Developmental mliestones (Gross motor)

Question 1

Gross motor

Answer 1

3 months
Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curve

6 months
Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back

7-8 months
Sits without support (Refer at 12 months)

9 months
Pulls to standing
Crawls

12 months
Cruises
Walks with one hand held

13-15 months
Walks unsupported (Refer at 18 months)

18 months
Squats to pick up a toy

2 years
Runs
Walks upstairs and downstairs holding on to rail

3 years
Rides a tricycle using pedals
Walks up stairs without holding on to rail

4 years
Hops on one leg

Question 2

3 months

Answer 2

Little or no head lag on being pulled to sit
Lying on abdomen, good head control
Held sitting, lumbar curv

Question 3

6 months

Answer 3

Lying on abdomen, arms extended
Lying on back, lifts and grasps feet
Pulls self to sitting
Held sitting, back straight
Rolls front to back

Question 4

7-8 months

Answer 4

Sits without support (Refer at 12 months)

Question 5

9 months

Answer 5

Pulls to standing
Crawls

Question 6

12 months

Answer 6

Cruises
Walks with one hand held

Question 7

13-15 months

Answer 7

Walks unsupported (Refer at 18 months)

Question 8

18 months

Answer 8

Squats to pick up a toy

Question 9

2 years

Answer 9

Runs
Walks upstairs and downstairs holding on to rail

Question 10

3 years

Answer 10

Rides a tricycle using pedals
Walks up stairs without holding on to rail

Question 11

4 years

Answer 11

Hops on one leg

Question 12

Normal lower limb variants in children

Answer 12

Flat feet (pes planus)
-All ages
-Absent medial arch on standing
-Typically resolves between the ages of 4-8 years
-Orthotics are not recommended
-Parental reassurance appropriate

In toeing
-1st year
-Possible causes:
-metatarsus adductus: abnormal heel bisector line. 90% of cases resolve spontaneously, severe/persistent cases may require serial casting
-internal tibial torsion: difference the thigh and foot ankle: resolves in the vast majority
-femoral anteversion: ‘W’ sign resolves in around 80% by adolescence, surgical intervention in the remaining not usually advised

Out toeing
-All ages
-Common in early infancy and usually resolves by the age of 2 years
-Usually due to external tibial torsion
-Intervention may be appropriate if doesn’t resolve as increases risk of patellofemoral pain

Bow legs (genu varum)
-1st-2nd year
-Increased intercondylar distance
-Typically resolves by the age of 4-5 years

Knock knees (genu valgum)
-3rd-4th year
-Increased intermalleolar distance
-Typically resolves spontaneously