Principles of Paediatric Orthopaedics Flashcards

1
Q

What are the causes of intoeing and tripping?

A
  • Femoral anteversion
  • Int. tibial torsion
  • Metatarsus adductus
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2
Q

Is femoral anteversion a developmental norm?

A

Yes

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3
Q

What does internal tibial torsion look like and how can it be treated?

A
  • Increased thigh foot angle
  • 90% spontaneously resolve
  • Splints, wedges and insoles
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4
Q

How can gait be analysed?

A
  • Observation
  • Video
  • 3D instrumented: lab, force plate and EMG
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5
Q

What is a gait cycle?

A

Single sequence of functions by one limb

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6
Q

What is a step length?

A

Distance between corresponding successive points of heel contact of the opposite feet

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7
Q

What is stride length?

A

The distance between successive points of heel contact of the same foot

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8
Q

What is a walking base?

A

The side to side distance between the line of the two feet

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9
Q

What is a cadence?

A

The number of steps per unit time (Normal is 100-115 steps/min)

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10
Q

What are the phases and components of a gait cycle?

A
  • Stance phase
  • Swing phase
  • Single support
  • Double support
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11
Q

What are the subdivisions of the stance phase of the gait cycle?

A
  • Heel contact
  • Foot flat
  • Mid stance
  • Heel off
  • Toe off
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12
Q

What are the subdivisions of the swing phase of the gait cycle?

A
  • Acceleration
  • Mid swing
  • Deceleration
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13
Q

List the common gait abnormalities

A
  • Antalgic gait
  • Lateral trunk tilt - Trendelenberg
  • Functional leg-length discrepancy
  • Increased walking base
  • Inadequate dorsiflexion control
  • Excessive knee extension
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14
Q

What are the features of an antalgic gait and what are the common causes?

A
  • The stance phase on the affected side is shortened
  • Corresponding increase in stance on unaffected side
  • Splinter in foot, OA and tendinitis
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15
Q

What are the features of a lateral trunk tilt (Trelenberg gait) and what are the common causes?

A
  • Usually unilateral
  • Bilateral = waddling gait
  • Painful hip, hip abductor weakness, leg-length discrepancy and abnormal hip joint
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16
Q

What are the features of functional leg length discrepancy and name the four common compensations?

A
  • Swing leg is longer than stance leg

- Circumduction, hip hiking, steppage and vaulting

17
Q

What are the common causes of an increased walking base?

A
  • Deformities: abducted hip and valgus knee

- Instability: cerebellar ataxia and proprioception deficits

18
Q

What are the features of inadequate dorsiflexion control and what are the common causes?

A
  • In stance phase: foot slap
  • In swing phase: toe drag
  • Weak tibialis anterior and spastic plantarflexors
19
Q

What are the features of excessive knee extension and what are the common causes?

A
  • Loss of normal knee flexion during the stance phase
  • Knee can go into hyperextension
  • Hyperextension deformity of the knee
  • Quadriceps weakness, quadriceps spasticity and knee flexor weakness
20
Q

What are the five S’s for identifying pathology ?

A
  • Symptoms: night pain and NWB
  • Symmetry: lack of it
  • Stiffness: of joints and paralysis
  • Syndromes
  • Systemic illness: pyrexia
21
Q

If a child has night pain which two conditions would you want to rule out?

A
  • Tumour

- Infection