Normal Ontogeny And Normal Position Of The Pediatric Lower Extremity

Front 1

Version (different from what we have learned so far)

Back 1

The angular difference between the transverse axis of each long end of a long bone. This represents the normal angular difference.

Front 2

Torsion: (different from what we have learned so far)

Back 2

This is present when version is increased and occurs when the value for a given measurement falls outside the norm by 2 Standard Deviations (SD). Abnormal Version Angle

Front 3

Femoral Anteversion

Back 3

The angle of femoral version made when the femoral head and neck axis is directed forward or anteriorly from the femoral shaft.

Front 4

Femoral retroversion

Back 4

The angle of femoral version made when the femoral head and neck axis is directed in a slightly backward, posterior from the femoral shaft

Front 5

What is the most common cause of in-toeing in the early walker up to the age of 10?

Back 5

Femoral Torsion

Front 6

What is the relation of the femoral condyles relative to the head and neck of the femur

Back 6

Development and perinatal- 30degrees
Age of 6- 8-12 degrees
Note that an Unwinding has occured, of about 20 degrees.
Note the age.
The rule is that it decreases 1-3 degrees per year.

Front 7

Adult normal femoral torsion

Back 7

12 degrees

Front 8

What is the position of a very young child's femur?

Back 8

Anteverted

Front 9

According to this lecture (wrong) what is a term that is synonymous with Antetorsion?

Back 9

Angle of declination

Front 10

What does Retrotorsion lead to? What does Retroversion lead to?

Back 10

Torsion- abnormally externally deviated femur- out toeing
Version- Tight soft tissues leading to an externally rotated femur (how we learned it)

Front 11

What does antetorsion lead to?
Anteversion?

Back 11

Lack of normal external bony twist leadingto abnormal internally rotated femur.
Anteversion- Abnormal internally rotated femur due to tight soft tissues.

Front 12

What is Hip ROM at birth?
What is Hip ROM up to age 7?
What is Hip ROM trend after age 7?
What plane are we talking about?

Back 12

Birth TROM- 100-120 degrees
up to age 7 Internal:Internal = 2:1
As person develops ROM decreases to 80 total degrees with equal external and internal rotation.
ROM refers to transverse plane motion

Front 13

Angle of femoral inclination:

Back 13

the angle formed in the frontal plane between the long axis of the head and neck of the femur and the long axis of the femoral shaft

Front 14

What is the angle of inclination at birth?
What is the average final angle?
What age does it reach that angle?

Back 14

140-150
~125
6yrs

Front 15

Angle of inclination =
Angle of declination =

Back 15

cervicofemoral angle
anteversion angle

Front 16

What plane is the deviation in an Angle of inclination disorder?

Back 16

Frontal deviation

Front 17

What are the results of an increased and decreased angle of inclination?

Back 17

Increased= coxa valgum (bowlegged- genu varum)
decreased= coxa varum (knock-kneed genu valgum)

Front 18

What are the three causes of a decreased femroal inclination angle less than 125?

Back 18

Coxa Vara- Slipped capital femroal epiphsis, trauma, developmental.

Front 19

Coxa vara pt is going to experience what symptoms?

Back 19

Decreased adduction and internal rotation (wording? both??)

Front 20

What are the two causes of a femroal inclination angle greater than 125? (never got down to the right place)

Back 20

May be due to developmental dysplasia of the hip or trauma.

Front 21

What is the patellar position before the age of six?
After the age of six?

Back 21

Slightly externally rotated up to the age 6
After the age of six the patella is straight on the frontal plane.

Front 22

What does a moving patella during gait show?

Back 22

The position of the patella during gait will let you know if there is a femoral component

Front 23

What is the major sign the patella can show during gait?

Back 23

If the patella is facing internally “squinting patella”; the in-toe gait is at least in part from the femoral component

Front 24

How does one clinically evaluat tibial torsion?

Back 24

To clinically evaluate tibial torsion, you must measure malleolar position.

Front 25

What is the definition of malleolar position in this lecture?

Back 25

vA line bisecting both malleoli relative to the frontal plane position of the patella

Front 26

What is the malleolar position at birth?
What is the adult angle? What age?

Back 26

0 degrees
after 8- 13-18 degrees of external rotation.

Front 27

What is the Knee Transverse Plane ROM with the knee flexed at birth?
With the Knee extended?
What is the final T.P. ROM?

Back 27

Transverse plane ROM at the knee at birth is 0-20 degrees with knee extended, 35-45 degrees with knee flexed
Transverse plane ROM at the knee 0-5 degrees after the age of 4.

Front 28

what is the normal deflection of the femur relative to the tibia (GRecurvatum) to the age of 5? After?

Back 28

Normal is 5-10 degrees
After 5 is straight as a flagpole.

Front 29

What is the most common cause of Genu Recurvatum?

Back 29

congenital Gastrocemius equinus

Front 30

Genu Recurvatum:
What gender?
What Plane?
What cause?

Back 30

Girls more
Saggital Plane
ligamentous laxity ( or CGE)

Front 31

Is genu varum normal?

Back 31

Normal physiologic genu varum from birth to age 4 due to inherent lateral bowing of the femur and tibia combined with a normal coxa valga

Front 32

When is genu varum not normal?

Back 32

Disease processes leading to genu varum: Rickets (Vit D deficiency), Blount’s disease (growth disturbance of the proximal medial epiphysis and metaphysis of the tibia)

Front 33

What is Blount's disease?

Back 33

Blount’s disease (growth disturbance of the proximal medial epiphysis and metaphysis of the tibia)

Front 34

What is the normal age for a child to have genu valgum?

Back 34

3-5, outgrown by age 8

Front 35

What are the three Knee positions relative to age?

Back 35

Bowlegs (varum) 0-3 yrs
Knock Knee (Valgum) 3-5yrs
Straight (straight) >5years

Front 36

What is normal Tibial Varum values at birth?Adult?

Back 36

Frontal plane bowing of the tibia is normally 5-10 degrees at birth.
Gradual reduction to 2-3 degrees by age 4 through adult
May be associated with genu varum.

Front 37

Ankle ROM at
Birth
Age 3
Age 10
Adult

Back 37

Ankle Dorsiflexion at:
Birth: 75 degrees (dorsum of foot may be dorsiflexed against anterior aspect of tibia)
Age 3: 20-25 degrees
Age 10: 15 degrees
Adult: 5-10 degrees

Front 38

Angle and base of gait for
Early Walker
By 6yrs
Adult

Back 38

Early Walker- 10 – 20 degrees external

By 6 yrs of age – 7- 10 degrees external

Adult – 15 degrees external