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This document discusses different deformities of the knee joint, including genu varum (bow legs), genu valgum (knock knees), and genu recurvatum (hyperextension of the knee). It focuses on genu varum, describing it as an abnormal divergence of the knees caused by unequal growth of the medial and lateral epiphyseal growth plate. Genu varum is usually physiological in infants but can persist into adulthood due to conditions like rickets, injuries, or arthritis. Treatment options for persistent genu varum include surgical procedures like stapling of the physes, hemi-epiphysodesis, high tibial osteotomy, and Ilizarov's technique.
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Angular deformities around the knee seminar
This document discusses various angular deformities of the knee, including genu varum (bowlegged), genu valgus (knock-kneed), genu recurvatum, and genu procurvatum. It provides details on the causes, presentations, treatments, and assessments of genu varum and genu valgus. For genu varum, treatment may involve observation, bracing, or osteotomy, while genu valgus can be treated with observation, bracing, hemiepiphysiodesis, or osteotomy in more severe cases. Assessments involve measurements like intermalleolar distance and Q angle to evaluate deformities.
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This document discusses lower limb alignment abnormalities and their evaluation and management. It describes genu varum and valgus deformities of the knee as well as coxa vara and valgus deformities of the hip. It outlines how to describe the location of deformities, identify physiological vs pathological knee deformities based on measurements, and evaluate patients presenting with knee deformities. Common causes of pathological deformities are discussed along with associated radiographic findings. Surgical management options including epiphysiodesis for immature patients and osteotomies for mature patients are described for correcting varus and valgus deformities of the knee and hip.
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Physiologic genu varum is normal in infants and young children under 2 years old, as the tight medial capsules from the fetal position gradually stretch out with growth. Bowing becomes most pronounced around 1-2 years when walking begins. The deformity typically improves spontaneously without treatment by age 2-3 years. Pathologic genu varum can be caused by conditions like rickets, Blount's disease, or bone dysplasias. It may require bracing, stretching, or surgery depending on the severity and underlying cause. A thorough history and physical exam including leg alignment, growth, and family history helps determine if the bowing is physiologic or pathological and guides appropriate treatment.
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This document discusses genu valgum (knock knees) and genu varum (bowlegs). It defines the Q angle and normal ranges. Genu valgum can be physiological in children under 4 years old or pathological. Bilateral cases may be due to various conditions while unilateral cases are often due to trauma or injury. Evaluation involves physical exam and x-rays. Treatment depends on age but may include observation, bracing, hemiepiphysiodesis, or osteotomy. Genu varum is also normally physiological initially but becomes pathological after age 2. Causes in children and adults are discussed. Evaluation and treatment methods including bracing and surgery are outlined.
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This document discusses genu varum (bow legs) and provides information on its normal development, differential diagnosis, assessment, and treatment. It notes that genu varum is normal in infants and typically resolves on its own by 18-24 months as the child begins walking. Persistent or worsening bowing after age 2 may indicate an underlying condition. Common causes include physiologic bowing, Blount's disease, rickets, and bone dysplasias. Assessment involves history, exam of limb alignment and growth, and full-length radiographs. Treatment depends on the etiology but may include stretching, bracing, or corrective osteotomy.
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This document discusses genu valgum, or knock knees. It defines the deformity as an outward deviation of the longitudinal axis of the tibia. Genu valgum results in the medial angulation of the knee and external rotation of the femur and tibia. It can be caused by physiological, pathological, traumatic or metabolic factors that create asymmetric growth of the epiphyseal plate. Treatment involves conservative measures like bracing or surgical options like osteotomies if the deformity is severe.
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This document discusses various angular deformities of the knee, including genu varum (bowlegged), genu valgus (knock-kneed), genu recurvatum, and genu procurvatum. It provides details on the causes, presentations, treatments, and assessments of genu varum and genu valgus. For genu varum, treatment may involve observation, bracing, or osteotomy, while genu valgus can be treated with observation, bracing, hemiepiphysiodesis, or osteotomy in more severe cases. Assessments involve measurements like intermalleolar distance and Q angle to evaluate deformities.
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This document discusses lower limb alignment abnormalities and their evaluation and management. It describes genu varum and valgus deformities of the knee as well as coxa vara and valgus deformities of the hip. It outlines how to describe the location of deformities, identify physiological vs pathological knee deformities based on measurements, and evaluate patients presenting with knee deformities. Common causes of pathological deformities are discussed along with associated radiographic findings. Surgical management options including epiphysiodesis for immature patients and osteotomies for mature patients are described for correcting varus and valgus deformities of the knee and hip.
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Physiologic genu varum is normal in infants and young children under 2 years old, as the tight medial capsules from the fetal position gradually stretch out with growth. Bowing becomes most pronounced around 1-2 years when walking begins. The deformity typically improves spontaneously without treatment by age 2-3 years. Pathologic genu varum can be caused by conditions like rickets, Blount's disease, or bone dysplasias. It may require bracing, stretching, or surgery depending on the severity and underlying cause. A thorough history and physical exam including leg alignment, growth, and family history helps determine if the bowing is physiologic or pathological and guides appropriate treatment.
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This document discusses genu varum (bow legs) and provides information on its normal development, differential diagnosis, assessment, and treatment. It notes that genu varum is normal in infants and typically resolves on its own by 18-24 months as the child begins walking. Persistent or worsening bowing after age 2 may indicate an underlying condition. Common causes include physiologic bowing, Blount's disease, rickets, and bone dysplasias. Assessment involves history, exam of limb alignment and growth, and full-length radiographs. Treatment depends on the etiology but may include stretching, bracing, or corrective osteotomy.
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This document discusses genu valgum, or knock knees. It defines the deformity as an outward deviation of the longitudinal axis of the tibia. Genu valgum results in the medial angulation of the knee and external rotation of the femur and tibia. It can be caused by physiological, pathological, traumatic or metabolic factors that create asymmetric growth of the epiphyseal plate. Treatment involves conservative measures like bracing or surgical options like osteotomies if the deformity is severe.
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Genu varum, also known as bow legs, is a physical deformity where the legs curve outward from the thighs. It can occur in children due to normal development or due to conditions like Blount's disease or rickets that affect bone growth. In children, genu varum is often monitored and may resolve on its own, while more severe cases or those caused by underlying diseases may require bracing or surgery to correct alignment and prevent long-term issues. Surgical options aim to stop abnormal bone growth or reshape the shinbone to straighten the legs.
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This document discusses angular deformities of the lower limbs, specifically genu varum (bowlegs) and genu valgum (knock knees). Genu varum can be physiological in infants and young children but may also be caused by conditions like Blount's disease, rickets, or injuries. Treatment depends on the cause but may include observation, bracing, or osteotomies. Genu valgum is also often physiological but can be caused by diseases like rickets. Mild cases are often observed but more severe or progressive cases may require hemiepiphysiodesis or osteotomies to correct alignment. Both conditions are generally assessed clinically and through measurement of limb alignment and deformity angles on
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(1) Genu varum, or bowlegs, is physiologically normal in infants and toddlers as they begin to walk. It typically resolves on its own by age 2-3 years.
(2) Pathological genu varum can be caused by conditions like Blount's disease, rickets, or bone dysplasias. It may involve a sharp angulation below the knee and not improve or get worse with growth.
(3) Evaluation of bowlegs includes a thorough history and physical exam assessing for limb length discrepancy, gait abnormalities, and radiographs to identify the site and characteristics of deformity. Differentiating physiological from pathological bowing guides treatment.
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Genu varum, also known as bow legs, is a physical deformity where the legs curve outward from the thighs. It can occur in children due to normal development or due to conditions like Blount's disease or rickets that affect bone growth. In children, genu varum is often monitored and may resolve on its own, while more severe cases or those caused by underlying diseases may require bracing or surgery to correct alignment and prevent long-term issues. Surgical options aim to stop abnormal bone growth or reshape the shinbone to straighten the legs.
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A 3-year-old girl presented with a limp in her right leg and was diagnosed with coxa vara. Coxa vara is a decrease in the angle between the femoral neck and shaft to less than 120 degrees. It can be congenital, developmental, or secondary to other bone diseases. Surgical management involves subtrochanteric osteotomy to correct the angle, which is fixed internally with plates or screws. Postoperative care includes casting for 8-12 weeks until radiographic healing is seen. Complications can include recurrence, physeal injury, or leg length discrepancy.
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This document discusses angular deformities of the lower limbs, specifically genu varum (bowlegs) and genu valgum (knock knees). Genu varum can be physiological in infants and young children but may also be caused by conditions like Blount's disease, rickets, or injuries. Treatment depends on the cause but may include observation, bracing, or osteotomies. Genu valgum is also often physiological but can be caused by diseases like rickets. Mild cases are often observed but more severe or progressive cases may require hemiepiphysiodesis or osteotomies to correct alignment. Both conditions are generally assessed clinically and through measurement of limb alignment and deformity angles on
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This document provides an outline and overview of paediatric orthopaedics, focusing on congenital talipes equino varus (clubfoot). It defines clubfoot as an idiopathic condition causing cavus, adductus, varus, and equinus deformities. It discusses the epidemiology, potential causes, anatomical abnormalities, clinical features, imaging, and main treatment approach of serial casting developed by Ponseti. The goal of treatment is to produce a plantigrade, supple foot through gradual correction of the deformities.
Blounts disease
Blount's disease, also known as tibia vara, is a progressive orthopedic condition that causes bowing of the legs in children. It results from a growth disturbance in the proximal medial tibial growth plate. The deformity includes varus alignment of the knees, internal tibial torsion, and leg length discrepancy. Radiographs show a characteristic wedging and irregularity of the proximal medial tibial epiphysis. Treatment depends on age and severity, ranging from bracing to corrective osteotomies. Congenital metatarsus adductus is another common pediatric foot deformity involving inward twisting of the forefoot. It is often mild and resolves with stretching, but more severe cases may require
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This document discusses clubfoot (congenital talipes equinovarus), a common birth defect where the foot is twisted into an abnormal position. It defines the condition and notes the most common type involves an elevated heel (equinus) and inwardly turned foot (varus). Potential causes are discussed like family history or issues during pregnancy. Diagnosis involves examination of the feet and ruling out other conditions. Treatment typically begins at birth and involves stretching and casting or surgery to gradually correct the position, often followed by bracing.
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This document discusses genu valgum (knock knees), including symptoms, factors to evaluate, investigations needed, and the procedure for temporary hemiepiphysiodesis of the growth plate to correct the deformity. It notes that knock knees can cause knee pain, difficulty running, patellar instability, and falls. History of trauma is important to identify post-traumatic tibia valga. Measurements like Q angle and intermalleolar distance can quantify the deformity. X-rays can show the mechanical axis and lab tests may be needed. The procedure involves making a small incision, inserting guide pins into the physis, predrilling, and inserting cannulated screws to tether the growth plate during
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Congenital club foot is a rigid deformity present at birth characterized by equinus, hind foot varus, midfoot cavus, and forefoot adduction. It has multiple potential etiologies including genetic and environmental factors. Pathoanatomically, there is rotatory subluxation of the talocalcaneonavicular joint complex with talus plantarflexion and hind foot inversion. Higher Pirani scores, which assess midfoot and hindfoot contractures, are associated with greater treatment challenges including more casts and higher rates of tendon release procedures. Imaging can help evaluate severity and assess for atypical or syndromic cases.
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Clubfoot is a birth defect where one or both feet are twisted into an abnormal position. It is caused by genetic and environmental factors and affects males more than females. Treatment involves stretching the feet into correct position with casting or taping and bracing to maintain correction. Parents are taught exercises and bracing is worn long-term to prevent recurrence. Nursing focuses on monitoring for skin issues from casting, teaching parents exercises and brace use, and supporting the child's development.
Blounts disease
Blount's disease is a developmental condition characterized by a disturbance of orderly bone growth in the upper tibia. This results in a varus deformity of the knee. It is more common in obese children who start walking early and has been linked to hereditary factors. Radiographs show a widened growth plate medially with beaking of the metaphysis. Treatment depends on age and severity but may include bracing, corrective osteotomies, or hemiepiphysiodesis in more severe cases. Complications can include recurrence of deformity or nerve palsies. Proper treatment can prevent long term osteoarthritis.
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This document provides information on congenital clubfoot and developmental dysplasia of the hip. It discusses the etiology, signs and symptoms, treatment options including serial casting, bracing and surgery. Treatment is aimed at correcting deformities early in infancy through gentle manipulation and casting. Extended monitoring is needed to prevent recurrence. Hip dysplasia treatment focuses on maintaining the femoral head in the acetabulum through bracing or casting. Surgery may be required in older children to correct bony deformities of the hip and pelvis.
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This document provides information on examining the foot, including anatomical features, common deformities, and examination techniques. It describes examining the child's foot for clubfoot and conditions like varus of the heel. Common mature foot issues are explored, such as hallux valgus, pes planus, claw toes, and hammer toes. Examination of movements, classifications of foot deformities, and specific conditions like flat foot are covered. Surgery for hallux valgus is also discussed.
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This document discusses angular limb deformities in horses. It covers the causes of angular limb deformities including uneven physeal growth and abnormal bone development. It describes the process of endochondral ossification and growth plate closure. Angular limb deformities are most commonly caused by static compression of the growth plate. Diagnosis involves visual examination, flexion of the limb, active movement examination, and radiography. Treatment depends on the underlying cause but may include stall rest, splinting, controlled exercise, and farrier techniques to guide physeal growth.
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Congenital talipes equino varus (CTEV), also known as clubfoot, is a congenital deformity of the foot where the foot is twisted inward and downward. The causes are mostly unknown but may be genetic, mechanical pressure in the womb, or issues with calf muscle development. Clinically, the foot appears smaller, turned inward and downward. Treatment depends on severity but may include manipulation, casting, soft tissue releases, tendon transfers and osteotomies. Splint
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- 2. Anatomy of knee joint
- 3. Deformities of knee joint Genu varum (bow legs) Genu valgum (knock knees) Genu recurvatum (hyperextension of knee)
- 5. Genu varum Definition: Condition where the knees are abnormally divergent and ankles abnormally approximated. Etiopathogenesis: unequal growth of the medial and lateral side of the epiphyseal growth plate
- 6. Physiological genu varum and genu valgum Genu varum occurs normally in infants. Degree of varus decreases till 18 – 24 months when the lower limb becomes almost straight Thenafter, genu valgus starts appearing, intensifies reaching its peak by about 4 years and then starts decreasing and by about 7 yrs it gets stabilized with residual valgus of about 5-7 degrees. Genu varum may occur in adults if this physiological varus fails to correct spontaneously. Exact cause of physiological genu varum is unknown
- 8. Other causes - Rickets - Blount’s disease - Injuries to epiphyseal growth cartilage - Osteoarthritis > rheumatoid arthritis - Ligament injuries - Malunited fractures - Paget’s disease of bone
- 9. Clinical features Patient usually consults because of cosmetic problem Usually bilateral If associated with joint instability can lead to osteoarthritis of medial compartment of knee (pain and stiffness) Severity measurement: intercondylar distance
- 10. Investigations Deformity is obvious from external appearance Radiograph : to differentiate physiological genu varum from from rickets, trauma, infection or Blount’s disease.
- 12. Treatment
- 14. Surgery: Stapling of the physes Hemi-epiphysodesis High tibial osteotomy Ilizarov’s technique plating
- 15. Thank you