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The Orthopedic Evaluation of The Child
06/02/2007
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The Orthopedic History
The chief complain. History of present illness. Birth history. Family history. Growth and development.
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Growth and Development
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Normal Control Progress
HEAD
HANDS
LEGS
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Gross Motor Skills
3 m. Holds head
6 m. Sits with support
9 m. Stands with support
12 m. Walks with support
18 m. Ascends stairs
3 yrs. Pedals tricycle
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Head-to-Trunk Proportion
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Secondary centers of ossification
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Secondary centers of ossification
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The Tanner’s Stages of Development
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General Principles
Inspection (Angular deformities, Skin lesions…)
Joints Range of Motion.
Grading of Muscle Strength.
Developmental Reflexes.
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The Muscular Torticollis
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Klippel-Feil Syndrome
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X-ray Examination
Birth – 3 m.
6 – 18 m.
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Neonatal Brachial Plexus Palsy
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Congenital High Scapula(Sprengel’s deformity)
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CONGENITAL PSEUDARTHROSIS OF CLAVICLE
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The Carrying Angle
- 15 degrees in the newborn- 17.8 degrees in adults
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X-ray Examination CRITOE
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X-ray Examination
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X-ray Examination
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Congenital Radial Head Dislocation
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Congenital Radial Head Dislocation
Arthrogryposis Larsen’s syn. E.D. syn.
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X-ray Examination
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Madelung Deformity
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InspectionScoliosis
Adams forward bending test
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Inspection - Kyphosis
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Radiographic Evaluation
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DDH – The Newborn
Barlow – Ortolani
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DDH – The Infant
Limited Abduction
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Galeazzi SignAsymmetry of the Thigh Folds
DDH – The Infant
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DDH – The InfantKlisic Sign
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Contractures
Signe du trépied
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Contractures
Ely Test
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Contractures
Thomas Test
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Contractures
Patrick Test
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X-ray Examination
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X-ray Examination
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X-ray Examination
Craig Test
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X-ray Examination – DDH
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X-Ray Examination - SCFE
Klein’s line
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X-ray Examination – Coxa-Vara
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Normal Knee Development
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Normal Knee Development
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Internal Tibial Torsion
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X-ray Examination
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Congenital Dislocation
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Osgood - Schlatter
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Osteochondritis Dissecans
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X-ray Examination
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Metatarsus Adductus
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Metatarsus Adductus
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Talipes Calcaneovalgus
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Flexible Flatfoot
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Flexible Flatfoot
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Flexible Flatfoot
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Cavus Foot
Meary’s angleHibbs’s angle
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Talipes Equinovarus
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Talipes Equinovarus
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Clubfoot
VerticalTalus
Cavus Foot
Flatfoot
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The Gait Analysis
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Special Consideration Based on Age Group
1 – 3 years
-Wide based gait.-Increased hip, knee flexion.-Increased cadence.
4 – 10 years-Stable velocity: 5 y.-Adult gait pattern: 7y.
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Toe-walker
Idiopathic (the most common).
Spastic.
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The Limping ChildToddler
1 – 3 y.Child
4 – 10 y.Adolescent
11 – 15 y.
-Transient synovitis.-Septic arthritis.-Diskitis.-Fractures.
-DDH.-Coxa-Vara.-Limb length discrepancy.-Cerebral palsy.
-Transient synovitis.-Septic arthritis.-LCP disease.-Discoid meniscus.-Limb length discrepancy.
-SCFE.-Hip dysplasia.-Chondrolysis.-Overuse syndromes.-Osteochondritis Dissecans.
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Abnormal Gait Patterns Trendelenburg Gait
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Abnormal Gait PatternsProximal muscle weakness
Gower’s Sign
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من • تقديمها و إعدادها تم محاضرات سلسلة من هي المحاضرة هذه , دمشق مشفى في العظمية الجراحة شعبة في المقيمين األطباء قبل
. . ميرعلي بشار د إشراف تحت• . المحاضرة هذه في الواردة األخطاء عن مسؤول غير الموقع
•This lecture is one of a series of lectures were prepared and presented by residents in the department of orthopedics in Damascus hospital, under the supervision of Dr. Bashar Mirali.
•This site is not responsible of any mistake may exist in this lecture.
كاظم. مؤيد Dr. Muayad Kadhimد