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PT Procedures 2 > Developmental Orthopedics > Flashcards

Developmental Orthopedics Flashcards

1
Q

Infant LE Alignment

A
  • General kyphosis
  • hips flexed, abducted, & ER
  • knees flexed & varus
  • ankles valgus & feet DF
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2
Q

Development of Mature Alignment

A
  • decreasing kyphosis, coxa valga, & reduction in femoral anteversion with extensor activation
  • knee: increased compression on medial side facilitates medial epicondyle growth to decrease varum
  • ankle: compression on lateral side directs shape & development of talus & calcaneus
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3
Q

Osteogenesis Imperfecta (OI)

A
  • brittle bone disease
  • genetic disorder characterized by bones that break easily without specific cause
  • 8 Types
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4
Q

OI Type I

A
  • most common
  • mildest form
  • collagen normal in quality but abnormal (low) quantity
  • bones fracture easy; low muscle tone
    • mostly occurs before puberty
  • stature near normal or slightly shorter
  • tendency toward spinal curvatures
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5
Q

OI Type II

A
  • most severe form
  • collagen abnormal in both quality & quantity
  • newborns severely affected
    • few survive to adulthood
  • severe bone deformity from fractures
  • new gene mutation
  • small stature with small chest & under-developed lungs
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6
Q

OI Type III

A
  • collagen is abnormal in quality but normal quantity
  • bones fracture easy & cause deformity
  • small stature
  • birth fractures common
  • loose joints
  • barrel-shaped rib cage
  • triangular face
  • spinal curve
  • possible respiratory problems
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7
Q

OI Type IV

A
  • between type I & III in severity
  • fair quantity but moderate quality of collagen
  • bones fracture easy, mostly before puberty
  • teeth problems
  • spinal curvatures
  • possible hearing loss
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8
Q

PT Role in OI

A
  • parent education about positioning & handling
  • fracture prevention
  • acquisition of age-appropriate gross motor skills
  • independence with ADL’s
  • Adaptive equipment
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9
Q

Developmental Dysplasia of the Hip

A
  • congenital condition of hip joint
  • acetabulum may be shallow (allows sublux) or femoral head may not have formed correctly
  • Females > Males
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10
Q

Risk Factors of DDH

A
  • MULTIFACTORAL
  • low amniotic fluid levels
  • first child
  • small uterus/large baby
  • breech
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11
Q

DDH Symptoms

A
  • Newborn: may move less, leg appears turned out, shorter, folds in skin of thigh appear uneven, space between legs looks wider than normal
  • Young Child: “waddle”, toe walk, limited abduction, leg appears shorter
  • Assessed with ultrasound (<6 months) or Ortolani & Barlow maneuvers
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12
Q

DDH Treatment

A
  • Pavlik Harness: used on babies up to 6 months to hold hip in place while allowing legs to move
    • worn full time 6+ weeks, then part time another 6 weeks
    • may not be completely successful
  • traction, casting, or surgery may be required if still dislocated
  • surgery required if diagnosed after 2 years
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13
Q

PT Role in DDH

A
  • promote normal motor development
  • preserve ROM/strength
  • positioning & transfer training
  • adaptive equipment
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14
Q

Arthrogryposis Multiplex Congenita (AMC)

A
  • group of diseases that involve joint contractures in 2+ areas
  • Amyoplasia (impaired blood circulation to fetus in 1st 2 months of pregnancy, damaging anterior horn cells) is most common
  • PT/OT, then orthotics, then surgery
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15
Q

Treatment of AMC

A
  • passive ROM/stretching
  • serial casting
  • splinting/orthotics
  • strengthening
  • adaptive equipment
  • post-op rehab
  • parent education
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16
Q

Clubfoot

A
  • congenital foot deformity affecting bones, muscles, tendons, & blood vessels
  • Boys > Girls
  • true clubfoot is rigid & stiff
17
Q

Treatment of Clubfoot

A
  • Serial manipulation/casting, taping, splinting, PT
  • Ponseti Method: casting 3-4 days/week for 3+ weeks
    • corrected in 2-3 months
    • recommended treatment at diagnosis, even at only 1 week old
    • braces worn 23 hours/day for up to 3 months, then nightly for 2-4 years
18
Q

PT Role in Clubfoot

A
  • manipulation/casting
  • positioning/adapting activities
  • facilitation of normal development & progression of motor milestones
19
Q

Congenital Limb Defects

A
  • unknown cause
  • Risk factors: conditions affecting baby in utero or pre-natal exposure to some chemicals, medications, or viruses
  • Longitudinal: overgrowth or undergrowth
  • Transverse: most commonly absence of limb
  • Other: failure of portion of limb to separate or duplication
20
Q

PT Role in Congenital Limb Defects

A
  • promote motor development
  • accessibility, orthotics, adaptive equipment
  • independence
21
Q

Leg Length Inequality

A
  • congenital, traumatic, NM, or pathological

- causes compensatory MS impairments, gait deviations, inefficient gait, pain, etc.

22
Q

PT Role in Leg Length Inequality

A
  • orthotics
  • treatment of cause (if NM)
  • treatment of gait deviations
  • progression of gross motor milestones
23
Q

Genu Varum

A
  • Bow Legs
  • exaggerated outward bend of legs from knees down
  • developmentally appropriate in infants
    • 2+ years old or unilateral = red flags
  • usually corrects itself if no other pathology present
24
Q

Genu Valgum

A
  • Knock Kneed
  • exaggerated outward flare of legs from knees down
  • developmentally appropriate in kids under 3
  • associated with obesity, anteversion, out-toeing, & pes planus
  • surgical intervention may be needed beyond 2 years, unilateral, or nonsurgical treatment ineffective
25
Q

Legg-Calve-Perthes Disease Phases

A

Phase 1: blood supply absent, hip becomes inflamed, stiff, & painful
- can last for several months to a year
Phase 2: body resorbs dead bone cells & replaces them with healthy bone cells
Phase 3: femoral head continues to remodel back into round shape with new bone
Phase 4: Femoral head fully reformed with permanent new bone cells

26
Q

Slipped Capital Femoral Epiphysis (SCFE)

A
  • condition where head of femoral bone slips off
  • causes loss of ROM & pain
  • boys > girls
  • usually develops during growth spurts
  • Mild: 1/3 femoral head slips off femur
  • Moderate: 1/3 - 1/2 femoral head slips off femur
  • Severe: more than 1/2 femoral head slips off femur
27
Q

SCFE Risk Factors

A
  • obesity
  • medications (steroids)
  • thyroid problems
  • radiation treatment
  • chemo
  • bone problems related to kidney disease
28
Q

SCFE Symptoms

A
  • poorly localized pain in groin, hip, thigh, knee
  • aggravated by PA & relieved with rest
  • limited ROM
  • chronic: walks with limp & leg is ER
  • acute: immediate pain, limp, and/or unable to WB
29
Q

PT Role in SCFE

A
  • treat pain
  • gait training
  • ROM
  • strength
  • NM re-education to correct body mechanics
30
Q

Legg-Calve-Perthes Disease

A
  • transient condition in which femoral head temporarily loses blood supply
  • damages femoral head & causes deterioration
  • Males > Females (boys that are small for their age but active)
  • 4-10 most common, 5-12 common as well
  • typically unilateral
  • gradual onset of limp
31
Q

PT Role in Legg-Calve-Perthes Disease

A
  • traction & rest for pain
  • modalities as appropriate
  • prevent deconditioning
  • ensure proper mechanics
  • taping/bracing/casting
  • adaptive equipment
  • ROM/strength

PT Procedures 2 (9 decks)

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