Clubfoot Flashcards Preview

Peds Orthopaedics > Clubfoot > Flashcards

Flashcards in Clubfoot Deck (16):
1

Rate of familial ocurrence?

25% - suggesting a strong genetic linkage

2

Associated conditions

- Streeter dysplasia (hand anomalies)
- Diastrophic dysplasia
- Arthrogryposis
- Tibial hemimelia
- Myelodysplasia
- Amniotic band syndrome
- Prune Belly Syndrome
- Absent anterior tibial artery

3

Contracted muscles causing cavus:

- tight intrinsics
- FHL
- FDL

4

Contracted muscles causing forefoot adductus:

tight tibialis posterior

5

Contracted muscles causing hindfoot Varus

- tendoachilles
- tibialis posterior
- tibialis anterior

6

Hindfoot equinus

tight tendoachilles

7

Bony deformity in clubfoot

- talar neck is medially and plantarly deviated
- calcaneus is in varus and rotated medially around the talus
- navicular and cuboid are medially displaced

8

Turco View

maximal dorsiflexion foot view, will demonstrate hindfoot parallelism between the talus and calcaneus

9

Kite's angle

the AP talocalcaneal angle
- <20 deg in clubfoot

10

After casting, how long in the brace?

23 hours per day for 3 months, THEN at night until age 4 years

11

When do you do split tib ant tendon transfer for dynamic supination gait?

at age 2-4 years
- transfer to the lateral cuneiform

12

The most common cause of recurrence?

poor compliance and education by parents

13

What is the dorsal bunion?

a dorsiflexed first metatarsal and overactivity of the FHB and abductor hallucis
- also requires overactivity of the tibialis anterior
- peroneus longus weakness

14

Treatment of dorsal bunion?

- capsulotomy
- FHL lengthening
- FHB flexor to extensor transfer at the MTP joint

15

Vascular abnormalities in clubfoot?

typically absent anterior tibial artery, dominant posterior tibial artery
- causes intrinsic smallness of the extremity

16

How many patients require tendoachilles releases?

70%
need to obtain 15 deg of dorsiflexion in the cast