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harris final

Intoeing gait is caused from metatarsus adductus (foot deformity) internal tibila torsion ( rotational deformity) excessive femoral anteversion ( rot deformity)
roational profile for exam of intoeing gait foot progression angle evaluation of foot prone hip rot thigh foot rot (angle)
morphologci features of MTA adducted forefoot concave med foot border convex lat foot border
MTA coption orrectable tx stretching reverse last shoes/straight last shoes education
MTA not correctable passively tx option stetching casting reverse last shoes surgical release
MTA Surgical options release adductor hallucis mdial release tarsometrsal capsulotomies multiple metatsal osteomies lateral closing cuboid osteomis opeing cuneform osteotomy
Internal Tibial Tosion tx NONE rotational tibial osteotomy if >10yrs old medial thigh foot angle >10 degrees
Excessive femoral anteversion medial foot progression angle medial hip rot > 70 degrees most resolve by ten yrs of age
tx for excessive femoral anteversion none rotational femoral osteotomy .>10 yrs 80 degrees of prone medial hip rotation
genu varum physilogic bow legs Blount's Disease
Genu Valgum knock knees
nomal knee alignment at birth 10-15 degrees varus
normal knee alginment at 18 months neutral
30-36 months genu valgum (outgrow in another 18 months part of normal growth
Physiologic bowlegs (varum) bilateral genu varum in child greater than 2 associated ITT natural hx (spontaneous resolution)
tx for physiolocal bow leg none
Tibial vara (BLOUNTs disease proressive varus and ITT defomity of the proximal tibia
etiology of Blount's disease pathologic compression on the proximal medial tibial results in abnormal growth and development of proximal medial epiphis and pramture physeal closure
who get blount's disease fmale>males overwight children early walkers african americans
Knocked knees genu valgum
types of knock knees physiologic metabolic skeltal dyplasia post traumatic (Cozens adolescence
physicologic gen valgum normal development 3-5 ys old child
metabolic knocked knees x-linked hypophosphatemia renal osteodystophy
genu valgu post traumatic (cozen) s/p proximal tibial metphsis overgorwoth with valgus deformity increasing leg length excellent remoldeling potential
genu valgum adolescence 10-11 yr old females 12-13 males knee pain (medial) large stature
genu valgum tx hemiephysiodesis guided growth stapling and 8-plating
common foot deformities calcaneovalgus talipes equinovarus pes planus toe walking
calcaneovalgus present at birth characterized by forefoot valgus and heel df allowing the dorsal suface to touch the anterior tibia
etiology fo calcaniovalgus inuterine molding
tx for calcaneovalgus observation passive stretching seral casting (rarely) rule out tibial bowing
talipes equinovarus clubfoot: present at birth forefoot adduction and supinated heel pf
etilogy for clubfoot multifactoral interuterine
morphologic features dimples oever talus forefoot adduction heel vaur ankle equinus shorter extremitiy smaller calf short smaller foot
clinical feature of club foot cave principle cavus adductus varus equinus
tx for club foot treatable but no correctable nonsurgical-->ponseti method (manipulation serial casting 3 months holding splints )
treatment results of clubfoot abnomal foot decreased size calf atrophy decreased motion pes planus MTA flat top of talus dorsal cubluxation of forefoot
treatment for pes plantus none
toe walking causes idiopathic cp myelodysplaia muscular dystrophy
toe walking bilateral always contracture develops limits df
idopathic toe walking clincal feature cariable toe walking altered choe wear decreased df normal neuro exam
ideopathic toe walking rx non operative ( stretching casting bracing and botox reoccurence common) operative achilles tendon lengthening decreased strength reoccurance rare
common hip conditons transient synovitis and septic arthritis developmetnal dysplasia legg clave perthes slipped capital femoral epiphysis
transient synovitis and septic arthritis pain decreased ROM refusal to bear weight
transient synovitis age 3-8 no/low fever no systemic illness inflammatory
septic arthritis ant greater then 2 fever system ilness infectious
tx for transent synovitis NSAID
septic arthrits tx I & D (incision and drainage) sensitive antibiotic
Developmental hip dysplasia wasterbasket term encompassing all forms of hip instability including subluxation and dilocation
developemental hip dysplasia incidence incidence; 1-6 in 100 births 40-60 in left hip 20 bilateral famales> males
developmentall hip dysplasia risk factors first born female positive familiy hx breech presentatino musculoskeletal abnomality
etilogy of developmetn hip dysplasia multifactorial (genetic disorder, hormonal factors and mechanical factors
dx fo hip dysplasia physical is more important thanradological exam dynamic us
DHD physical exam ortolani barlow galeazzi
ortonlani reduces a dislocated hip
barlow dilocated hip
galeazzi leg length shot leg is dislocated
tx for hip dysplasia birth to 6 months birth to 6 months pavik harness
DHD tx 6-18 months limited abduction galeazzi test telescoping true shortenign gait abnomalities
complication with DHD avascualr necrosis with Leg length discrepancy coxa brevis coxa valga DJD
legg clve perthes disease condition of the immature hip caused by necrosis of al or part of the femoral head which subsequently deforms as necrotic bone is replaced by living bone
stage of leff calve perthes necrosis 5-7 months fragmetnation 7-months reossification 20-38 months remolding ( until maturity
clinical feature of legg perthes painful limp groin pain anteriomedial thigh and knee waddling gait atrophic extremtiy decreased ROM ( mid flexion contracture) limited internal rotation and abduction
tx for Legg calve perthes mainatin ROM head contaitnment (abd orthosis or maybe femoral pelvic osteotomy
exercises for legg calve perthes butterfly knee to chest standing straddle hip extension prone
prognosis for legg calve perthes femoral head deformity jt incongruity impingement 86 percent have symptom of DJD before the age of 65
slipped capital femoral epiphysis (SCFE) posterior and medial displacement of the
Created by: klkoester
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