Torticollis, Hip Dysplagia Flashcards
Torticollis CPG
- Cervical PROM
- Cervical and Trunk AROM
- Development of Symmetrical movement
- Environmental Adaptations
- Caregiver Education
Torticollis Interventions
- HEP and education
- PROM for lateral flexion and rotation
- AROM supine, prone, sidelying
- SCM massage
- Positioning
- Developing typical sequence
- Kinesiotaping
- Cranial Orthosis
Torticollis HEP
-Feeding: head in midline
-Tummy time: observe symmetry
-Cervical Stretching: opp of SC,
-Carrying: lateral tilt for righting reactions
-Side prop sitting: toys
-Pull to sit
-Visual tracking: food, mobile, sounds
Muscular Torticollis
-congenital
-nonprogressive unilateral contracture of SCM
-rule out non muscular first
-SCM ipsi SB and contra ROT
S/s:
-lump of SCM
-dec AROM and PROM
-plageiocephaly
-issues with feeding or vision or hearing
CMT Goals of Treatment
-no head tilt
-full ROM
-normal strength
-not palpable tumor
-best outcomes before 1 year
Non-Muscular Torticollis
-cause is different but affect is the same
-18% of cases
Causes:
-cervical rib
-tumor
-acid reflux
-subluxation of cervical vertebrae
-extra ocular muscle paresis
-BP injury
Developmental Dysplasia of Hip: Diagnosis
-Ultrasound is GS
-Limited hip ABD or asymmetry (5 of 10 deg) of (most consistent sign)
-Asymmetric thigh folds
-Pistoning
Developmental Dysplasia of Hip: Incidence
20% incidence of also having toricollis
10% incidence of also having adductus or calcaneovalgus
Developmental Dysplasia of Hip: Types
Subluxable
Dislocatable and Reducible
Dislocated (no reducible)
Developmental Dysplasia of Hip
-atypical development or growth of hip
-1 per 100 for dysplagia
-1 per 1000 for dislocation
DDH: Causes
Mechanical factor:
-small intrauterine space
-breech
Physiological factors:
-hormonal influence of estrogen
Environmental or cultural factors:
-positions during sleeping
DDH: Interventions
Pavlik Harness:
-puts hip into flx and abd
-resists ext and add
-85-95% success rate
-donning and doffing
Closed Reduction and Spica Cast
-3-6 months
-if Pavlik not successful
-WB precautions
-gait training
>9 months might need orthoses
6-18m surgery, closed
>2 years, open reduction
DDH: Post-Surgical
Acute Care:
-precautions
-AAROM
-Gait training
-wheelchair if needed
Post-Acute Care:
-treat hip weakness
-gait training
-balance
Galeazzi Sign
-observation
-uneven knee heights in hooklying
Barlow Test
-hip flex, ABD then ADD w/ posterior pressure
-(+) feel dislocation
Ortolani Sign
-Hip flex and ADD then ABD
-Should reduce hip
Plagiocephaly
-misshapen head
-eyes and ears can be unaligned
Brachycephaly
-flat head
Scaphocephaly
-elongated head
Posterior Fontanelle
-usually closes by 1-2 months
Anterior Fontanelle
-7-18 months to close
