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PHS321 Lecture 15/15
Paediatric Orthopaedics - Review of devlopment and Assessment in children
Question | Answer |
---|---|
by what year are most of the 3d allignment changes completed by? | By year 6/7 |
What stage of gestation do structural deformities occur and what do they include | in early gestation includes arthrgyposis and club foot |
What stage of gestation do postural deformities occur and what do they include | in third trimester of gestation and it includes DDH,MTA,Torticolis due to interuternie px |
What stage of gestation do aquired deformities occur and what do they include | in early infancy and childhood includes Cerebral palsy |
what is normal alignment change for hip and femur | hip flex and ER decrease in first 2 years and femur slowly unwinds lateraly (medial fem torsion) |
what is normal alignment change for knee and tibia | decrease knee flexion contracture, tibia unwinds lateraly faster than femure |
what is normal alignment change for ankle and foot | hind foor inversion to eversion and decrease in forefoot supination |
describe normal age changes with the knee | infanct = genuvarum (horse riding), 18 months inline, 3.5 years genu varum (knocked knees) 7 years aligned. |
how is tibial torsion measured and describe the measeurment | bimalleolar angle and thigh foot angle. Procedure includes take heights of ankle in supine, take width of malleolar then draw horizontal line form shortest and line from both heights and measure angle |
how is femoral anteversion measured what are normal values | FNA where pt is supine and lateral trochlear of femure is palpated while moving knee in 90 degrees to IR. neonate = 30 adult 16 |
what are normal values for thigh foot angle | neonate = 0-20IRadult= 30 ER |
in children with genuvarum what is a typical measure | 4 finger width distance |
what is the management of genu varum and valugs | 1. inform of normals 2. refer if 7.5 diff btw malleoli or knees, varum after 3, assymetry or shortening. |
what are general guidlines to rotaiton | medial rotaion will improve with growth, lateral roation will increase with growth |