Pediatric Ortho/Surg Rehab of the Lower Extremity

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Coxa valga vs. coxa vara
- Coxa Valga: >135 degrees
- Coxa Vara: <120 degrees
SLR
- 100 @ birth
- 110 @ 12 months
- 80 @ 5-6 years
Popliteal angle
- 180: birth - 24 months
- -24: 6 years
- -40: significant tightness
Touching Toes
- 1+/-3cm
- <-5cm under 6
- <-15 cm older 6, significant tightness
Pelvic Osteotomies
- Chiari Pelvic Osteotomy
- Salter Innominate Osteotomy
- Steele Triple Osteotomy
Femoral Osteotomies: Indications
- Restore congruency of dysplastic hip
- Decrease pain
- Place stress on area of healthier cartilage
(Typically no improvements in ROM)
Tibial Osteotomies: Types and Indications
- Close Wedge Osteotomy
- Open Wedge Osteotomy
- Indications:
- →Genu valgum/varus
- →Blount's disease
- →Pain
Complications: nonunion
Proximal Femoral Derotational Osteotomy: Indications
- Excessive femoral anteversion
- Coxa valga
- Improve gait
- Increase hip ER and extension
- Increase knee extension
Distal Femoral Varus Osteotomy: Indications
- Lateral compartiment OA/RA of knee
- Correction of genu valgus associated w/ tibiofemoral angle ≥ and narrowing of lateral joint space
- Patellofemoral pain
- Improve function
Limb Lengthening: Complications
- Infection
- Nerve damage
- Reconsolidation
- Fracture
- Pain
- Dislocation
- Limited functional mobility
- Stress on family
- Management of the fixator
Ankle/Foot Fusions: Indications

Hyper/hypomobile joints causing increased pain

Typically not performed until teen years
Tenotomies: Indications
- Prevent further subluxation or dislocation of the joint
- To balance forces around the joint to allow normal development
- To improve ROM/improve function
Ankle Tenotomies: Indications
- Tight heel cord
- Neurogenic
- Club foot
- Immobility
Muscle Transfers: Indications
- Balance foot
- Improve control/gait
- Improve function

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dmshaw9

242388

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Pediatric Ortho/Surg Rehab of the Lower Extremity

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MS1

Updated

2014-02-13T15:59:03Z

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