Development of the foot and ankle Flashcards

1
Q

When does foot disks are recognisable

A

by week 5, but toes and rays are not yet identifiable

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2
Q

describe the foot development at week 6 of gestation.

A

14-16 MM
inward rotation continues, leg left
digital rays become more distinct
LF counterclockwise. right clockwise

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3
Q

Describe foot development at week 7?

A

foot structure is clearly recognisable.
Plantar surface faces medial, dorsal surface lateral
Foot is in equines.
entire lower limb externally rotated.

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4
Q

Describe foot development at the end of 8th week?

A

continual progessive internal rotation of the thigh and leg with the foot beginning in equinus. supination and external rotation

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5
Q

Describe foot development in 2nd month.

A

equines of 90 degrees and foot adducted

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6
Q

Describe foot development in 3 month?

A

equines of 90 and foot adducted and supinated.

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7
Q

Describe foot development in the middle of 3rd month?

A

Mild equnius and foot supination still present. 1st ray adducted, continual foot dorsiflexion..

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8
Q

describe doot development at 4 months of pregnancy?

A

Foot pronates and plantar surface faces inferiorly. Equinus resolves. mild metatarsus varus remains.
note: foot pronation continues until unwinding, but still not complete at birth!

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9
Q

describe the foot growth growth from 1st to 3rd trimester.?

A

1st and second trimester rapidly growing. gets slower at third trimester.

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10
Q

What is the average annual groth of foot length from age 5-12 for female or 5-14 for male?

A

0.9cm

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11
Q

what age is mature foot length for female and male respectively?

A

14, and 16

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12
Q

outline the foot length growth from 2-5 years old?

A

on average,
half shoe size increase every2-3 month until the age of 2yrs
half shoe size increase every 3-4 months from 2-3 years
Hlaf shoe size increase every 4 months from 3-5 years

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13
Q

When does the mesenchymal analges of the distal tibia and fibula seprated?

A

at Carnegie 17 distal tibia and fibula separated. the talar element is wedged in between.
the distal end of tibia is oblique and concave

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14
Q

when does lateral and medial malleoli are the same length

A

at carnegie 18 and 20

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15
Q

at which carnegie laterall malleoli extends distally?

A

22

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16
Q

at which carnegie calcaneofibular contact established and when it is sperated?

A

20 and 22

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17
Q

at which Carnegie Tibiofibular joint formed?

A

22

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18
Q

when does Talus forms?

A

Carnegie 18

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19
Q

Which segment of Talus is formed in TP?

A

body and Trochlea

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20
Q

Which segment of talus is formed in sp?

A

talar neck and head

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21
Q

describe each surface of talar element which communicates with other tarsal bone.?

A

lower surface-calcaneus
anterior navicular
posterolateral surface-lateral malleolus
Posterior medial surface-Tibial plafond and medial malleolus

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22
Q

When does sustentaculum tali appears in embryonic?

A

at carnegie 22

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23
Q

What is the declination angle of talar neck relative to head???

A

25

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24
Q

Describe dimentional development of Talus?

A

Talar body grows more in height and posterior width than length

Talar neck declination angle continues to increase
Talar head turns more laterally relative to the body
unwinding and lateral shift of talar head-reduction of supinated rearfoot posture and adduction of the metatarsus

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25
Q

at which Carnegie posterior lateral and posteromedial tuberosities on the inferior calcaneal surface appear?

A

carnegie 20

26
Q

Describe calcaneus embryonic. development?

A

short with a narrow superior surface
anteromedial segment of superior surface corresponds to the overlapping talus.
Posterior lateral surface supports the distal end of the tibia which resolves in Carnegie 22
sustentaculum tali visible at carnegie 22 extends further medially by 34mm.

27
Q

when does cuboid ossification occur?

A

10 month

28
Q

When is lat cuneform ossification centre

A

4-20

29
Q

Med cuneiform

A

2 yrs

30
Q

int cuneiform

A

3yrs

31
Q

Navicular

A

2-5 yrs

32
Q

when does talus starts to ossify

A

more than 7 month

33
Q

When does calcaneus starts to ossify

A

more than 4 months

34
Q

When does distal phallanux of hallux ossify?

A

1- less than 3 month

35
Q

proximal second and 1st phalanx ossifies at

A

jsut more than 3 months

36
Q

proximal3-5 ossifies

A

4- more than 3 month

37
Q

when does inter-phalangeal ossifies?

A

5, 2-4 sigits just more than 4 month. 5th digit a lillt more than 4 month

38
Q

When does shaf of metatarsal ossifes?

A

2-4 less than 3 month .
1-5 just more than 3 months

39
Q

how much dorsiflexion is available at new born

A

excessive Df availabe. dorsum of foot almost touches shin.

40
Q

what is the position of Tibial plafond

A

everted parallel to transverse plane by 12 years

41
Q

what is the postion of rear foot in OKC and ckc

A

okc rear foot is in varus
ckc rearfoot is in valgus

42
Q

what is ankle joint plantar flexion rom from new born to 15 yrs old?

A

30-45

43
Q

what is ankle joint df of a newborn?

A

75

44
Q

what is anke joint df rom of 3 years old?

A

20-25

45
Q

what is ankle joint df of 10 yrs old?

A

15

46
Q

What is ankle joint df of 15 yrs old?

A

10

47
Q

what is foot posture of newborn?

A

neutral stj position 22 varus
Total stj rom 45
forefoot varus 12-15
metatarsus primus adductus= 8-15

48
Q

What is the foot posture of a child?

A

less than 7 year everted due to soft tissue
1st yr 10 everted

49
Q

what is the formula we used for calculation RCSP?

A

7-child age+/-2

50
Q

What are the potential problems with obtaining lower limb
measurements with young children

A

we get children sit next to partent.
sometimes we may only get observational. for less than 5 years
gestimation is fine

51
Q

ankle joint equinus?

A

reduction in ROM of df at ankle joint relative to the age

52
Q

assessment of ankle joint equnius?

A

gastroc equinus
soleal equinus
gastroc and soleal equinus

53
Q

What are the conditions associated with toe walking?

A

Congenital talpies equinus, autisim, cerebral pulsy, charcot marie tooth, developmental coordination disorder, muscle dystrophy, spina bifida

54
Q

Describe Os trigonum?

A

accessory ossicle at posterolateral tubercle of talus
treatment is cast immobilisation and surgical excision

55
Q

os tibiale eternum

A

most problematic ossicle
has 3 types
Seasomoid bone within tendon of tib post
Type 2 is most common
secondary ossificationof navicular
Type 3
secondary ossification of navicular and synostosis with navicular body

56
Q

How to treat os tibiale externum

A

RICER
CAM WALKER
NWB cast
ARTHERODESIS
surgical managment

57
Q

os intermetatarsum

A

between medial cuneiform and based of the 1st and second metatarsals
incidence reported between 1.2-8.2
typically fused to the dorsolateral aspect of medial cuneiform

58
Q

what does additional digit called?

A

polydactyly
5th toe most commonly
issues with trippping and shoes fitting

59
Q

what does fusion of adjecent digits called, describe the aetiology

A

syndactyly. due to failure of interdigital webbing to regress between adjecent toes during development of week 6

60
Q

what are the treatment option for curly ro raised digit

A

may resolve on its own
taping and proper shoe fitting

61
Q
A