1. Epidemiology Congenital metatarsus varus 1/1000 live birth Common
Male=female
1-5% together with CDH
Single or with other deformity(club foot)

2. Types
Mild corection +overcorection moderate only corection sever no corection & medial tranvers crease& 1th 2th web space widening

6. Xray

7. } TREATMENT Mild no treatment MODERATE SEVER
Stretching & cast weaks

10. Club foot
Congenital talipes equinovarus deformity

11. 1/1000 live births Male>female 50% bilateral Genetic
epidemiology
1/1000 live births
Male>female
50% bilateral
Genetic
autozomal dominant

12. Etiology 1-Primary germ plasm dis of talonavicular
Secondary soft tissue changes
2-soft tissue

13. Clinical findings 1 -hypotrophy of Tibialis anterior?
2-internal tibial tortion
3-./5-1cm small involved foot
4-heel varus&equinus&adduction of forfoot

18. Types
Flexible
rigid

19. pathology

20. Xray AP LATERAL FORCED DORSIFLEXION AP STANDING LATERAL SRANDING
در بچه ها يي
كه راه نميروند
AP STANDING
LATERAL SRANDING
دربچه هايي كه
راه ميروند

23. TREATMENT 6 weaks 1-NON SURGICAL Manipulation Serial cast
A-adduction B-varus C-equinus
15%-80% ankle foot orthosis
6 weaks

24. SURGICAL 1-TURCO postero medial release درموارد خفيف
2-Mcky posterolaterral relea
در موارد شديد
10-12 weaks cast
در كمتر از 2 سال

25. 5-فيوژن كال كا نئو كو بوئيد
2-12 سال
1- تطويل آشيل
2-آزاد كردن مديال
3-استئوتومي كال كا نئوم
4-انتقال
5-فيوژن كال كا نئو كو بوئيد TA

26. >12 YEARS
TRIPLE ARTHRODESIS

33. 1- displasic 2-subluxation 3- dislocation types
Congenital hip displasia
types
1- displasic
2-subluxation
3- dislocation

34. Developmental
Dyplasia of
The hip
DDH
CDH

35. Spectrum of disorders of development of the hip
That present in different forms at different ages

36. Epidemiology 1-1/1000 live births 2-female.>male 5times
3-left>right
4-bilateral>right
5-first birth>other
6-breech delivry>
7-family history +
10%
8-whites>black

37. Etilogy 1-Ligament laxity 2-mechanical (breech ) 3-genetic 70%
4-enviromental

38. بيماري همراه 1- torticoli 2- metatarsus adductus
3-talipes calcaneovalgus

39. Clinical findings 1- skin fold 2-barllo 3-ortolani 4-Allis sign
5- limitation of adduction
6-telescoping
7-telendelenburg
8-waddling gait
9-lumbar lordosis
10-widening of prinum(bilateral CDH)

46. Radiography AP PELVIS SONOGRAPHY Acetabular index 30digree Hilgenriner
CE angle
Shenton line
Perkins line AP
PELVIS
SONOGRAPHY

49. treatment

50. 0-6 mounth
Pavlic harnes

51. 6-18 MOUNTH Traction Adductor tenotomy Close reduction Arthrography
Open reduction may be necesary

53. 18-36 mounth Open reduction Pelvus osteotomy OR femoral osteotomy
OR both

59. 3-8 years FOR AVN Femoral shortening Open reduction Adductor tenotomy
DECREASE
AVN
&
REDISLOCATION
Femoral shortening
Open reduction
Adductor tenotomy
Pelvis osteotomy

60. >8 YEARS Bilateral Unilateral open reduction femoral shortening
pelvic osteotommy
no arthrodesis
Bilateral
no treatment (total hip replacement in
future