Congenital Abnormailities (Lower Extremity)

Question 1

Metatarsus Adduct descr.

complication
Tx

Answer 1

Supinated/invert Forefoot (metatarsal)

Hallux valgus
Severe - denis browne splint or cast

Question 2

Talipes equino (thru ankle) varus descr

Demog

Tx

Answer 2

Club - supinated + adduct forefoot. MED dev of foot
Bilat 50%

Boys 2:1

Passive stretch Early minor surgery

Question 3

Talipes calcaneovalgus

Prog

Answer 3

Dorsiflx + evert

Mild/transient intra uterine

Question 4

Tarsal coalition

Tx

Prognosis

Answer 4

Rigid valgus, 2+bone fused

Surgical sep if needed

Permanent collapse of Med. long arch, rigid flat foot

Question 5

Pseudoarthrosis of tibia

Tx

Answer 5

Tibia - anterior bowing

Sclerotic frx - fail to unite (poor blood sup), serious

Micro surgery, autogen graft

Question 6

Coxa vara

Tx

Demo

Answer 6

Congenital femoral neck prog. varus,

Surgical subtrochanteric Osteotomy abduction

No sex predilection

Question 7

Congenital hip dislocation

Demograph

Progn

Answer 7

Head outside of acetabulum, w/i stretched capsule (intracap sublux)

1.5:1000 - v. common, more in girls

If not early tx, crppling degen. arth

Question 8

Congenital hip sublux

Hip stable in ____
unstable in ____

Demograph + Progn.

Answer 8

Femur head edge of acetabulum

Hip reduced+stable in FLX+ABD

Hip sublux+unstable in EXT+ADD

Same as Cong. hip dislocation

Question 9

Acetab Dysplasia

Demo

Diagnosis

Tx

Answer 9

Hip disloc. or sublux, abn. dev. acetab

Girls 8: 1

<=3: Barlow Ortolani test, Fejka split/Pavlik harness
3-18: Galeazzi’s sign -

<3mth - splint
3-18: sub adductor tenotomy (division of tendon)
>5 - coxal osteotomy