34 Questions
What is the most common term synonymous with the congenital deformity talipes equino-varus?
Club Foot
Which treatment method is usually advised for moderate disability in osteoarthritis cases?
Physiotherapy
What is the characteristic radiographic feature of osteoarthritis seen in the text?
Prominent osteophytes
In cases where osteoarthritis becomes a serious handicap, what surgical procedure is usually recommended?
Arthrodesis
Which condition is characterized by poor development of calf muscles and bilateral club foot in an infant boy?
Talipes Equino-varus
Which term describes the deformity where the footrests in a position of eversion and dorsiflexion, almost in contact with the shin?
Talipes calcaneovalgus
What is the main cause of talipes calcaneovalgus according to the text?
Postural deformity in intrauterine life
Which soft tissue tightness prevents the foot from being easily brought down into inversion and equinus in talipes calcaneovalgus?
Dorsolateral soft tissues
What is the recommended treatment for most cases of talipes calcaneovalgus?
Manual stretching by parents
Which statement best describes the difference between talipes calcaneovalgus and talipes equino varus?
Talipes calcaneovalgus presents with tightness of dorsolateral soft tissues while talipes equino varus presents with eversion of the foot.
What is the main idea behind early operative treatment for restoring a plantigrade foot?
To remove deforming stresses and allow bones to develop normally
In children aged 2 to 12 with congenital talipes, which operation involves transferring the tibialis posterior tendon to the outer side of the foot?
Transfer of tibialis posterior tendon through interosseous membrane
Which operation involves arthrodesis of the calcaneo-cuboid joint with excision of a wafer of bone?
Arthrodesis of calcaneo-cuboid joint
What is the prominent feature that an osteotomy of the calcaneus with insertion of a bone wedge aims to correct?
Inversion of the heel
Congenital talipes calcaneo-valgus presents which type of deformity compared to talipes equino-varus?
Eversion and dorsiflexion
What is the major component of the deformity in talipes equino-varus?
Subluxation of the talo-navicular joint
Which muscle imbalance is responsible for most cases of club foot deformity?
Imbalance between the invertor-plantar-flexor and evertor-dorsiflexor muscles
What is a striking feature in most cases of talipes equino-varus related to muscle development?
Under-development of the calf and peroneal muscles
Why is there a marked discrepancy in calf girth between the two sides when only one foot is affected by talipes equino-varus?
Under-development of calf and peroneal muscles on the affected side
What is a key clinical feature that distinguishes talipes equino-varus from congenital dislocation of the hip?
Boys are more commonly affected by talipes equino-varus, while girls are more commonly affected by congenital dislocation of the hip
What is a common radiographic finding when the lateral ligament is torn or lax?
Tilting of the talus away from the tibiofibular mortise
What is a characteristic sign observed when the heel is fully inverted?
Visible dimple or depression in front of the lateral malleolus
What might be the diagnosis if radiographs do not show abnormality but symptoms of lateral ligament strain are present?
Chronic strain of the lateral ligament
What is a common feature of abnormal mobility due to lateral ligament injury?
Heel can be passively inverted beyond normal range
What is a key indicator of a torn lateral ligament during radiographic examination under adduction stress?
Tilting of the talus away from the tibiofibular mortise
What are the three elements that make up the deformity of club foot?
Inversion, adduction, equinus
Which term describes the inward deviation of the forefoot relative to the hindfoot in club foot?
Adduction
What is a common consequence of delayed primary treatment for club foot in infants?
Reduced chance of complete cure
Which condition might be associated with poor development of calf muscles in infants?
Club foot
What is the recommended treatment for a slight disability in the talus that allows for up to a 15-degree tilt in a normal ankle?
Strengthening exercises for the peronei muscles
What is a common factor that leads to premature wear and destruction of the articular cartilage in the ankle?
Fractures causing mal-alignment of joint surfaces
Which condition is characterized by poor development of calf muscles and bilateral club foot in an infant boy?
Congenital deformity talipes equino-varus
What type of joint disease is a primary factor leading to osteoarthritis of the ankle?
Rheumatoid arthritis
In cases where osteoarthritis becomes a serious handicap, what surgical procedure is usually recommended?
Construction of a new lateral ligament from the peroneus tertius tendon
Study Notes
Talipes Equino-Varus
- The most common term synonymous with talipes equino-varus is club foot.
- The major component of the deformity in talipes equino-varus is the inward and downward deviation of the foot.
- Muscle imbalance, particularly the overactivity of the gastrocnemius and soleus muscles, is responsible for most cases of club foot deformity.
- A striking feature in most cases of talipes equino-varus is the poor development of calf muscles, which is often accompanied by a marked discrepancy in calf girth between the two sides when only one foot is affected.
- A key clinical feature that distinguishes talipes equino-varus from congenital dislocation of the hip is the rigid deformity of the foot.
Talipes Calcaneovalgus
- Talipes calcaneovalgus is characterized by the deformity where the foot rests in a position of eversion and dorsiflexion, almost in contact with the shin.
- The main cause of talipes calcaneovalgus is the tightness of the soft tissues on the anterior and lateral aspects of the foot.
- The recommended treatment for most cases of talipes calcaneovalgus is conservative management with stretching and manipulation.
- The prominent feature of talipes calcaneovalgus compared to talipes equino-varus is the outward and upward deviation of the foot.
Osteoarthritis
- Osteoarthritis is characterized by the narrowing of the joint space, sclerosis, and osteophyte formation.
- The main cause of osteoarthritis is the wear and tear of the articular cartilage due to joint disease.
- In cases where osteoarthritis becomes a serious handicap, arthrodesis is usually recommended.
- Treatment for moderate disability in osteoarthritis cases usually involves shoe modification and orthotics.
Surgical Procedures
- In children aged 2 to 12 with congenital talipes, the operation involves transferring the tibialis posterior tendon to the outer side of the foot.
- The Dennyson-Fulford procedure involves arthrodesis of the calcaneo-cuboid joint with excision of a wafer of bone.
- An osteotomy of the calcaneus with insertion of a bone wedge aims to correct the deformity of the heel.
Lateral Ligament Injury
- A common radiographic finding when the lateral ligament is torn or lax is the increased lateral tilt of the talus.
- A characteristic sign observed when the heel is fully inverted is the lateral ligament strain.
- If radiographs do not show abnormality but symptoms of lateral ligament strain are present, the diagnosis might be lateral ligament strain.
- A common feature of abnormal mobility due to lateral ligament injury is the excessive lateral tilting of the talus.
- A key indicator of a torn lateral ligament during radiographic examination under adduction stress is the increased lateral tilt of the talus.
Test your knowledge on congenital talipes equinovarus, also known as clubfoot, which consists of inversion, adduction, and equinus deformities. Learn about the diagnosis and characteristics of this condition in newborn infants.
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