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31 Cards in this Set
- Front
- Back
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How do you quantify metatarsus adductus?
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line bisecting heel up forefoot should bisect between 2nd and 3rd rays of foot; mild=3rd ray; moderate=4th ray; severe=5th ray
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actively correctable metatarsus adductus vs passively correctable M.A.
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actively correctable: corrects when tickle lateral border of foot; passively correctable: doesn't correct with tickling but can be moved back into place
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treatment for passively correctable metatarsus adductus
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stretching exercises; 5 times per foot, held for 10 sec, with each diaper change
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treatment for rigid metatarsus adductus
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serial casting
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what are the components of clubfoot?
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metatarsus adductus, equinus, and hindfoot varus (supination)
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what is equinus?
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inabiity to dorsiflex at ankle
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what causes tibial torsion?
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packaging defect
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most common cause of intoeing in children younger than 3 years of age
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tibial torsion
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most common cause of intoeing in children older than 3 years
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medial femoral torsion (femoral anteversion)
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difference between medial femoral torsion and femoral anteversion
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femoral anteversion= normal alignment of femur; medial femoral torsion=pathologic degree of femoral anteversion
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treatment of MFT
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resolves without intervention; some recommend discouraging sitting in W position
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What causes outtoeing?
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packaging defect; external tibial torsion and calcaneovalgus feet (opposite of metatarsus adductus)
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What is the first step in the rotational profile?
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watch the child walk to determine in which direction the feet point
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step 2 in the rotational profile?
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lying prone: extrapolate the heel bisector to check for metatarsus adductus
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step 3 in rotational profile?
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imagine line down center of thigh; angle forme with heel bisector is called the "thigh-foot angle"
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what should the "thigh-foot angle" be?
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0 to +10 degrees
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What does a negative thigh-foot angle mean?
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tibial torsion
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step 4 in rotational profile
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degree of internal and external rotation at hip joint are measured
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What are the normal degrees of rotation? and with femoral torsion?
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normally, hips rotate about 45 degrees in both directions; increased internal rotation indicates femoral torsion
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What is malignant malalignment syndrome?
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increased medial femoral torsion combined with excessive lateral torsion of tibia; may result in patellofemoral pain
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clubfoot is associated with?
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developmental dysplasia of the hip
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treatment of club foot
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serial casting for 3 months and then surgery if unsuccessful
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what is a cavus foot?
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high-arched foot that is a variation of normal
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what is a calcaneovalgus foot?
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packaging defect associated with external tibial torsion; feet apear flat and heelbone angled away from midline, ankles dorsiflexed
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if calcaneovalgus foot cannot be manipulated easily into plantar flexion
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r/o congenital vertical talus--rare condition
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how do you know if pes planus is flexible?
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feet reform arch when patient stands on toes
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treatment for flexible pes planus
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unnecessary unless painful--shoe inserts
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What causes rigid pes planus?
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tarsal coalition
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when does rigid pes planus become symptomatic?
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early adolescence because bones no longer cartilaginous and fused areas stress neighboring open joints
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how to diagnose tarsal coalition?
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CT
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treatment for tarsal coalition
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surgical
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