Normal developmental milestones Flashcards
normal varus and valgus
every baby is born with genu varus by age 3 this becomes 15 degrees genu valgus and by 7-8 it becomes physiological genu valgus which is about 6 degrees
how do bones grow
longitudinally by the process of endochondral ossification
factors affecting growth of bone
- vitamin D
- nutrition
- trauma
- growth hormone
- illness can cause temporary bone growth arrest
pathological genu varus or valium is considered if
it is 6 degrees more of less from the mean value, is painful or is unilateral
causes of pathological genu varus
skeletal dysplasia, rickets, tumour, blunts disease, trauma
genu varum known as
bow legs
genu valgum known as
knocked knees
persistent genu varum is at risk of
early onset medial compartment osteoarthritis
what is blounts disease
idiopathic growth arrest of the medial tibial physis which causes unilateral genu varum and a classical beak like protrusion on x-ray
pathological causes of genu valgum
rickets, tumours, neurofibromatosis, trauma
monitoring of pathological genu varum and valgum
charted and monitored to see if they improve with age if not they may need an osteotomy
in-toeing
child who walks with feet pointing towards midline
in-toeing children commonly
trip over their own feet
causes of in-toeing
femoral neck anteversion, internal tibial torsion, forfoot adduction
femoral neck anteversion
femoral neck lies abnormally anterior in relation to the femoral condyles causing increased internal rotation of the hip, patients tend to sit in w position, of no consequence but can predispose to patello-femoral dislocation
internal tibial torsion
tibia can be rotated inwards about its vertical axis and usually always resolves by 6 years
forefoot adduction also known as
metatarsus adductus
forefoot adduction
the forefoot is turned inwards and nearly always resolves by 6 years
flat feet affects
1 in 5 adults
is flat feet present at birth
at birth all feet are flat but as me begin to walk most people develop a medial arch
types of flat feet
mobile or fixed
mobile flat feet definition
the medial arch forms with dorsiflexion of great toe (Jack test) which is of no consequence
fixed flat feet
the medial arch does not form on dorsiflexion of great toe and is caused by tarsal coalition which can cause pain and may need surgical seperation
which score is used to classify hyper-mobility
beighton score
curly toes
minor overlapping of the toes with the 5th toe being the most commonly affect
anterior knee pain
affects mostly female adolescents because they have more physiological valgus which cause more tension in the patella, causes localised patellar tenderness and does not need treatment
