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