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43 Cards in this Set
- Front
- Back
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types of rigid flat foot
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congenital
tarsal coalitions |
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if rigid flat foot is unilateral what side is it usually on
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right side
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what are clinical signs of congenital conves pes planus
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sole rigidly convex
talar head palpable forefoot abducted and dorsiflexed at MTJ |
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what is position of navicular with congenital convex pes planus
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it articulates with talus dorsally
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what is position of talus in congenital convex pes planus
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talar head is rotated downward/medially
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what is position of equinus in congenital convex pes planus
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lock in equinus
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what is different about STJ facets in congenital convex pes planus
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abnormal or absent
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what is position of lateral column in congenital convex pes planus
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rigidly concave
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what is the function of treatment for congenital convex pes planus
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to restore the normal anatomic relationship of the navicular and calcaneus to the talus
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what is treatment for congenital convex pes planus at birth
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gentle manipulation
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what is other treatment option for congenital convex pes planus
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open reduction
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majority of tarsal coalition is associated with what
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rigid flatfoot deformity and peroneal spasm or contracture
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what are the congenital tarsal coalitions
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talocalcaneal
calcaneonavicular |
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what are the acquired tarsal coalitions
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os trigonum fusion with talus and calcaneus
hypertropic ossicle RA juvenile RA Juvenile ankylosing spondylitis Neurotrophic jt dz major tarsal infection fx's to stj |
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classifications of tarsal coalitions
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tissue between bones
degree of fusion number of bones fused |
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coalitions classification by tissue
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synostosis-osseous
synchondrosis-cartilage syndesmosis-fibrosis |
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coalitions by degree of fusion
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complete
incomplete rudimentary |
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complete coalition
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bony bridge connects bone to bone
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incomplete coalition
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mass of bone projecting which is completed with fibrous or cartilage tissue
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rudimentary coalition
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projection of bone from talus or calcaneus which blocks inversion of calcaneus
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dual coalition
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two tarsal bones joined
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multiple coalition
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more than two tarsal bones joined
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massive coalition
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all tarsal bones are fused into a single block
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most common tarsal coalition
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talocalcaneal
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2nd most common tarsal coalition
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calcaneonavicular
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other tarsal coalitions
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talonavicualr
calcaneocuboid cubonavicular naviculocuneiform |
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most common clinical presentation of talocalcaneal coalition
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13-14yrs old
calcaneus in valgus off weight bearing anterior, posterior, middle facet coalition pain STJ and MTJ |
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where is the pain localized to in talocalcaneal coalitions
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medial talar head
anterior sinus tarsi sinus tarsitis talocalcaneo and calcaneonavicular joints associated pain lateral malleolus |
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what facets are involved in talocalcaneal coalitions
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middle
anterior posterior |
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what age is normal presentation for coalition
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adolescence
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what are the clinical findings of coalitions
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non-reducable flatfoot
failure of windlass mechanism peroneal pain or spasm valgus heel pain or prolonged walking or standing |
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harris beath view
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ski jump view
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when shoul harris beath be taken
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if heel fails to invert with hubscher maneuver
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age of presentation for talonavicular coalition
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2-3yrs
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age of presentation for calcaneal navicular coalition
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8-12yrs
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age of presentation for talocalcaneal presentation
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10-14yrs
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secondary radiographic signs of tarsal coalition
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talar beaking
narrowing of posterior facets rounding of lateral process of talus ant eaters sign failure to visualize middle facet |
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what should be viewed on lateral radiographs
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middle and posterior facets lie in same plane
facets should be parallel to each other |
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what are isherwood views
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series of lateral radiographs at 15, 30, and 45 degrees
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what might an MRI show with coalition
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may demonstate rudimentary or incomplete coalition
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goals of conservative treatment for tarsal coalition
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decrease knee and hip pathology
allow some heel eversion control valgus heel position |
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conservative treatment options
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arch supporst
plastizote shoe inserts UCBL orthotics Thomas heel shoes AFO injection of STJ short leg walking cast with heel in slight varus |
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surgical options for tarsal coalition
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removal of primary osseous bridge
fuse totally limited tarsal bones triple arthrodesis cowell procedure general anesthesia with reduction of coalition |
