Paed Ortho - Intro Flashcards
What are the “classes” of abnormal presentations in children that arn’t true pathologies?
Normal Variants
Physiological Development
Self-Correcting Pathologies
How many pediatric referrals to orthopaedics are normal variation?
Well over 50% with intoeing and flexible flat feet being the commonest reasons for refferal
What “pathologies” are part of physiological development and not pathology?
Young children with bow legs, knock knees, flat feet or excessive anteversion.
This is actually normal for their age and will grow into the adult shape
What is a self-correcting pathology?
Not a true pathology, its a problem that mostly correct themselves during growth.
How do you assess a childs hip rotation?
Get them to lie on their front with legs flat
Flex one knee and rotate the leg out for medial rotation of hip and in for lateral rotation
What can cause normal intoeing in children?
Children have increased hip anteversion and lateral rotation.
May also be Tibial Torsion which is also normal for their age.
Can be Metatarsus Adductus, meaning the metatarsals are bent medially, again almost every patient grows out of it themselves.
Only be concerned if its 1 sided or painful.
How do we assess for tibial torsion?
Thigh foot angle
while they’re lying on their front lift up the foot and look down the foot against the thigh to see the angle between them.
How would you clinically assess a child?
- Walking
- Standing (alignment from front / Patellar position / length from behind)
- Tip Toe
- Stahelli rotational Profile (done with child lying on front)
What presentations of a child might require further investigation?
- Outside the normal age boundary for their presentation. E.g. Bow legged at the wrong age i.e. after age 2
- Assymetry. 1 leg intoeing/bowing/longer etc,
What presentations may require treatment?
Metatarsus Adductus - Rarely
Tibial Torsion
Persistant Femoral Anteversion
Curly Toes
Basically only needs to be done if the child is past the age where they might outgrow it themselves
