Paediatric Foot, Ankle and Spine

Question 1

Talipes Equinovarus

Answer 1

Clubbed foot

Congenital deformity of the foot due to inter abnormal alignment of the joints between talus, calcaneus and navicular leading to soft tissue contractures

Question 2

Talipes Equinovarus Characteristics

Answer 2

Ankle Equinos (plantar flexion)

Supination of the forefoot

Varus alignment of the forefoot

Question 3

Talipes Equinovarus epidemiology

Answer 3

More common in boys

Question 4

Talipes Equinovarus Risk Factors

Answer 4

Male gender
Family history
Breech birth 
Oligohydramnious (low amniotic fluid content) 
Co-existant skeletal dysplasia

Question 5

Talipes Equinovarus Treatment

Answer 5

Ponseti Technique

• Deformities are corrected progressively by being help in evolving plaster casts with 6 weekly cast changes
• 80% require achilles tendon tenotomy
• Patients are placed in brace once full correction is achieved (Worn 23/24)

Delayed presentation
- extensive surgery involving bony and soft tissue procedures

Question 6

Hallux Valgus

Answer 6

bunions

Big toe deviates from normal position and angles inwards toward second toe

Question 7

Hallux valgus characteristics

Answer 7

Affects adolescents
Strong family history
Surgery has high recurrence rate

Question 8

Scoliosis

Answer 8

lateral curvature of the spine

Question 9

Scoliosis epidemiology

Answer 9

Females

Adolescents

Question 10

Scoliosis Aetiology

Answer 10

Idiopathic
neuromuscular disease
Tumours
Skeletal Dysplasia
infection

Question 11

Scoliosis Investigations

Answer 11

Urgent MRI if painful

Question 12

Scoliosis Treatment

Answer 12

Surgery

-Due to restrictive lung effects

Question 13

Spondylolithesis

Answer 13

Slippase of one vertebrae over another

Question 14

Spondylolithesis Epidemiology

Answer 14

Adolescents

- Due to increased body weight and increased sporting activity

Question 15

Spondylolithesis Characteristics

Answer 15

L4/L5

L5/S1

Question 16

Spondylolithesis Aetiology

Answer 16

Developmental defects

Recurrent stress fracture of the posterior elements of the vertebrae which fail to heal

Question 17

Spondylolithesis Symptoms

Answer 17

Low back pain 
Radiolopathy (severe slippage)
Flat back 
(due to muscle spasm) 
Waddling

Question 18

Spondylolithesis Treatment

Answer 18

Minor

• Rest
• Physiotherapy

Severe

• Stabilisation
• Reduction