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31 Cards in this Set

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