Musculoskeletal diseases

Question 1

Clubfoot (Talipes)

Answer 1

D/S Foot is permanently bent:
Varus: Inversion/inward bending of foot
Valgus: Eversion/outward bending
Equinus: Plantar flexion
Calcaneus: Dorsiflexion
E/T Unknown; genetic, environmental factors in utero; more common in boys
S/S Deformed talus; Achilles tendon shortened; calcaneus flattened, shortened
D/X Obvious at birth
T/X Simple manipulation, casting, corrective surgery; special exercises, night splints and orthopedic shoes
P/P Good with prompt treatment/None known

Question 2

Congenital Hip Dysplasia

Answer 2

D/S Unstable hip dysplasia with manual dislocation; incomplete or complete dislocation
E/T Unknown; effect of maternal hormones on fetal hip, improper position of fetus
S/S Obvious when patient attempts to walk
D/X Physical examination, observation, positive Ortolani’s sign
T/X Closed reduction with splint brace; open reduction with casting
P/P Excellent with prompt treatment/None known