Normal/Common Variations Flashcards
What is the name for bow legs?
Varus/varum
What is the name for knock knees?
Valgus/valgum
Describe the normal pattern of knee alignment from birth to adolescence?
At birth –> varus knees (bow legs)
Become neutral at about 14 months
Become valgus 10-15 degrees at about 3 years
Regress to physiological valgus (6 degrees) at about 7-9 years
When is alignment considered abnormal/pathological?
+/- 6 degrees from mean value for age
What are some causes of pathological knee alignment?
Trauma Bone tumours Rickets Skeletal dysplasia Blount's disease (varum deformity) Idiopathic
What is Blount’s disease?
Growth disorder of medial proximal tibial physis
–> marked + persisting (beyond age 4-5) varus deformity
How are excessive knee alignment deformities managed?
Osteotomy
What does persistent genu varum increased the risk of?
Early medial OA
What are the features of in-toeing?
Pigeon toes:
- feet point toward midline, exaggerated by running
- clumsy, wear through shoes quickly
What are some causes of in-toeing?
Femoral neck anteversion
Internal tibial torsion
Forefoot adduction
How does femoral neck anteversion affect a child’s sitting position?
Sit in W position
What is the management of in-toeing?
Usually none, most correct themselves
What are the two types of flat feet and what is their significance?
Flexible flat feet –> normal variant
Rigid flat feet –> pathological, may require correction
What are some causes of rigid flat feet?
Bony abnormality e.g. tarsal coalition
Inflammatory
Neurological disorder
What are curly toes?
Overlapping of toes
