T he O rthopedic E valuation of T he C hild 06/02/2007
The Orthopedic History The chief complain. History of present illness. Birth history. Family history. Growth and development.
Growth and Development
Normal Control Progress
Gross Motor Skills
Head-to-Trunk Proportion
Secondary centers of ossification
The Tanner ’ s Stages of Development
General Principles Inspection ( Angular deformities, Skin lesions … ) Joints Range of Motion. Grading of Muscle Strength. Developmental Reflexes.
The Neck
Range of Motion
The Muscular Torticollis
Klippel-Feil Syndrome
The Shoulder
Range of Motion
X-ray Examination Birth – 3 m. 6 – 18 m.
Neonatal Brachial Plexus Palsy
Congenital High Scapula (Sprengel ’ s deformity)
CONGENITAL PSEUDARTHROSIS OF CLAVICLE
The Elbow
Range of Motion
The Carrying Angle - 15 degrees in the newborn degrees in adults
X-ray Examination CRITOE
X-ray Examination
Congenital Radial Head Dislocation
Arthrogryposis Larsen ’ s syn. E.D. syn.
The Hand
X-ray Examination
Madelung Deformity
Polydactyly
Syndactyly
Macrodactyly
The Spine
Inspection Scoliosis Adams forward bending test
Inspection - Kyphosis
Radiographic Evaluation
Risser Sign
The Hip
DDH – The Newborn Barlow – Ortolani
DDH – The Infant Limited Abduction
Galeazzi Sign Asymmetry of the Thigh Folds DDH – The Infant
Klisic Sign
Contractures
Signe du tr é pied
Contractures Ely Test
Contractures
Thomas Test
Contractures Patrick Test
X-ray Examination
Craig Test
X-ray Examination – DDH
X-Ray Examination - SCFE Klein ’ s line
X-ray Examination – Coxa-Vara
The Knee and Leg
Normal Knee Development
Internal Tibial Torsion
X-ray Examination
Blount ’ s Disease
Rickets
Congenital Dislocation
Osgood - Schlatter
Osteochondritis Dissecans
The Foot
X-ray Examination
Metatarsus Adductus
Talipes Calcaneovalgus
Flexible Flatfoot
Cavus Foot
Meary ’ s angle Hibbs ’ s angle
Talipes Equinovarus
Vertical Talus
Clubfoot Vertical Talus Cavus Foot Flatfoot
The Gait Analysis
The Gait Cycle
Special Consideration Based on Age Group - Wide based gait. - Increased hip, knee flexion. - Increased cadence. 1 – 3 years - Stable velocity: 5 y. - Adult gait pattern: 7y. 4 – 10 years
Intoeing
Toe-walker Idiopathic (the most common). Spastic.
The Limping Child Adolescent 11 – 15 y. Child 4 – 10 y. Toddler 1 – 3 y. - SCFE. - Hip dysplasia. - Chondrolysis. - Overuse syndromes. - Osteochondritis Dissecans. - Transient synovitis. - Septic arthritis. - LCP disease. - Discoid meniscus. - Limb length discrepancy. - Transient synovitis. - Septic arthritis. - Diskitis. - Fractures. - DDH. - Coxa-Vara. - Limb length discrepancy. - Cerebral palsy.
Abnormal Gait Patterns T rendelenburg Gait
Abnormal Gait Patterns Proximal muscle weakness Gower ’ s Sign
Thank You
MoKazem.com هذه المحاضرة هي من سلسلة محاضرات تم إعدادها و تقديمها من قبل الأطباء المقيمين في شعبة الجراحة العظمية في مشفى دمشق, تحت إشراف د. بشار ميرعلي. الموقع غير مسؤول عن الأخطاء الواردة في هذه المحاضرة. This lecture is one of a series of lectures were prepared and presented by residents in the department of orthopedics in Damascus hospital, under the supervision of Dr. Bashar Mirali. This site is not responsible of any mistake may exist in this lecture. د. مؤيد كاظمDr. Muayad Kadhim