Normal Development Milestones, Lower Limb Development and Abnormalities

Question 1

At what age is an infant expected to manage stairs independently?

Answer 1

3 years

Question 2

At what age is an infant expected to sit alone/crawl?

Answer 2

6-9 months

Question 3

At what age is an infant expected to jump?

Answer 3

24 months

Question 4

At what age is an infant expected to understand 200 words and learn around 10 per day?

Answer 4

18-20 months

Question 5

At what age is an infant expected to walk?

Answer 5

14-17 months

Question 6

At what age is an infant expected to be potty trained?

Answer 6

2-3 years

Question 7

At what age is an infant expected to eat with fingers or use a spoon?

Answer 7

14 months

Question 8

At what age is an infant expected to stand?

Answer 8

8-12 months

Question 9

At what age is an infant expected to speak a few words?

Answer 9

9-12 months

Question 10

At what age is an infant expected to stack blocks?

Answer 10

18 months

Question 11

At what age is an infant expected to lose primitive reflexes e.g. grasp reflex?

Answer 11

1-6 months

Question 12

At what age is an infant expected to gain head control?

Answer 12

2 months

Question 13

At birth children have ______ knees which become __________ aligned at around __ months progressing to __ __ __ ___________ at age _ and then gradually regress to the physiologic ______ of _ at age _-_

Answer 13

At birth children have varus knees which become neutrally aligned at around 14 months progressing to 10-15º valgus at age 3 and then gradually regress to the physiologic valgus of 6º at age 7-9

Question 14

What is considered pathological varus or valgum?

Answer 14

Alignment outwith the normal range by +/-6º

Question 15

What is Blount’s disease?

Answer 15

A growth disorderof the medial proximal tibial physis which causes marked and persisting varus deformity

Question 16

How can Blount’s disease be treated?

Answer 16

Surgical correction with osteotomy

(growth plate restriction with a small plate and screws on the medial side can be used in adolescence)

Question 17

As well as Blount’s disease, what are some other pathological causes of genu verum?

Answer 17

1. Rickets
2. Osteochondroma
3. Traumatic physeal injury
4. Skeletal dysplasia

Question 18

Persistent bow legs are at risk of which condition?

Answer 18

OA (on the medial compartment)

Question 19

What are some causes of pathological genu valgum?

Answer 19

1. Rickets
2. Enchondromatosis
3. Trauma
4. Neurofibromatosis
5. Idiopathic

Question 20

Excessive genu valgum can be treated in which ways?

Answer 20

1. Osteotomy
2. Growth plate manipulation surgery (in adolescence)

Question 21

What are three major causes of intoeing?

Answer 21

1. Femoral neck anteversion
2. Internal tibial torsion
3. Forefoot adduction

Question 22

How can it be determined if a child has flexible or fixed flat footedness?

Answer 22

Jack test

In flexible flat feet, the flattened medial arch will form with dorsiflexion of the great toe, this does not happen with the fixed variant

Question 23

What are the common causes for flexible flat footedness?

Answer 23

1. Idiopathic
2. Familial
3. Ligamentous laxity

Question 24

In children flexible flat footedness is a _________ variant

Answer 24

Normal

(in adults this can be related to tibialis posterior dysfunction)

Question 25

What does fixed flat footedness suggest?

Answer 25

There is an underlying bone abnormality

(e.g. tarsal coalition)

Question 26

In which instances does fixed flat footedness present?

Answer 26

1. Tarsal coalition (or other underlying bone abnormality)
2. Underlying inflammatory disorder
3. Neurological disorder

Question 27

Minor overlapping and curling of toes is ________

Answer 27

Common

Question 28

Which toe is most commonyl affected by curly toes?

Answer 28

Fifth toe (little toe)

Question 29

What is the treatment for curly toes?

Answer 29

1. Self-correction with time (most)
2. Surgery (cases which cause pain or persist)