Term
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Definition
-Talipes Equinovarus
-Boys : Girls 2:1
All components must be present for diagnosis
Cause unknown
Some genetic
• Differential diagnosis
Idiopathic vs Positional
Idiopathic vs Neuromuscular
• Treatment:
Manipulation / Casting
Surgery
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Term
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Definition
-Continued monitoring
-↓ Foot / calf size
-Noticeable if unilateral
-Troy Akimen had clubfoot
-Kristi Yamguchi had clubfoot
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Term
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Definition
Flexibility = Correction
Differential diagnosis:
Clubfoot
Overactive abductor hallucis
Internal tibial torsion
Treatment
Parental education
cast/straight last shoes
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Term
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Definition
-Pes Plano Valgus
Absent longitudinal arch
Flexible Vs Rigid
No treatment for Flexible
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Term
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Definition
-By age 7-8 child should have normal foot progression angle which is slight out-toeing (external rotation)
-Prior to age 7-8 in-toeing most common due to internal tibial torsion or femoral anteversion.
-Persistence of rotational deformities due to failure of these to spontaneously correct.
80% professional athletes intoe
90% correct spontaneously
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Term
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Definition
-Knock Knees
-Normal 2-4 years of age
-Excessive Valgus
99% Spontaneously
Persistent in:
• Rickets
•Multiple epiphyseal
•Pseudoachondroplasia
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Term
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Definition
Bow Legs
-Normal variant newborn
-Spontaneous correction age 2-3
-Treatment: Education
[image]Genu Varum
-Persistent > Age 3
-Severe
-Rule out Blounts
Rickets
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Term
Developmental dysplasia of the hip |
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Definition
(DDH)
Spectrum of hip disease
-Radiographic only
-Subluxation
-Dislocation
-Non-reducible dislocation
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Term
DDH- Congenital Dislocation |
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Definition
-Left hip predominance
-Female – male (5:1)
-Breech birth
-First born
Click vs. clunk
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Term
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Definition
-Barlow Test
-Ortolani Test
-Galeazzi Test
-Abduction Test
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Term
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Definition
-Treatment
-Early intervention
< 6 months of age
-Pavlik Harness
-Cause AVN
-Brachial plexus injury
-Femoral nerve palsy
-Skin lesions
Pavlik Failure
Age >6 months
Closed Reduction under general → anesthesia
Open
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Term
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Definition
-Idiopathic necrosis of femoral head
-Age range 2 – 12 (1° 4-8)
-Male : Female 4:1
-Unilateral 90%
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Term
Legg-Perthes
Clinical Symptoms
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Definition
-Limp
-Ipsilateral Knee Pain
-Painful Internal Rotation
Treatment:
Containment of femoral head in acetabulum
Bracing (not currently recommended)
Surgery |
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Term
Legg-Perthes Differential Diagnosis
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Definition
Differential diagnosis
-Septic arthritis
-Transient synovitis
-Epiphyseal dysplasia
-SCFE
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Term
[image]Slipped Capital Femoral Epiphysis
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Definition
SCFE
-Frequently present with knee pain/gait disturbance
-Age 8-12 (older than typical LCP)
-Associated with obesity
-endocrine disorder possible
-Pain, external rotation deformity of hip
-AP/LAT x-ray diagnostic
Treatment – Surgical pinning
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Term
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Definition
-Infection in bone
-Usually bacterial
-Usually 2° to hematogenous spread
-Metaphyseal location
Symptoms:
Pain, Swelling ,Tenderness ,Pseudoparalysis (refusal to move extremity)
Lab ↑ Temperature
CBC - ↑WBC
↑ ESR
↑C-reactive protein
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Term
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Definition
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[image]Treatment
Aspiration of involved area
Culture and sensitivity
Appropriate antibiotics
Occasional surgical drainage
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Term
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Definition
[image]Organisms
-Staphylococcus – most common
-Streptococeus – neonates
-I.Influenzae – 6 month - 4 years
-Puncture wounds - pseudomonas
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Term
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Definition
-Hematogenous seeding
-Direct extension from adjacent osteomyelitis
Diagonsis
Joint Aspiration
Differential diagnosis
Transient Synovitis (Viral)
JRA
Treatment
Aspiration and antibiotics
Hip – Surgical drainage and antibiotics
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Term
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Definition
Greater than 10 degrees
Causes
Idiopathic
Congenital
Neuromuscular
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Term
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Definition
[image]Physeal fractures may result in Residual deformity 2° to interference with normal growth
lSalter Harris
Classification
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