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31 Cards in this Set

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  • Back
What is talipes equinovarus?
• aka clubfoot
• high arched foot that may have a crease
• heel inversion (varus) with internal rotation
• forefoot inverted and adducted (soles face each other)
• plantar flexion with inability to dorsiflex
• internal leg rotation
What is the treatment for clubfoot?
• serial casting
• surgery (50 to 75% may require surgery)
What are causes of intoe gait?
• femoral anteversion
• internal tibial torsion
• forefoot adductus
What is the most common congenital foot deformity?
metatarsus adductus
What is metatarsus adductus?
• a sharp, inward angle of the front half of the foot
• 90% resolve by age 1
When is orthopedic referral indicated for patients with metatarsus adductus?
indications for possible casting for deformities persisting greater than 3 months
What is metatarsus varus?
a fixed deformity where the foot cannot be brought into the neutral position
What is the treatment for metatarsus varus?
• serial casting followed by corrective shoes or inserts (1st line)
• surgery (rare)
Medial tibial torsion is a disorder associated with in-toeing and is commonly seen in what age group?
12-24 months
Medial femoral torsion is a disorder associated with in-toeing and is commonly seen in which age group?
3-5 years
What is the MCC of in-toeing?
femoral anteversion
What is the a striking feature of femoral anteversion on examination of the hips in children?
excessive range of internal rotation, but limited external rotation
What is the most common neonatal foot deformity?
out-toeing
What is pseudo-out-toeing?
• most commonly seen in children who are just learning to walk
• although both feet turn outward when infants stand, the lateral rotation of both hips is normal on exam
What are the 2 processes associated with true out-toeing?
• lateral tibial torsion
• physiologic out-toeing
What are characteristics of lateral tibial torsion?
• 3-5 years of age
• presents with out-toeing that worsens with time
• mal-alignment between the knee and direction of gait may produce knee pain
• severe torsion may require surgical correction with osteotomy
What is physiological out-toeing?
a rotation problem that spontaneously resolves when children learn to walk
Newborns initally present with bow legs (varus), knees become straight by 18 months, and gradually drift into knock knees (valgus). At what age is their knock knee deformity at its maximum?
3-4 years
What is pes planus?
• aka flat feet
• most common type is the hyper-mobile or flexible flat foot
A flat foot associated with a tight heel cord may be caused what disorders?
• muscular dystrophy
• cerebral palsy
What is the primary method of treating developmental dysplasia of the hip (DDH) during infancy?
Pavlik harness
What is Legg-Calve-Perthes disease?
• aseptic (avascular) necrosis of the femoral head
• unknown etiology
• occurs in children between the ages of 4-10 years
• can cause a painful or painless limp
What is the position of the hip in patients with SCFE?
• hip held in abduction and external rotation
• patients have limited internal rotation
What is the most common hip disorder in adolescents?
slipped capital femoral epiphysis
What is slipped capital femoral epiphysis?
• a fracture of the proximal femoral growth plate
• occurs during maximal pubertal growth spurt
• can present with a limp and pain localized to the knee or groin
What 2 distinct body types are susceptible to SCFE?
• obese
• very tall
What is Osgood-Schlatter disease?
• traction apophysitis of the tibial tubercle
• caused by repetitive trauma that causes partial avulsion of the patella tendon at its insertion on the tibia
• present with swelling and tenderness over the tibial tubercle
What is syndactyly?
fusion of the fingers
What is polydactyly?
extra fingers
What is Nursemaid's elbow?
subluxation of the radial head from the annular ligament
How do you reduce a nursemaid's elbow?
• apply pressure at the radial head
• grasp wrist and apply slight traction
• supinate the wrist while flexing elbow to 90 degrees