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Pediatric Orthopedics > Digital Deformities > Flashcards

Digital Deformities Flashcards

1
Q

What is post axial polydactyly

A

Polydactyly of the 5th toe

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2
Q

What is pre axial polydactyly

A

Polydactyly of the 1st toe

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3
Q

Define polydactyly

A

Presence of supernumerary digits or metatarsals

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4
Q

Describe the hereditary of polydactyly

A

Transmitted as an autosomal dominant trait
Most common congenital deformity of the hand and foot

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5
Q

What are the two presentations of polydactyly

A
  • single deformity in the foo (non syndromatic)
  • associated with accessory digits in the hand, and there may be other congenital malformations as well (syndromatic)
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6
Q

What is the most common for of polydactyly

A

post-axial - 5th toe

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7
Q

What is brachymetatarsia

A
  • aberrant condition in which a metatarsal is short and hypoplasicq
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8
Q

Which MT is most commonly affected by brachymetatarsia

A

4th MT

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9
Q

What happens to the digit in brachymetatarsia

A

Contracted and cosmetically unacceptable fourth digit

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10
Q

Is brachymetatarsia usually bilateral or unilateral

A

Bilateral

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11
Q

What are the 7 surgical procedures for surgical management of brachymetatarsia

A
  1. Callus distraction (Ilizarov technique)
  2. Syndactylization
  3. Bone graft
  4. Implants
  5. Auto-implants
  6. Step-up osteotomies
  7. Amputation
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12
Q

What is the callous distraction principles based on

A

The fact that living tissue, when subjected to slow, steady distraction can become metabolically activated in both the biosynthetic and proliferatio

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13
Q

What bone offer advantages for the location of callus distraction

A

Metaphyseal and diaphyseal bones

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14
Q

Which bone offers the greatest surface area for regeneration and more abundant blood supply for callus distraction

A

Metaphyseal bone, with its increased diameter and trabecular pattern

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15
Q

What is the most common procedure for brachymetatarsia

A

Bone graft

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16
Q

What type of osteotomy did Marcinko perform for brachymetatarsia

A

Z plasty of bone - to lengthen short metatarsal

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17
Q

What are some complications of brachymetatarsia

A
  • Neurovascular compromise
  • Overlenthening
  • under correction
  • malunion
  • non-union
  • transfer lesion
  • recurrence
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18
Q

What is macrodactyly

A

An increase in the size of the digital elements or structures of the affected part including the theft bones, nerves, subcutaneous, fat nails and skin

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19
Q

Are tendons and blood vessels affected in macrodactyly

A

No

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20
Q

What type of tissue are involved in macrodactyly

A

Hypertrophy of plantar and distal tissues

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21
Q

Which are the digits most commonly involved in macrodactyly

A

1stm 2nd, 3rd

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22
Q

What is the primary treatment for macrodactyly

A

Surgery

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23
Q

What are the surgical techniques for macrodactyly

A
  • digital amputation (partial versus total)
  • ray resection - may be preferred to digital amputation with MT involvement
  • digital salvage -
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24
Q

Describe the digital salvage for macrodactyly

A
  • soft tissue procedure to reduce digital bulk
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25
Q

What is the mainstay treatment for the static milder deformity of macrodactyly

A

Digital salvage

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26
Q

When is Juvenile Hallux Valgus more common (type of condition)

A

Flexible pronated foot

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27
Q

What is the IMA at birth

A

12 degrees

28
Q

What is the IMA at 6-9 years

A

10 degrees

29
Q

What is the IMA of an adult

A

8-10 degrees

30
Q

What are the treatment options for Juvenile Hallux Valgus

A
  • conservative care options
  • orthotics - Control of pronatory forces
  • shoe selection - fit and function
  • if flexible, treatment with toe spaces
31
Q

What are indications for surgery for juvenile hallux valgus

A

Pain
Significant deformity
Chronic paronychia
Treat of global pathology

32
Q

What is Engel angle at birth?

A

30

33
Q

What is Engel angle at 6-9 yrs ?

A

25

34
Q

What is Engel angle at adult

A

Less than 21

35
Q

What is MA angle at birth

A

25-30

36
Q

What is MA angle at 6-9 yrs

A

15-25

37
Q

What is MA angle at adult

A

Less than 15

38
Q

What is talocalcaneal (Kite) angle at birth

A

40-50

39
Q

What is talocalcaneal (Kite) angle at 6-9 years

A

20–40

40
Q

What is talocalcaneal (Kite) angle at adult

A

20-25

41
Q

What is talar-fit MT angle at birth

A

Slightly medial

42
Q

What is talar-fit MT angle at 6-adult

A

Parallel

43
Q

What is tibiocalcaneal angle at birth

A

70-75

44
Q

What is tibiocalcaneal angle at 6-9 yrs

A

65

45
Q

What is tibiocalcaneal angle at adult

A

55

46
Q

What is talar declination angle at birth

A

Slightly above 1st MT

47
Q

What is talar declination angle at 6-9 yrs

A

Parallel

48
Q

What is talar declination angle at adult

A

21

49
Q

What is calcaneal inclination angle at birth

A

10 -15

50
Q

What is talar declination angle at 6-9 yrs

A

15-20

51
Q

What is talar declination angle at adult

A

Less than 21

52
Q

What is talocalcaneal angle at birth

A

35-50

53
Q

What is talocalcaneal angle at 6-9 yrs

A

30-40

54
Q

What is talocalcaneal angle at adult

A

25-30

55
Q

What did study Ferrari et al show us regarding juvenile hallux valgus and met adductus

A

Combined juvenile hallux valgus and met adductus in 55% of patients

56
Q

What is a distal procedure for juvenile hallux valgus

A

Austin bicorrectional

57
Q

What is a midshaft procedure for juvenile hallux valgus

A

Opening base wedge
Hemiepiphysiodesis - growth plate closure (10-12 F, 12-14M)
Lapidus - beware of growth plates

58
Q

What is opening wedge of cuneiform for juvenile hallux valgus

A

Total avoidance of growth plate with reduction of the distal angle of the MC joint

59
Q

What is the soft tissue procedure for juvenile hallux valgus

A

Release of the adductor from base of proximal phalanc with capsulorraphy

60
Q

How to treat fixed flexed curly toes

A

Flexor tenotomy with pin fixation

61
Q

When does syndactyly occur

A

6-8 weeks IU

62
Q

What is claw toes

A

DF at MPJ, PF at IPJ

63
Q

What is hammertoe

A

DF at MPJ, PF at PIPJ

64
Q

What is the treatment for hammer toes

A

Flexor tenotomy with K wire in pediatrics

65
Q

What is mallet toe

A

PF of DIP

Pediatric Orthopedics (18 decks)

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