Wk 9 - Pes Cavus And Planus Flashcards
Ligamentous laxity definition.
- Joint that are excessively lax with the range of motion being in exesss of the accepted norm in most of the joints examined
- joint hypermbility and hyper mobility syndrome
Hyper mobile features
- more common in females
- increased according to ethnicity
- often familial
- Associated with joint pain, especially lower limb
- Reduces with age
Brighton’s scale
Useful clinical scoring system for accessing and rating generalised hyper mobility in children
A score of more than or equal to 5/9 is commonly used to define hyper mobility
Joint hyper mobility syndromes
- benign joint hyper mobility syndrome (BJHS)
- Ehlers Danlos syndrome (eds)
- Marfan syndrome
- osteogenesis imperfects (bone fragility)
Pes planus
Feet with a lower than normal medial arch
Rigid pes planus
Lowered arch weight bearing and non-weakght bearing
- reduced or absence of STJ and mid foot ROM
- symptomatic or asymptotic
- underlying primary pathology
Rigid pes planus - congenital
Tarsal coalitions
Congenital convex pes valgus
Tarsal coalition
Congenital union between 2 or more tarsal bones
May be fibrous, cartilaginous or osseous
Most common = calcaneo-nav and facet of STJ talo-calc
Talocalcaneal coalition
More difficult to visualise
Cartilaginous
- Harris and Beath projection
Talocalcaneal coalitions clinical features
May be asymptomatic
Children: joint stiffness, muscle spasm, altered foot shape, protective gait
Adolescents: symptomatic, local tenderness, reduced or absent RF ROM, muscle spasm
Congenital vertical talus
Also known as congenital convex pes valgus
Talus lies between Calcaneaus and navicular
Often rigid rocker-bottom foot
Another cause of congenital rigid flatfoot
Rigid pes planus acquired
Arthritis induced
Truama included
Charcot neuropathy
Spastic flat foot
Charcots neuroarthropathy
Rocker bottom foot
Commonly associated with diabetes
Rapid progression
Destruction
Treatment
Immobilisation
Accommodate the deformity
Reconstructive surgery
Perineal spastic flatfoot
Possible causes of peroneal spastic flatfoot: tarsal coalition, juvenile chronic arthritis, osteochondral fractures, neoplas, idiopathic
Skew foot
S or Z shaped foot with forefoot Adductus ans RF valgus
Suspect skew foot I’d metatarsal adductus treatment is not successful
Can be asymptomatic
