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T he O rthopedic E valuation of T he C hild 06/02/2007.

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Presentation on theme: "T he O rthopedic E valuation of T he C hild 06/02/2007."— Presentation transcript:

1 T he O rthopedic E valuation of T he C hild 06/02/2007

2 The Orthopedic History The chief complain. History of present illness. Birth history. Family history. Growth and development.

3 Growth and Development

4 Normal Control Progress

5 Gross Motor Skills

6 Head-to-Trunk Proportion

7 Secondary centers of ossification

8

9 The Tanner ’ s Stages of Development

10 General Principles Inspection ( Angular deformities, Skin lesions … ) Joints Range of Motion. Grading of Muscle Strength. Developmental Reflexes.

11

12 The Neck

13 Range of Motion

14 The Muscular Torticollis

15 Klippel-Feil Syndrome

16 The Shoulder

17 Range of Motion

18 X-ray Examination Birth – 3 m. 6 – 18 m.

19 Neonatal Brachial Plexus Palsy

20 Congenital High Scapula (Sprengel ’ s deformity)

21 CONGENITAL PSEUDARTHROSIS OF CLAVICLE

22 The Elbow

23 Range of Motion

24 The Carrying Angle - 15 degrees in the newborn - 17.8 degrees in adults

25 X-ray Examination CRITOE

26 X-ray Examination

27

28 Congenital Radial Head Dislocation

29 Arthrogryposis Larsen ’ s syn. E.D. syn.

30 The Hand

31 X-ray Examination

32 Madelung Deformity

33 Polydactyly

34 Syndactyly

35 Macrodactyly

36

37 The Spine

38 Inspection Scoliosis Adams forward bending test

39 Inspection - Kyphosis

40 Radiographic Evaluation

41 Risser Sign

42

43 The Hip

44 DDH – The Newborn Barlow – Ortolani

45 DDH – The Infant Limited Abduction

46 Galeazzi Sign Asymmetry of the Thigh Folds DDH – The Infant

47 Klisic Sign

48 Contractures

49 Signe du tr é pied

50 Contractures Ely Test

51 Contractures

52

53 Thomas Test

54 Contractures Patrick Test

55 X-ray Examination

56

57 Craig Test

58 X-ray Examination – DDH

59 X-Ray Examination - SCFE Klein ’ s line

60 X-ray Examination – Coxa-Vara

61

62 The Knee and Leg

63 Normal Knee Development

64

65 Internal Tibial Torsion

66 X-ray Examination

67 Blount ’ s Disease

68 Rickets

69 Congenital Dislocation

70 Osgood - Schlatter

71 Osteochondritis Dissecans

72 The Foot

73 X-ray Examination

74 Metatarsus Adductus

75

76 Talipes Calcaneovalgus

77 Flexible Flatfoot

78

79

80 Cavus Foot

81 Meary ’ s angle Hibbs ’ s angle

82 Talipes Equinovarus

83

84 Vertical Talus

85

86 Clubfoot Vertical Talus Cavus Foot Flatfoot

87

88 The Gait Analysis

89 The Gait Cycle

90 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

91 Intoeing

92

93 Toe-walker Idiopathic (the most common). Spastic.

94 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.

95 Abnormal Gait Patterns T rendelenburg Gait

96 Abnormal Gait Patterns Proximal muscle weakness Gower ’ s Sign

97 Thank You

98 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


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