Feet turn in Feet turn out Who Cares?!?! · 2016. 8. 25. · Trigger thumbs . Flat feet 80% of 2yr...
Transcript of Feet turn in Feet turn out Who Cares?!?! · 2016. 8. 25. · Trigger thumbs . Flat feet 80% of 2yr...
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Feet turn in
Feet turn out
Who Cares?!?! Andrew Graydon
Starship Childrens’ Hospital Eastwood Orthopaedic Clinic
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Why Paeds Ortho?..
30% of GP visits are for children
40% of GP visits are for musculoskeletal complaints
Children are challenging
Parents can be even more challenging!!...
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Staying out of trouble...
Flat feet
Intoeing
Curly toes
Trigger thumbs
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Flat feet
80% of 2yr olds have flat feet
20% of 8yr olds have flat feet
For most kids it is NORMAL
Which ones are not normal?..
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Congenital Vertical Talus
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Tarsal coalition
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Take home points
Painless flexible flat feet are OK
Painless rigid flat feet are probably OK but should be referred for discussion
Painful flexible flat feet are probably OK but should be referred for orthotics and possibly surgery
Painful rigid flat feet should be referred for surgery
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Intoeing
Physiologic change in lower limb alignment
Intoeing is usually due to;
Femoral anteversion
Internal tibial torsion
Metatarsus adductus
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Femoral anteversion
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Internal tibial torsion
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Metatarsus adductus
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Curly toes
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Curly toes
Usually stretch out with growth and weight
If still present and problematic by age 4 look at
correction
Toenail deformities and/or infections are an indication
to intervene
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Trigger thumb
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Trigger thumb treatment
Can resolve spontaneously
Splinting is controversial and difficult for parents
Surgical treatment consists of simple A1 pulley release
Provided correction prior to age 4, thumb function will be normal long term