Module 6, General Orthopaedist Level

This is a two year old girl who was the product of a normal gestation. She has two healthy half-sisters. At birth the following problems were noted: 1. Disproportionate short-limb dwarfism with hitch-hiker thumbs, 2. Cleft palate, 3. Bilateral clubfoot (left worse right), 4. Respiratory difficulties because of laryngomalacia, 5. Lack of extension in elbows and knees (moderate) and 6. Cauliflower deformity of ears occurred in the first weeks of life. She started walking at the age of 17 months (with some flexion of hips and knees).

Question 6A

When started soon after birth, the clubfeet can usually be easily corrected with casts.

Question 6B

This is an autosomal dominant condition.

Question 6C

Prenatal diagnosis is possible using ultrasound.

Question 6D

These children have to be carefully evaluated for cervical occipital instability before undergoing any anesthesia.

Question 6E

The cauliflower ear deformities may not be present in all children with diastrophic dwarfism.