Nbr - Juvenile Hallux Abducto Valgus

Front 1

What percent of adult patients with HAV deformity is a result of untreted juvenile HAV?

Back 1

approximately 40% of adults with HAV have evidence of the deformity before the age of 20

Front 2

Is there a gender predisposition towards juvenile HAV?

Back 2

Befoer age of 12 the male: female prevalence of HAV is approximately 1:1
HOwever in adolescnts greater than age 12, the deformity was foudn to be three times more common infemles

Front 3

Explain why a child wiht spastic cerebral palsy ofen develops juvenile HAV

Back 3

Scissor gaid due to tight posterior muscles, inclding hte triseps surae produce an equinus force at he ankle joint. The joints distally try to compensate and dorsiflex the foot via pronation throught the majority fo coantact phasoe fo the giat. . The felxible pronated foot does nto provide and effect lever for htemuscle and tendons ahthat are tneede to stabilze the first ray during propulsion

Front 4

What musculoskeletal deformity usually accoompaneis juvenile HAV in the absence of extrinsic and systemic etiologies

Back 4

metatarsus adductus

Front 5

What systemic disease results in a high incdence of juvenile HAV

Back 5

juvenile rheumatoid arthritis

Front 6

Name tha pedal factos that are implicated casueing the severity fo jevenile HAV deformity

Back 6

Roudn metatrasal haead, astavistic cuneiform, hypermobile first ray,hyperpronation, a high intermetataral angle.

Front 7

Why are the failure rates for soft tissue buninectomy proceures so High?

Back 7

Soft tissue procedures do not correct hte osseous deformity.

Front 8

When planning surgical interventin, when is is the appropriate time?

Back 8

surgical intervention safely performed afte the closur of the epiphysis

Front 9

What are the indications for suergery prior to clsure of hte epiphys?

Back 9

restore joint aligmnent, reduce intermetataral angle, planargrade first ray, address etioogy of deormity, post operative control of deforming forces

Front 10

Concering juvenile HAV, waht are the indications ofr performing a lapidus procedure?

Back 10

Severe incrased intermetararsal angle with instability of the first ray ususally associated with neuromuscular and collage disorders

Front 11

The only indication of ephysiodesis in juvenile HAV surgery is?

Back 11

increased intermetarasal angle

Front 12

Describe two techniques for performing epiphysiodesis

Back 12

lateral stapling of hte growth plaee or insertion of bone graft

Front 13

The most common complication of epiphysiodesis is...?

Back 13

recurrence

Front 14

Name two proceures for jevenile HAV that addres the atavistic cueniform

Back 14

Foweler and lapidus

Front 15

Name all type sof internal fixaztion tat are accceptable to sue acrossa agrowth plate.

Back 15

smooth K-wires

Front 16

The basal metarsal ostoeotmy is emplyed to?

Back 16

reduce the sever intermetatarsal angle

Front 17

The metarsal head osteootomy may be mployed ot correct?

Back 17

mild increased intermetatarsal angle as well as to resore joint congruity

Front 18

at what age does the epiphyis appear readiographically?

Back 18

approximately 2 years of age

Front 19

at waht age do the seasmoids begin to ossify?

Back 19

10-12 year sof age

Front 20

what is the major difference regarding the ossification fo the lesser metatarsal and the first metatarsal?

Back 20

the first metatarsal epiphyis is at hte vase, compared ot hte head of hte lesser metatarsal

Front 21

The adductor tendon transfer is used as an adjunctive procedure to..?

Back 21

relocate and maintain the corrected sesamoid position.

Front 22

The Hiss procedure is?

Back 22

a transfer of the abducto hallucis to the dorsomedial proximal phalnx of the hallux

Front 23

Is there a strong familial predilection for juvenile HAV?

Back 23

yes, literature reports vary between 50-78% familal incidence

Front 24

what is the most common postoperative complication for the closing base wedge osteotomy?

Back 24

elvatus

Front 25

Regarding juvenile HAV, phalangeal ostoetomis are indicated for?

Back 25

Phalangeal ostoeotmies such as the akin, should only be used when there is astructual abnormality withing hte proximal phalanx