Metatarsus Adductus inward turning of forefoot at metatarsal joint CC

Metatarsus adductus inward turning of forefoot at

This preview shows page 24 - 26 out of 31 pages.

Metatarsus Adductus: inward turning of forefoot at metatarsal joint, CC: intrauterine positioning, genetic factors TX: exercise, PT, Denis brown splint, casting Talipes Equinovarus : club foot, bones same length, atrophy lower leg muscles, shortened Achilles tendon, causes feet to turn inward towards each other, family hx increases risk TX: serial casting, changed every 1-2 wks, entire foot in cast, gently progress foot turning towards normal, denis brown splint, car seat care, surgery Developmental Dysplasia of the Hip : acetabular dysplasia of the hip, place child prone & bend knees, asymmetrical skin folds may indicate dysplasia, more freq on left than right, non genetic, more with breach presentation, can be cultural Allis sign: one knee lower than the other with knee flexion Ortolani: abduct thighs, gentle pressure forward, clunking = dislocation
Image of page 24
Barlow: adduct hips, gentle pressure foreword & down with thumbs, fever pop out of hip joint DX: x ray or ultrasound TX: pavlik harness- removable, should always be in it, spica cast- goes up torso, down to legs, worry about diaper area- use multiple diapers, lots of swelling with application, monitor pulses & cap refill- compartment syndrome Legg-Calve- Perthes Disease : avascular necrosis of femoral head, 2-14 yrs, mostly 4-8 yrs, cc; family hx, mild to traumatic injury, pain in knee or hip, limp relieved with rest 1. Pre-necrosis: vascular insult, blood isn’t going to femur, asymptomatic 2. Revascularization: pain, limited movement 3. Bone healing Re-Ossification: decreasing pain, healing 4. Remodeling: no pain, regain joint movement DX: bone scan, MRI, coagulation issues (caused decreased blood supply to femoral head) TX: Toronto (removable, abduction, more difficult to walk, skin integrity issues), Scottish rite brace (removable, keeps hips abducted), PT, traction, anti inflammatory meds- steroids Scoliosis : lateral S or C shaped curve of spine with rotational deformity of the spine & ribs, in girls, 10-13 yrs, curvatures > 10 degrees is abnormal DX: observation, scoliometer, xray, ct, watching movement TX: braces, surgery- spinal fusion (40 degree or greater deviation, post op logroll, up with brace), PT & OT, complications- pain, urinary retention (foley insertion), paralytic ileus, N&V, hypotension Kyphosis : curvature of the thoracic spine, no pain, top Lordosis : accentuated cervical or lumbar curvature, pain Osteomyelitis : infection of the bone, bacterial, twice as common in boys, most often in femur or tibia S&S: pain, swelling DX: increased WBC, ESR, positive bone & blood cultures, x rays may be normal TX: abx for 4 wks Soft Tissue Injury: crush injury, Dislocations-nursemaids elbow, shoulder dislocations, swinging child Sprains- ligament torn or stretched Strain- tear to tendon TX: rest, ice, compression, elevation, heal faster in kids Fractures : heal faster in kids, not common in infancy, radiographic exam show healing at different stages- physical abuse, fractures of epiphyseal plate may affect bone growth *watch for spiral fractures- abuse S&S: swelling, pain, deformity, not using the extremity, bruising, crepitus TX: immobilize, cast, splint, brace, traction, open reduction, external pins/fixators
Image of page 25
Image of page 26

You've reached the end of your free preview.

Want to read all 31 pages?

  • Spring '17
  • The Maids, fine motor skills, yrs

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Stuck? We have tutors online 24/7 who can help you get unstuck.
A+ icon
Ask Expert Tutors You can ask You can ask You can ask (will expire )
Answers in as fast as 15 minutes