4th-5th IMA
Normal = 7 degrees High = 8-10 degrees
5th metatarsal lateral deviation angle
Bisection of 5th metatarsal head and neck compared to medial cortical margin of proximal shaft
Normal = 3 degrees High = 8 degrees
Osteochondrosis
AKA Epiphyseal ischemic necrosis
- A disease of the growth or ossification center in children, which begins as a degeneration or necrosis and is followed by regeneration or recalcification
Blount’s disease
Osteochondrosis of medial proximal epiphyseal ossification center of the tibia
This can cause limping and lateral bowing of the leg
Infantile type
Adolescent type
Freiberg’s infarction
Osteochondrosis of the metatarsal head - most commonly 2nd (followed by 3rd, 4th and 5th)
Kohler disease
Osteochondrosis of the navicular
Legg-Calve-Perthes disease
Osteochondrosis of femoral head (most common osteochondrosis)
Osgood Schlatter disease
Osteochondrosis of tibial tuberosity
Sever’s disease
Osteochondrosis of the calcaneal apophysis
Islin’s disease
Osteochondrosis of 5th metatarsal base
Treve’s disease
Osteochondrosis of fibular sesamoid
Renandier’s disease
Osteochondrosis of tibial sesamoid
Lance’s disease
Osteochondrosis of the cuboid
Assmann’s disease
Osteochondrosis of the 1st met head
Ortolani’s sign
The hip is already out
With baby supine, hips and knees are flexed to 90 degrees, grasp thigh with middle finger over greater trochanter, lift and abduct thigh
If there is a palpable click, the test is positive, as the femoral head was out and the click was felt as it was relocated into the acetabulum
Barlow’s sign
Dislocatable hips
With baby supine, hips and knees are flexed, thumb placed on greater trochanter laterally, apply pressure down and lateral
The dislocatable hip becomes displaced with a palpable clunk as the head slips over the posterior acetabulum
Club foot (3 deformities)
Talipes equinovarus
Radiographic angles in club foot
Kite’s ankle low
Calcaneal inclination low
Talar head/neck to body adduction high
Talar head to body plantarflexion high
Reduction of clubfoot deformity should be performed in the following order:
AVE “clubfoot AVEnue”
Congenital vertical talus
Treatment
- Surgical reduction of TN joint and posterior release
Evans
Calcaneal opening wedge osteotomy 1.5 cm proximal to CC joint
Kidner
Hoke