Ortho: Pediatrics

Question 0

Metatarsus Adductus Treatment

Answer 0

CHECK HIPS!
Stretch
Shoe Modifications (wear opposite shoe)
2-4yrs Tarsometatarsal Capsulotomies
4yrs Multiple Metatarsal Osteotomies
95% Resolves

Question 1

Metatarsus Adductus

Answer 1

First MT abnormally adducted
Tibial Torsion
Under age 2
Bilateral 50%
First born
10% Acetabular Dysplasia
"Toe In"

Question 2

Calcaneovalgus

Answer 2

DF, forefoot abducted, heel in valgus
Bowing of tibia
In utero foot against wall

Question 3

Calcaneovalgus Treatment

Answer 3

Stretching

Resolves in 6 months

Question 4

Flexible Pes Planus

Answer 4

Flat foot when weightbearing

Normal arch present on tip toes

Question 5

Flexible Pes Planus Treatment

Answer 5

No Symptoms = No Treatment
If Symptoms...
OTC/custom orthotics
Shoes with arch support
Exercise intrinsics
Arthrodesis if pain necessitates and willing to lose INV/EV

Question 6

Rigid Flat Foot

Answer 6

Vertical Talus or Tarsal Coalition

Flat foot when weightbearing or not

Question 7

Vertical Talus

Answer 7

Convex Pes Valgus
Rare
Abnormal position of talus
Rocker bottom foot
Present at birth
Often with arthrogryposis or spina bifida

Question 8

Vertical Talus Treatment

Answer 8

Surgery
Realign talus and pin other joints in place
6 months - 2 years

Question 9

Tarsal Coalition

Answer 9

Peroneal Spastic Flatfoot
Abnormal fusion from calcaneus to navicular or calcaneus to talus
1-2% Incidence
Teens-twenties after recurrent ankle sprains

Question 10

Tarsal Coalition Treatment

Answer 10

Surgery

Disconnect the coalition

Question 11

Clubfoot

Answer 11

Talipes Equinovarus
1/1000
Male
Bilateral 50%
Bones abnormal shape with tight muscles, tendons, and ligaments
Small, weak foot
"Toe In"

Question 12

Positional Club Foot

Answer 12

Normal foot in abnormal position in utero

Bones normal

Question 13

Teratologic Club Foot

Answer 13

Associated with neurological disorders (spina bifida)

Question 14

Syndromic Club Foot

Answer 14

Associated with genetic syndrome (arthrogryposis)

Question 15

Congenital Club Foot

Answer 15

Present at birth
Abnormal bone deformity
Not associated with neuromuscular disorder or syndrome

Question 16

Club Foot Treatments

Answer 16

30% conservative
-Manipulation
-Casting
70% require surgery
-Release ligaments to move bones
-Osteotomy
-Arthrodesis
Positional: Stretch, cast
Syndromic: Surgery with casting beforehand

Question 17

Severs Disease

Answer 17

Apophysitis: inflammation of growth plate
Heel pain
Ages 8-14
Soccer, basketball, track, figure skating

Question 18

Severs Disease Treatment

Answer 18

Rest
Heel cup
OTC orthotics
Shoe changes
Stretch LE - all muscle groups (easy on gastroc/soleus) unloading insertion

Question 19

Genu Varum

Answer 19

Born in varus

Question 20

Genu Valgum

Answer 20

Present age 3-5

Question 21

Blount’s Disease

Answer 21

Tibia Varum

Question 22

Tibial Torsion

Answer 22

Tibia normally externally rotated 20 degrees

Question 23

Osgood Schlatter Disease

Answer 23

Ages 8-14

Question 24

Toddler's Fracture

Answer 24

Age 1-5

Question 25

Toddler's Fracture Treatment

Answer 25

Cast 3-4 weeks

Question 26

Developmental Dysplasia Of The Hip (DDH)

Answer 26

Female

Question 27

Developmental Dysplasia Of The Hip Treatment

Answer 27

Pavlik harness

Question 28

Internal Femoral Torsion

Answer 28

Over age 2

Question 29

Idiopathic Femoral Anteversion

Answer 29

15 degrees anteversion normal

Question 30

Legg-Calves-Perthes Disease

Answer 30

Avascular Necrosis

Question 31

Legg-Calves-Perthes Disease Treatment

Answer 31

Good prognosis: - Age < 6 - <50% head involvement - No stiffness/shortening

Question 32

Slipped Capital Femoral Epiphysis (SCFE)

Answer 32

Limp Hip/Groin pain Age 10-15

Question 33

Cerebral Palsy

Answer 33

Hemiplegic: Diplegic: Quadriplegic:

Question 34

Cerebral Palsy Treatment

Answer 34

Achieve milestones

Question 35

Myelodysplasia

Answer 35

Lumbosacral area