Orthopedic Diagnosis Classifications Flashcards
DDH
Profile
-birth
Legg-Calve Perthes
Profile
2-13 years
Slipped Capital Femoral Epiphysis
Profile
Boys: 10-17 years
Girls: 8-15 years
Osgood-Schlatter
Profile
Boys: 10-15 years
Girls: 8-13 years
DDH
Incidence
- male>female
- left>right
- black>white
DDH
Observation
- short limb
- asymmetrical thigh folds
DDH
Position
-hips flexed and abducted
DDH
History
- may be breech birth
- often associated with torticollis
DDH
ROM
Limited hip abduction
DDH
Special Tests
- Galeazzi
- Barlow
- Ortalani
DDH
Radiologic findings
- upward and lateral hip displacement
- delayed development of acetabulum
DDH
Intervention
- Birth-9 months: hip flexion/abduction–Pavlik harnes
- 9 Months+: abduction orthosis (allow walking)
- > 6 months with dislocated/dislocatable hips: surgery (open or closed reduction)
Legg-Calve-Perthes
Incidence
- male>female
- rare in blacks
- 15% bilateral
Legg-Calve-Perthes
Observation
- short limb
- high gr trochanter
- quad atrophy
- adductor spasm
Legg-Calve-Perthes
Pain
- gradual onset
- ache hip/thigh/knee
Legg-Calve-Perthes
History
- 20-25% familial
- LBW
- growth delay
Legg-Calve-Perthes
ROM
-limited hip abd/extension
Legg-Calve-Perthes
Gait
-antalgic after activity
Legg-Calve-Perthes
Radiologic findings
-in stages: increased density, fragmentation, flattening of epiphysis
Legg-Calve-Perthes
Intervention
- may not be necessary
- bracing/casts: preserve contour of fem head and keep in acetabulum
- obtain/maintain hip ROM
- surgery
Slipped Capital Femoral Epiphysis
Incidence
- male>female
- black>white
Slipped Capital Femoral Epiphysis
Observation
- Short limb
- obese
- quad atrophy
- adductor spasm
Slipped Capital Femoral Epiphysis
Pain
- vague in knee/thigh/hip
- pain in extreme motion
Slipped Capital Femoral Epiphysis
History
-trauma
Slipped Capital Femoral Epiphysis
ROM
- limited hip IR/ABD/Flex
- increased hip ER
Slipped Capital Femoral Epiphysis
Gait
- Acute: antalgic
- Chronic: trendelenberg, hip ER
Slipped Capital Femoral Epiphysis
Radiologic Findings
-displacement of upper femoral epiphysis
Slipped Capital Femoral Epiphysis
Intervention
- surgical fixation to keep displacement to minimum
- maintain ROM
- delay/prevent premature degen arthritis
Osgood-Schlatter
Incidence
- male>female
- 25-33% bilateral
Osgood-Schlatter
Observation
-swelling at insertion of patellar tendon
Osgood-Schlatter
Pain
- activity-related
- at insertion of patellar tendon
- acute or gradual
Osgood-Schlatter
History
-brought on by running or sports
Osgood-Schlatter
Gait
-antalgic
Osgood-Schlatter
Intervention
- rest, ice, compression
- decrease activity
- avoid squat/jump
- severe may require cast immobilization
Metatarsus Adductus
DF ROM
-full
Metatarsus Adductus
Foot Shape
- kidney shaped
- forefoot medially deviated
Metatarsus Adductus
Heel Position
-hindfoot valgus
Metatarsus Adductus
Intervention: Grade I
- no treatment
- resolves by 4-6 months
Metatarsus Adductus
Intervention: Grade II
-stretching and corrective shoes
Metatarsus Adductus
Intervention: Grade III
- Manipulation
- serial casting
- corrective shoes
Talipes Equinovarus
DF ROM
No
Talipes Equinovarus
Foot Shape
- kidney shaped
- forefoot medially deviated
Talipes Equinovarus
Heel Position
- small calcaneus
- hindfoot varus with equinus of ankle
Talipes Equinovarus
Intervention
- manipulation
- serial casting
Positional Calcaneovalgus
DF ROM
-full/excessive
Positional Calcaneovalgus
Foot Shape
- banana shaped
- deviated laterally
Positional Calcaneovalgus
Heel Position
-hindfoot valgus
Positional Calcaneovalgus
Intervention
- no treatment necessary
- resolves spontaneously
Flexible Flat Foot
Foot Shape
-longitudinal arch decreases/disappears in standing
Flexible Flat Foot
Intervention
- natural history of improvement
- little evidence to support the use of special shoes/arch supports
- use of lightweight running shoe with arch support/strong counter may decrease wear on medial border of shoes
