Pediatric Ortho/Surg Rehab of the Lower Extremity

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Author:
dmshaw9
ID:
242388
Filename:
Pediatric Ortho/Surg Rehab of the Lower Extremity
Updated:
2014-02-13 10:59:03
Tags:
Ped Ortho Surg Rehab LE
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MS1
Description:
MS1
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  1. Coxa valga vs. coxa vara
    • Coxa Valga: >135 degrees 
    • Coxa Vara: <120 degrees
  2. SLR
    • 100 @ birth
    • 110 @ 12 months
    • 80 @ 5-6 years
  3. Popliteal angle
    • 180: birth - 24 months
    • -24: 6 years
    • -40: significant tightness
  4. Touching Toes
    • 1+/-3cm
    • <-5cm under 6
    • <-15 cm older 6, significant tightness
  5. Pelvic Osteotomies
    • Chiari Pelvic Osteotomy
    • Salter Innominate Osteotomy
    • Steele Triple Osteotomy
  6. Femoral Osteotomies: Indications
    • Restore congruency of dysplastic hip
    • Decrease pain
    • Place stress on area of healthier cartilage 

    (Typically no improvements in ROM)
  7. Tibial Osteotomies: Types and Indications
    • Close Wedge Osteotomy
    • Open Wedge Osteotomy

    • Indications:
    • →Genu valgum/varus
    • →Blount's disease
    • →Pain 

    Complications: nonunion
  8. Proximal Femoral Derotational Osteotomy: Indications
    • Excessive femoral anteversion
    • Coxa valga
    • Improve gait
    • Increase hip ER and extension
    • Increase knee extension
  9. Distal Femoral Varus Osteotomy: Indications
    • Lateral compartiment OA/RA of knee
    • Correction of genu valgus associated w/ tibiofemoral angle ≥ and narrowing of lateral joint space
    • Patellofemoral pain
    • Improve function
  10. Limb Lengthening: Complications
    • Infection
    • Nerve damage
    • Reconsolidation
    • Fracture
    • Pain
    • Dislocation
    • Limited functional mobility
    • Stress on family
    • Management of the fixator
  11. Ankle/Foot Fusions: Indications
    Hyper/hypomobile joints causing increased pain

    Typically not performed until teen years
  12. Tenotomies: Indications
    • Prevent further subluxation or dislocation of the joint
    • To balance forces around the joint to allow normal development
    • To improve ROM/improve function
  13. Ankle Tenotomies: Indications
    • Tight heel cord
    • Neurogenic
    • Club foot
    • Immobility
  14. Muscle Transfers: Indications
    • Balance foot
    • Improve control/gait
    • Improve function

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