Pediatric Ortho/Surg Rehab of the Lower Extremity

• Coxa Valga: >135 degrees 
• Coxa Vara: <120 degrees

• 100 @ birth
• 110 @ 12 months
• 80 @ 5-6 years

• 180: birth - 24 months
• -24: 6 years
• -40: significant tightness

• 1+/-3cm
• <-5cm under 6
• <-15 cm older 6, significant tightness

• Chiari Pelvic Osteotomy
• Salter Innominate Osteotomy
• Steele Triple Osteotomy

• Restore congruency of dysplastic hip
• Decrease pain
• Place stress on area of healthier cartilage 

(Typically no improvements in ROM)

• Close Wedge Osteotomy
• Open Wedge Osteotomy

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

Complications: nonunion

• Excessive femoral anteversion
• Coxa valga
• Improve gait
• Increase hip ER and extension
• Increase knee extension

• Lateral compartiment OA/RA of knee
• Correction of genu valgus associated w/ tibiofemoral angle ≥ and narrowing of lateral joint space
• Patellofemoral pain
• Improve function

• Infection
• Nerve damage
• Reconsolidation
• Fracture
• Pain
• Dislocation
• Limited functional mobility
• Stress on family
• Management of the fixator

Hyper/hypomobile joints causing increased pain

Typically not performed until teen years

• Prevent further subluxation or dislocation of the joint
• To balance forces around the joint to allow normal development
• To improve ROM/improve function

• Tight heel cord
• Neurogenic
• Club foot
• Immobility

• Balance foot
• Improve control/gait
• Improve function