findings (widening, irregularity, cystic changes, positive ulnar variance), MRI staging of physeal stress injury, and management from activity modification to surgical epiphysiodesis in refractory cases.
- Hemihypertrophy (Hemihyperplasia)Congenital lateralized overgrowth causing progressive limb-length discrepancy and limb/digit enlargement, with a critical embryonal tumour (Wilms, hepatoblastoma) surveillance imperative - orthopaedic assessment, monitoring and growth-modulating management for fellowship exam preparation
- HemophiliaComprehensive guide to the orthopaedic manifestations of haemophilia: haemophilic arthropathy, target joints and hemarthrosis, radiosynovectomy, perioperative factor cover and inhibitors, and arthroplasty in the modern prophylaxis era.
- Hereditary Motor Sensory NeuropathiesComprehensive guide to Hereditary Motor Sensory Neuropathies (Charcot-Marie-Tooth Disease) - Orthopaedic manifestations and management.
- Hereditary Spastic Paraplegia / Metachromatic Leukodystrophy (Orthopaedic Sequelae)Fellowship-level guide to the orthopaedic sequelae of two progressive neurological disorders - hereditary spastic paraplegia (HSP, a group of inherited disorders of the corticospinal tracts causing progressive lower-limb spasticity and a spastic gait) and metachromatic leukodystrophy (MLD, a lysosomal storage leukodystrophy causing neuroregression) - focusing on the spasticity-driven lower-limb problems (equinus/pes planovalgus, flexed-knee 'crouch', hip displacement, contractures) and neuromuscular scoliosis, managed on cerebral-palsy-like principles with tone management, orthoses and selective surgery.
- Herring Lateral Pillar Classification of PerthesThe Herring lateral pillar classification for Legg-Calvé-Perthes disease — groups A, B, B-C border, and C by lateral pillar height preservation, prognosis, and containment guidance.
- HypochondroplasiaFellowship-level guide to hypochondroplasia - a common autosomal-dominant skeletal dysplasia caused by FGFR3 gain-of-function mutation (a milder allelic relative of achondroplasia) producing disproportionate short stature with mild rhizomelia and lumbar features - covering its often subtle, postnatally-diagnosed phenotype, the radiographic clues (failure of interpedicular widening down the lumbar spine, squared short pelvis), the differential from achondroplasia, and management (limb-length/spinal monitoring, with emerging FGFR3-pathway therapy).
- Idiopathic Toe WalkingA comprehensive guide to Idiopathic Toe Walking, including differential diagnosis (CP, muscular dystrophy), clinical assessment, and management algorithm.
- Infantile Idiopathic ScoliosisA comprehensive guide to Infantile Idiopathic Scoliosis (Age 0-3), distinguishing resolving from progressive curves using the Mehta Angle and Rib Head Phases.
- Iselin Disease (Fifth Metatarsal Apophysitis)Comprehensive guide to Iselin disease - traction apophysitis of the base of the fifth metatarsal and a frequently missed cause of lateral foot pain in active children. Covers the peroneus brevis traction mechanism, the apophysis-versus-fracture trap, evidence-based conservative management, and exam viva preparation.
- Juvenile Hallux ValgusA comprehensive guide to Juvenile Hallux Valgus, focusing on the high recurrence rates, Distal Metatarsal Articular Angle (DMAA), and physeal-sparing surgical options.
- Juvenile Idiopathic ArthritisComprehensive guide to orthopaedic manifestations of Juvenile Idiopathic Arthritis including joint contractures, growth disturbance, and surgical management.
- Juvenile Idiopathic ScoliosisA comprehensive guide to Juvenile Idiopathic Scoliosis (Age 4-10), emphasizing the high risk of progression, neural axis abnormalities, and management challenges.
- Kingella kingae Osteoarticular InfectionComprehensive guide to Kingella kingae musculoskeletal infections in young children, covering the commonest cause of septic arthritis and osteomyelitis under 4 years, indolent presentation, blood-culture-bottle inoculation, PCR diagnosis, and beta-lactam treatment.
- Klippel-Feil SyndromeComprehensive guide to Klippel-Feil Syndrome - congenital cervical fusion, Samartzis classification, associated anomalies (Sprengel's, Renal, Cardiac), and management of instability.
- Klippel-Trénaunay-Weber SyndromeFellowship-level guide to Klippel-Trénaunay(-Weber) syndrome - a sporadic, PIK3CA-mosaic, low-flow combined capillary-lymphatic-venous malformation with limb overgrowth - covering the clinical triad (capillary malformation, atypical lateral varicosities, limb overgrowth), the embryonic lateral marginal vein of Servelle, localised intravascular coagulopathy, the distinction from the high-flow Parkes-Weber syndrome, imaging, and orthopaedic and vascular management including compression, sclerotherapy, endovenous ablation, epiphysiodesis and sirolimus.
- Kniest DysplasiaFellowship-level guide to Kniest dysplasia: an autosomal dominant COL2A1 type II collagenopathy causing disproportionate short-trunk dwarfism with stiff enlarged joints and dumbbell-shaped long bones, plus the extra-skeletal features of type II collagen disease (myopia/retinal detachment, hearing loss), its place in the COL2A1 spectrum, and supportive multidisciplinary management.
- Kohler Disease (Navicular Osteochondrosis)Comprehensive guide to Kohler disease - avascular necrosis of the tarsal navicular in children, including diagnosis, imaging, conservative management, and excellent prognosis
- Larsen SyndromeComprehensive coverage of Larsen syndrome (FLNB-related osteochondrodysplasia) including multiple large-joint dislocations, congenital knee and hip dislocation, clubfeet, cervical kyphosis with myelopathy risk, dysmorphic facies, and a staged orthopaedic management approach for fellowship examination preparation
- Legg-Calvé-Perthes DiseaseComprehensive guide to Legg-Calvé-Perthes disease - idiopathic avascular necrosis of the femoral head in children, classification systems, containment principles, and surgical decision-making for orthopaedic exam
- Limb Length Discrepancy and EpiphysiodesisDetailed clinical guide to paediatric limb length discrepancy: assessment, calibrated imaging, growth prediction, treatment thresholds, epiphysiodesis, physeal bar management, shortening, lengthening, congenital deficiency planning and complications.
- Limping ChildStructured orthopaedic approach to the limping child, including age-based differential diagnosis, painful versus painless limp, septic arthritis exclusion, imaging, laboratory workup, and red flags.
- Little League ElbowExam-focused guide to Little League elbow: medial epicondyle apophyseal stress in young throwers, how valgus overload injures the open apophysis, imaging choices, rest-and-rehab management, return-to-throwing, red flags for avulsion fracture, and viva-ready prevention advice.
- Marfan SyndromeComprehensive guide to orthopaedic manifestations of Marfan Syndrome including scoliosis, protrusio acetabuli, and pes planus.
- McCune-Albright SyndromeComprehensive guide to McCune-Albright Syndrome covering the classic triad, GNAS1 mutation, skeletal manifestations, endocrine features, and orthopaedic management including shepherd's crook deformity.
- Medial Epicondyle Fractures in ChildrenComprehensive guide to pediatric medial epicondyle fractures - elbow dislocation association, fragment entrapment, classification, ORIF indications, and ulnar nerve considerations
- Metaphyseal ChondrodysplasiaComprehensive guide to metaphyseal chondrodysplasias (Schmid, Jansen, McKusick types), including genetics, clinical features, differentials, and management.
- Metatarsus AdductusComprehensive guide to metatarsus adductus covering packaging aetiology, Bleck classification, non-operative management, and the rare indications for surgery.
- Metatropic Dysplasia, Jeune (Asphyxiating Thoracic) & Ellis-van CreveldFellowship-level guide to a group of rare skeletal dysplasias with a small/narrow thorax and limb shortening - Jeune asphyxiating thoracic dysplasia (short-rib thoracic dysplasia, with life-threatening thoracic insufficiency and renal disease), Ellis-van Creveld (chondroectodermal dysplasia - postaxial polydactyly, nail/dental defects, congenital heart disease) and metatropic dysplasia (a 'changing pattern' dysplasia with a coccygeal tail, severe progressive kyphoscoliosis and platyspondyly) - covering recognition, the thoracic/spinal threats, and management.
- Monteggia Fractures in ChildrenComprehensive guide to pediatric Monteggia fracture-dislocations - Bado classification, missed diagnosis pitfalls, reduction maneuvers, and management of chronic radial head dislocation
- MucopolysaccharidosesComprehensive guide to mucopolysaccharidoses (MPS) - lysosomal storage disorders affecting orthopaedic practice including Hurler, Hunter, Morquio, and Maroteaux-Lamy syndromes with clinical features, radiographic findings, and surgical management
- Multiple Epiphyseal DysplasiaComprehensive guide to Multiple Epiphyseal Dysplasia (MED), including COMP and COL9 mutations, clinical presentation with small irregular epiphyses, early-onset osteoarthritis, and differentiation from bilateral Perthes disease.
- Multiple Fractures in a ChildPattern and differential for a child with multiple fractures: separating non-accidental injury from osteogenesis imperfecta, rickets, and metabolic bone disease with real discriminators.
- Multiple Hereditary ExostosesComprehensive guide to Multiple Hereditary Exostoses (HME/MHE) covering diagnosis, deformity, malignant transformation, and surgical management.
- MyelomeningoceleComprehensive guide to Myelomeningocele (Spina Bifida) management - Neurological levels, Orthopedic interventions, Chiari II, Tethered Cord, and Latex Allergy.
- Nail-Patella SyndromeOrthopaedic-focused guide to nail-patella syndrome (LMX1B): the classic tetrad of dysplastic nails, absent/hypoplastic patellae, iliac horns and elbow dysplasia, with patellar instability management and nephropathy surveillance.
- NeurofibromatosisComprehensive guide to orthopaedic manifestations of Neurofibromatosis Type 1 including scoliosis, tibial dysplasia, and congenital pseudarthrosis.
- Neuromuscular ScoliosisComprehensive guide to neuromuscular scoliosis management - Cerebral Palsy, SMA, Duchenne, pelvic obliquity, and surgical fixation strategies
- Non-Accidental InjuryA comprehensive guide to Non-Accidental Injury (NAI) in children, covering recognition, fracture patterns, investigation protocols, and medico-legal considerations.
- Nursemaid's Elbow (Pulled Elbow / Radial Head Subluxation)Fellowship-level guide to nursemaid's elbow: radial head subluxation under the annular ligament in young children, the classic pull mechanism, a clinical diagnosis, and reduction by the hyperpronation manoeuvre (better than supination-flexion on Cochrane evidence).
- Oblique TalusComprehensive guide to Oblique Talus for the Orthopaedic Exam. Covering differentiation from congenital vertical talus, radiographic findings, and management spectrum.
- Osgood-Schlatter DiseaseComprehensive guide to Osgood-Schlatter disease - tibial tubercle apophysitis, diagnosis, treatment, return to sport, and differentiation from other causes of anterior knee pain in adolescents
- Osteogenesis ImperfectaComprehensive guide to Osteogenesis Imperfecta covering classification, fracture management, bisphosphonates, and rodding surgery.
- OsteopetrosisComprehensive guide to Osteopetrosis covering pathophysiology, clinical types (malignant infantile vs benign adult), radiographic features, surgical challenges, and management including bone marrow transplant.
- Paediatric ACL InjuryAdvanced orthopaedic guide to ACL injury in skeletally immature patients, including tibial spine avulsion, meniscal risk, skeletal maturity, physeal-respecting reconstruction, graft choice, rehabilitation and return to sport.
- Paediatric Amputee & Congenital Limb Deficiency ManagementFellowship-level guide to the management of the paediatric amputee and congenital limb deficiency - covering the key differences from adults (the growing skeleton, terminal bony overgrowth, the preference for disarticulation over transosseous amputation, and remarkable adaptation/prosthetic tolerance), the evaluation of congenital limb differences (often part of a syndrome) versus acquired amputation (most commonly traumatic), and a multidisciplinary, family-centred plan integrating prosthetic milestones, growth and function.
- Paediatric Ankle Fractures and Transitional InjuriesAdvanced orthopaedic guide to paediatric ankle fractures and transitional injuries: mechanism, distal tibial physeal closure, Salter-Harris patterns, Tillaux and triplane fractures, CT-based thresholds, operative technique and growth-arrest follow-up.
- Paediatric Back PainPattern and differential page for back pain in children: separating spondylolysis, discitis, osteoid osteoma, tumour and inflammatory causes by age, site and discriminating features.
- Paediatric Bone and Joint InfectionComprehensive orthopaedic reference on paediatric osteomyelitis and septic arthritis beyond the hip, including septic knee, shoulder, ankle, neonatal disease, Brodie abscess, CRMO, pyomyositis, and treatment principles.
- Paediatric Distal Radius, Buckle and Physeal Wrist FracturesStructured orthopaedic guide to paediatric distal radius fractures, torus/buckle fractures, greenstick injuries, distal radial physeal injuries, acceptable alignment, remodelling, and follow-up.
- Paediatric Elbow Radiology and AssessmentOrthopaedic reference guide to paediatric elbow radiology, including CRITOE ossification centres, Baumann angle, anterior humeral line, radiocapitellar line, fat pad signs, and common injury traps.
- Paediatric Femoral Neck FracturesComprehensive orthopaedic guide to paediatric femoral neck fractures, Delbet classification, femoral-head perfusion risk, urgent reduction, fixation, decompression, AVN, coxa vara and long-term surveillance.
- Paediatric Femur Fractures by AgeStructured orthopaedic guide to paediatric femoral shaft fractures by age, including Pavlik harness, spica cast, traction, flexible nails, submuscular plating, rigid nails, open fractures, and complications.
- Paediatric Pelvic Osteomyelitis & Sacroiliac Joint InfectionFellowship-level guide to pelvic osteomyelitis and septic sacroiliitis in children: the vague, often-delayed presentation (limp, hip/buttock/back pain, refusal to weight-bear, fever) that mimics hip and spine pathology, the 'metaphyseal equivalent' concept that makes the sacroiliac joint and pubis common sites, the central role of MRI, the predominance of Staphylococcus aureus, and antibiotic-led management with drainage reserved for abscess.
- Paediatric Pelvis and Hip TraumaAdvanced orthopaedic guide to paediatric pelvis and hip trauma, including assessment, injury families, imaging, pelvic ring injury, acetabular injury, traumatic hip dislocation, paediatric femoral neck fracture, apophyseal avulsion fractures, operative decision-making and complications.
- Paediatric Radial Neck, Olecranon and Elbow Dislocation InjuriesAdvanced orthopaedic guide to paediatric radial neck fractures, olecranon fractures and elbow dislocations: clinical assessment, radiographic interpretation, treatment thresholds, operative choices and complications.
- Paediatric Rotational Profile and In-toeing/Out-toeingComprehensive orthopaedic guide to paediatric rotational profile, in-toeing, out-toeing, femoral anteversion, tibial torsion, metatarsus adductus, natural history, red flags and derotation osteotomy indications.
- Panner Disease (Capitellar Osteochondrosis)Comprehensive guide to Panner disease - osteochondrosis (avascular necrosis) of the humeral capitellum in young children, including how to distinguish it from osteochondritis dissecans, imaging, conservative management and excellent prognosis
- Patellar Instability (Pediatric)Comprehensive guide to Pediatric Patellar Instability - Risk Factors, TT-TG, MPFL Reconstruction, and Management
- Pediatric Acute OsteomyelitisComprehensive guide to Pediatric Acute Osteomyelitis - Hematogenous spread, diagnosis, antibiotics, and surgical indications.
- Pediatric Patella Sleeve FracturesComprehensive guide to Pediatric Patella Sleeve Fractures - Diagnosis, treatment, and the importance of early recognition.
- Pediatric Psoas AbscessFellowship-level guide to the paediatric psoas (iliopsoas) abscess - a collection of pus within the psoas/iliacus muscle that classically mimics hip septic arthritis or appendicitis in a child - covering the primary (haematogenous, often Staphylococcus aureus/MRSA) versus secondary forms, the characteristic presentation (fever, flexed irritable hip, painful extension/'psoas sign', limp), the central role of MRI/ultrasound, and management by antibiotics plus drainage (image-guided or open retroperitoneal).
- Pediatric SpondylolysisComprehensive guide to pediatric spondylolysis (pars defect) - diagnosis (Scottie Dog), imaging algorithm (SPECT/MRI), and management from bracing to repair
- Physeal Injuries (Salter-Harris Classification)A comprehensive guide to Physeal Injuries using the Salter-Harris Classification, covering anatomy, prognosis, and management principles.
- Poland SyndromeAdvanced orthopaedic guide to Poland syndrome (congenital unilateral chest wall and ipsilateral hand hypoplasia), covering the subclavian artery disruption theory, symbrachydactyly, classification, imaging, hand and chest wall management, complications and global practice.
- Poliomyelitis (Orthopaedic Sequelae)Exam-focused guide to the orthopaedic sequelae of poliomyelitis - flaccid paralysis, limb-length discrepancy, flail joints, foot deformity, post-polio syndrome, and the principles of tendon transfer, osteotomy and arthrodesis.
- Polydactyly of the FootA comprehensive guide to Polydactyly of the foot, covering classification (Pre-axial, Post-axial, Central), surgical management, and syndrome associations.
- Posteromedial Bow of TibiaComprehensive guide to congenital posteromedial bowing of the tibia - benign angular deformity that remodels spontaneously, but with progressive limb-length discrepancy that frequently requires treatment, plus calcaneovalgus and ankle-dorsiflexion sequelae
- Prader-Willi Syndrome (Orthopaedic Manifestations)Fellowship-level guide to the orthopaedic manifestations of Prader-Willi syndrome - a genetic imprinting disorder (loss of paternal 15q11-q13) characterised by hypotonia, hyperphagia/obesity and developmental issues - focusing on the high prevalence of scoliosis and developmental hip dysplasia, the effects of hypotonia and growth-hormone therapy, and the perioperative considerations (obesity, OSA, anaesthetic risk) for the orthopaedic surgeon.
- Proteus SyndromeFellowship-level guide to Proteus syndrome - a rare mosaic AKT1 (c.49G>A, p.Glu17Lys) overgrowth disorder defined by progressive, disproportionate, distorting overgrowth with cerebriform connective-tissue naevi, vascular malformations and orthopaedic deformity - covering the dyadic diagnostic criteria, the tumour and thromboembolic risks, cystic lung disease, and the principles of staged orthopaedic management including the evidence for guided growth in leg-length discrepancy and AKT-pathway targeted therapy.
- Proximal Femoral Focal DeficiencyComprehensive guide to proximal femoral focal deficiency (PFFD) - classification (Aitken), clinical features, treatment options from reconstruction to rotationplasty, and outcomes
- Proximal Tibial Physeal InjuriesA comprehensive guide to Proximal Tibial Physeal Injuries, covering vascular risks, classification, and management principles.
- PseudoachondroplasiaFellowship-level guide to pseudoachondroplasia: an autosomal dominant COMP skeletal dysplasia presenting as normal-at-birth short-limb dwarfism with a normal face and normal intelligence, its epiphyseal-and-metaphyseal radiographic features, the orthopaedic problems (lower-limb malalignment, early osteoarthritis, cervical instability), and how it differs from achondroplasia, MED and SED.
- Pterygium Syndromes / Congenital Popliteal WebbingFellowship-level guide to the pterygium syndromes - congenital skin/soft-tissue webs ('pterygia') bridging the flexor aspect of joints, producing fixed flexion deformity - focusing on popliteal pterygium syndrome (a popliteal web with knee flexion contracture, often with orofacial clefting, genital and foot anomalies) and the multiple pterygium syndrome (Escobar) - covering the soft-tissue/neurovascular challenges, the role of the shortened sciatic nerve in the popliteal web, and a staged surgical and rehabilitative approach.
- PyknodysostosisComprehensive coverage of pyknodysostosis (Toulouse-Lautrec disease) including cathepsin K deficiency, clinical features, radiographic findings including diffuse osteosclerosis and acroosteolysis, orthopaedic management of fractures and complications for fellowship examination preparation
- Radial Longitudinal DeficiencyOrthopaedic teaching chapter on radial longitudinal deficiency, including systemic screening, radius and thumb classification, clinical assessment, centralisation, radialisation, pollicisation, recurrence and follow-up.
- Radioulnar SynostosisComprehensive guide to Congenital and Post-Traumatic Radioulnar Synostosis - Classification (Cleary & Omer), Management, and Complications
- Rett SyndromeComprehensive guide to Rett Syndrome focusing on orthopaedic manifestations including scoliosis and orthopaedic management principles.
- Rigid FlatfootA comprehensive guide to the assessment and management of Rigid Pes Planus (Rigid Flatfoot), focusing on Tarsal Coalition, Vertical Talus, and other etiologies.
- Russell-Silver SyndromeFellowship-level guide to Russell-Silver (Silver-Russell) syndrome - an imprinting disorder of prenatal and postnatal growth restriction defined clinically by the Netchine-Harbison Clinical Scoring System and molecularly by loss of methylation at the 11p15.5 H19/IGF2 ICR1 or maternal uniparental disomy of chromosome 7 - covering relative macrocephaly, feeding failure and ketotic hypoglycaemia, the hemihypoplastic (SMALLER-side) body asymmetry that distinguishes it from Beckwith-Wiedemann overgrowth, limb-length discrepancy and spinal deformity, growth hormone evidence, perioperative hypoglycaemia and airway risk, and why routine tumour surveillance is not part of Russell-Silver care.
- Scheuermann KyphosisComprehensive guide to Scheuermann disease - juvenile kyphosis, diagnostic criteria, bracing, surgical indications, and differentiation from postural kyphosis
- SCIWORAComprehensive guide to SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) - pathophysiology, pediatric susceptibility, Pang classification, and management protocols.
- ScurvyVitamin C deficiency causing defective collagen synthesis with characteristic musculoskeletal manifestations including subperiosteal hemorrhage, pathognomonic radiographic signs, and implications for differential diagnosis from non-accidental injury
- Secondary Causes of SUFEPattern and differential for atypical slipped upper femoral epiphysis: when age, weight, bilaterality or side signs point to endocrine, renal or syndromic disease.
- Septic Arthritis of the Pediatric HipComprehensive guide to diagnosis and management of septic arthritis of the hip in children - a true orthopaedic emergency requiring urgent surgical washout.
- Sever's Disease (Calcaneal Apophysitis)Comprehensive guide to Sever's disease - the most common cause of heel pain in active children. Covers the calcaneal apophysis, traction overuse mechanism, the squeeze test, differential diagnosis, evidence-based conservative management, and exam viva preparation.
- Seymour Fracture and Paediatric Nail-bed InjuriesOrthopaedic reference guide to Seymour fractures, paediatric open distal phalanx physeal injuries, nail-bed trauma, fingertip injuries, infection risk, and operative management.
- Sickle Cell DiseaseComprehensive guide to orthopaedic manifestations of sickle cell disease including AVN, osteomyelitis, bone infarcts, and perioperative management.
- Sinding-Larsen-Johansson SyndromeComprehensive guide to Sinding-Larsen-Johansson syndrome - inferior pole patellar apophysitis, diagnosis, treatment, return to sport, and differentiation from other causes of anterior knee pain in adolescents
- Skeletal DysplasiasComprehensive guide to skeletal dysplasias - achondroplasia, osteogenesis imperfecta, mucopolysaccharidoses, classification, radiographic diagnosis, and orthopaedic management for fellowship examinations
- SkewfootComprehensive guide to skewfoot: component anatomy, differentiation from metatarsus adductus and planovalgus, imaging measurements, and selective reconstruction.
- Spastic Equinovarus Foot (Cerebral Palsy)Comprehensive guide to spastic equinovarus foot deformity in cerebral palsy, covering dynamic vs fixed deformity, gait analysis, orthopaedic management including SPLATT, tendon transfers, and bracing strategies.
- Spastic Hemiplegia of Cerebral PalsyFellowship-level guide to spastic hemiplegia of cerebral palsy (unilateral spastic CP) - covering perinatal arterial ischaemic stroke and periventricular venous infarction as the dominant aetiologies, the Winters, Gage and Hicks gait groups as originally defined, hemiatrophy and limb-length discrepancy, the examination that separates tibialis anterior from tibialis posterior as the driver of varus, botulinum toxin A and serial casting evidence and their limits, unilateral single-event multilevel surgery, SPLATT and tibialis posterior procedures, and the sensation-led selection of children for upper-limb surgery.
- Spina BifidaComprehensive guide to Spina Bifida focusing on orthopaedic manifestations including hip dysplasia, scoliosis, clubfoot, and fractures.
- Spinal Muscular AtrophyComprehensive guide to Spinal Muscular Atrophy (SMA), covering classification, orthopaedic manifestations, and management including scoliosis and hip dysplasia.
- Sprengel DeformityAdvanced orthopaedic guide to congenital elevation of the scapula, including clinical assessment, associated anomaly screening, imaging, classification, non-operative care, Woodward and Green procedures, complications and follow-up.
- Stickler SyndromeFellowship-level guide to Stickler syndrome - an inherited collagenopathy (most often COL2A1, type I; COL11A1, type II) producing ocular, orofacial, auditory and skeletal abnormalities - covering the high-myopia/retinal-detachment risk, the Pierre Robin/cleft-palate orofacial features, the sensorineural hearing loss, and the orthopaedic relevance of early-onset osteoarthritis, joint hypermobility and spinal/epiphyseal changes, with the central message of mandatory ophthalmology surveillance.
- Stippled EpiphysesPattern and differential for stippled epiphyses on paediatric radiographs: discriminating features separating peroxisomal, teratogenic, endocrine and storage causes, with a viva-ready algorithm.
- Supracondylar Humerus FractureComprehensive guide to supracondylar humerus fractures in children
- Tarsal CoalitionComprehensive guide to Tarsal Coalition - Diagnosis, classification, and management of Calcaneonavicular and Talocalcaneal coalitions.
- ThalassemiaComprehensive guide to orthopaedic manifestations of thalassemia including bone changes, osteoporosis, pathological fractures, and management strategies.
- The Widened or Abnormal PhysisPattern-based approach to the widened, irregular or abnormal growth plate on paediatric radiographs — rickets, SCFE, trauma, infection and dysplasia, with the discriminators that separate them.
- Thiemann DiseaseExam-focused guide to Thiemann disease: its pathophysiology as an avascular necrosis of the phalangeal epiphyses, clinical presentation, radiological findings of epiphyseal fragmentation, and conservative management.
- Thrombocytopenia-Absent Radius (TAR) SyndromeOrthopaedic teaching chapter on Thrombocytopenia-Absent Radius (TAR) syndrome: the absent-radii-with-thumbs-present pattern, RBM8A genetics, neonatal thrombocytopenia, lower-limb and knee deformity, and how the bleeding disorder shapes the timing of hand and limb reconstruction.
- Tibial HemimeliaComprehensive guide to tibial hemimelia - Jones classification, knee functionality assessment, treatment from synostosis to amputation, and outcomes
- Torticollis in ChildrenComprehensive guide to pediatric torticollis - congenital muscular torticollis, differential diagnosis, stretching programs, surgical release indications, and outcome assessment
- Transient SynovitisComprehensive exam-ready guide to transient synovitis of the hip in children - diagnosis, differentiation from septic arthritis using Kocher criteria, management, and outcomes
- Transitional Fractures: Tillaux and TriplaneA comprehensive guide to transitional ankle fractures in adolescents, including Tillaux and Triplane patterns, CT-based treatment decisions, and surgical techniques.
- Transphyseal Distal Humerus Fracture (Distal Humeral Physeal Separation)Fellowship-level guide to transphyseal fracture of the distal humerus: a separation through the largely cartilaginous distal humeral physis in infants and young children, its strong link to birth and non-accidental trauma, how to diagnose it (forearm-humerus malalignment, arthrogram/ultrasound), the DeLee classification, and treatment by closed reduction and percutaneous pinning.
- Trevor Disease (Dysplasia Epiphysealis Hemimelica)Comprehensive Orthopaedic exam guide to Trevor disease (dysplasia epiphysealis hemimelica) covering its hemimelic epiphyseal osteochondromas, the Azouz and Arealis classifications, distinction from osteochondroma, MRI-led diagnosis, marginal excision, deformity correction, and the risks of recurrence and early osteoarthritis.
- Turner Syndrome (Orthopaedic Manifestations)Fellowship-level guide to the orthopaedic manifestations of Turner syndrome (45,X and variants) - whose skeletal features are largely attributable to haploinsufficiency of the SHOX gene - covering the characteristic short stature, cubitus valgus, genu valgum, short fourth metacarpals, Madelung deformity and high-arched palate, the increased risk of scoliosis/kyphosis and reduced bone density, and the management interface with growth-hormone and oestrogen therapy.
- VEPTR and Growing Rods for Early-Onset ScoliosisGrowth-friendly surgery for early-onset scoliosis: casting, traditional and magnetic growing rods, VEPTR and Shilla — rationale, decision thresholds, complications and graduation strategy.
- Wheelchair Seating and PositioningComprehensive exam-focused review of wheelchair seating and positioning principles including pelvic positioning, pressure management, postural supports, and interface with orthopaedic surgery for patients with neurological conditions
- Windswept Deformity (CP / Rickets)Fellowship-level guide to the windswept deformity - the combination of genu valgum in one leg and genu varum in the other (or, at the hips, abduction of one and adduction of the other) - covering its varied aetiologies (rickets and other metabolic bone disease being the largest group, plus skeletal dysplasias/genetic disorders, trauma/physeal injury, and neuromuscular causes such as cerebral palsy, with an idiopathic group), the diagnostic work-up to find the underlying cause, and aetiology-directed management.
- Wormian BonesPattern and differential for wormian bones on skull radiographs: how to confirm they are pathological, the PORKCHOPS causes, and the discriminators that separate each.