INTOE GAIT

Question 1

angle of gait?

Answer 1

line of progression and midline of foot

Question 2

what does not cause in toeing?

Answer 2

pelvis
hip joint
femur
knee joint
leg/ankle
foot

Question 3

anteversion is? vs retroversion?

*what -version is normal?

Answer 3

medial or internal position of the distal part as compared to the proximal

lateral or external position of the distal part as compared to the proximal part

*normal is femoral ante version, tibial retroversion

Question 4

what causes intoe gait? (etiology)

Answer 4

MSK
neuromuscular disease
-cerebral palsy
-spina bifida
-charcot marie tooth
developmental dysplasia
lower limb deformities (most common)
-femoral antetorsion 
-tibial internal torsion (antetorsion)
-persistent talar torsion
-metatarsus adductus

Question 5

during gait, the limb will internally rotate at terminal swing phase

limited hamstring flexibility, especially with the hip externally rotated

what are these the features of?

Answer 5

tight medial hamstrings

Question 6

frequently seen with downs syndrome,

what is this?

Answer 6

benign hypermobility joint syndrome, *not danlos or marfans

Question 7

what criteria is used to diagnose benign hyper mobility joint syndrome (BHJS)?

Answer 7

Beighton Criteria

Question 8

what shows increase coveralls of fem head by acetabulum on plain films, better eval with 3D-CT or MRI?

what shoes decreased coverage of head of femur?

Answer 8

retrotorsion

acetabular antetorsion

Question 9

this can result in dislocated hip?

Answer 9

acetabular torsion

Question 10

at skeletal maturity it is 8-14 degrees ante version; males lower than females, what is this version?

Answer 10

femoral version

Question 11

major etiology of femoral antetorsion?

Answer 11

excessive femoral anteverion
internal vehicular position
neuromuscular, cerebral palsy

Question 12

a brace adequately treating femoral antetorsion, T/F?

does conservative tx work?

Answer 12

false

nope, need surgery pretty much

Question 13

normal range of medial tibial version at birth?

by age 12, this rotates to about how many degrees?

Answer 13

5 degrees medial version

10-20 degrees lateral version

Question 14

what malleolar position degree?

Answer 14

18-23 degree external

Question 15

thigh foot angle?

what version does this represent?

Answer 15

normal 13 degrees abducted in young children, can be as much as 5 degrees adducted in infants

tibial version

Question 16

intoe gait due to tibial antetorsion is seen where?

how’s it diagnosed?

Answer 16

blounts disease
-epiphysiodesis, perform early surgery

gait analysis
radiographs
measurements seen clinically, segmental CT/MRI scan

Question 17

intoe gait due to foot deformity etiology?

Answer 17

persistent talar torsion and treated if deformity shoes >10 degree internal position of foot to medsagittal plane

tx: type C heel stabilizer, Shaffer plate with deep heel cup, Robert Whitman