Lower Limb Dx

Question 1

Blounts Disease

Answer 1

• Growth disturbance proximal/medial tibia, genu varum/internal rotation of tibia
• Treat: KAFO (nocturnal and daytime), surgery (rotation osteotomies)

Question 2

Arthrogryposis

Answer 2

• Wooden doll appearance, sensation is intact, limbs look cylindrical, joint rigidity, flex/ext deformities, club foot, possible seizures (CNS)
• overall goal is to Maintain ROM

Question 3

Osteogenesis Imperfect

Answer 3

-Bone development growth, not ideal due to collagen defect.
-Goal: prevent, or manage Fractures
Treatment: PT, Fracture bracing, Spinal bracing

Question 4

Legg-Calve Perthes

Answer 4

• Avascular necrosis of the hip or coxa plana (flat hip)

- Ox treatment: Scottish-Rite, Trilateral socket, Toronto, Newington, Petrie Casts. All prevent hip SUBLUXATION

Question 5

Congenital Hip Dysplasia

Answer 5

• 2 types: Teratologic dislocation (2%), Typical CHD (dislocation, subluxation, hip joint laxity, abnormal development)
• Treatment: Frejka Pillow, Pavlik Harness, Von Rosen, Ilfeld, polypro abduction, plaster hip spica

Question 6

Spina Bifida

Answer 6

-development defect, failed fusion between vertebral arches, dysplasia of the spinal cord and its membranes
-Ox goal: promote efficient independent mobility with least amount of bracing and prevent deformities
Treatment: Thoracic/High lumbar (Standing Frame, parapodium, RGO, HKAFO), Low Lumbar (KAFO, SAFO, Ground Reaction AFO), High Sacaral (AFO), Low Sacaral (AFO, SMO, Insert)

Question 7

Talipes Equinovarus

Answer 7

Clubfoot
-Combo of deformities: FF Adduction, Midtarsal Jt supination, equinus at ankle, medial deviation at foot.
Ox Treatment: Dennis Brown Bar, Ponsetti (no AFO due to limiting of muscles), used after serial casting

Question 8

Cerebral Palsy

Answer 8

• a disorder of movment and posture due to non progressive lesion or injury to an immature brain
• leading cause of childhood disability
• Ox Treatment: AFO, SMO, SWASH, WHO, Hand splint, body jacket, TLSO (large range of needs)