3.3 - peds orthopedics 1

• 0-18 months = varus

• 18-30 months = straight

• 3-4 years = valgus

• 8-10 years = straight

describe the lower extremity bony alignment development from 0 months to 10 years

1-7

linear correlation in development of gait:

step length to leg length is _________ years

1-4

linear correlation in development of gait:

step length to age is ____________ years

7 years

linear correlation in development of gait:

walking velocity increases through _________ years

decreases; 1-2

linear correlation in development of gait:

cadence (decreases or increases) with age, ________ years is biggest change

• flexion, abduction, femoral anteversion

• genu varum

• eversion

0-9 months old:

• what position is the hip in?

• what position is the knee in?

• what position is the calcaneus in?

8-9 months

at _________ months, there is better flexion/extension, cruising, and standing

40; 15-20

we are born with about ________ degrees of anteversion and overtime/weight bearing brings it to ________

• flexion, abduction, slight ER

• IR and varus

• eversion

• thoracic

9-15 months:

• what position is the hip in?

• what position is the tibia in?

• what position is the calcaneus in?

• where is the COM?

extensor

at 9-15 months, the __________ muscles are still underdeveloped which affects their single leg stance which limits their walking speed

24 months

what age should a child begin to heel strike

valgus; neutral

at 3-3.5 years the knees are in a __________ position and the calcaneus is in a __________ position

7 years

postural control matures at age __________

10-12 years

vision, vestibular, proprioception matures at age __________

• neutral

• neutral

• L3

6-7 years:

• what position is the tibia/femor in?

• what position is the calcaneus in?

• where is the COM?

6-7 years (minimal changes occur in the future after this age)

what age does the child develop a “mature gait”

soft moccasin or barefoot

what type of shoe does Dr. Buck suggest children wear

negative

is in toeing negative or positive degrees

• mild = -5 - -10

• moderate = -10 - -15

• sever = > -15

degrees of in toeing:

• mild =

• moderate =

• sever =

more than -15

if a child is dragging their toe during gait via toe in, we can assume they have _________ degrees of toe in

out; 10 (norm range is -3 to +20)

it is normal to have (toe in or out) about ___________ degrees

positive

is out toeing negative or positive degrees

-3 to +20

what is the normal range of out toeing

anteversion

femoral ___________

retroversion

femoral ___________

anteversion

femoral anteversion or retroversion:

too much internal rotation

retroversion

femoral anteversion or retroversion:

too much external rotation

anteversion

femoral anteversion or retroversion:

more at risk for posterior dislocation

retroversion

femoral anteversion or retroversion:

more at risk for pain and arthritis

anteversion

femoral anteversion or retroversion:

more common

• craigs

• ryder test

• ROM

what are the options to measure femoral anteversion/retroversion

4 years

if genu varum is present after __________ age, start considering that there may be a disease

varum (bowing)

genu ___________ could lead to rickets or blounts

valgus

genu _________ can lead to knee pain and patellofemoral instability

10

it is normal to have _______ degrees of tibial torsion

-; +

when measuring tibial torsion, internal degrees are (- or +) and external degrees are (- or +)

internal

internal or external tibial torsion:

most resolve

internal

internal or external tibial torsion:

treat with bracing (not always effective tho)

internal

internal or external tibial torsion:

may actually help with sprinting sports

external

internal or external tibial torsion:

predisposes of osgood-schlatter syndrome

9

more than ______ degrees of external tibial torsion predisposes someone for osteoarthritis

8 (all the slide says is 8… I’m guessing either degrees or age?)

both internal and external tibial rotation need surgery after _______

between 2-3 toes

in a normal foot, where does the midline pass

4

if the child is ________ years old or more, casting and surgery are possible interventions for metatarsus adductus

1

grade _________ metatarsus adductus:

mild, flexible, can correct beyond midline

2

grade _________ metatarsus adductus:

moderate, can correct to midline, stretching and shoes

3

grade _________ metatarsus adductus:

severe, cannot correct to midline

observational gait scale (OGS)

the _______________ assessment tool measures the amount of change in an individual’s gait pattern over time