Orthopedic disorders in children
1 FOOT AND LOWER LIMB DISORDERS
Survey
- Feeth: Causes of pain in the footh congenital foothdisorders
- Lower limb: rotational and axial deformities
1.1 PAIN IN THE FOOTH
1.1.1 Pes Planus – Flatfoot
- No medial footh arch and valgus of the heel
- Most frequent
- Physiologically till 4 years
- Mostly no complaints of pain
- Sometimes pain or fatigue
- Corrects by standing on toe
Van 2jaar kan nog corrigeren tegen de leeftijd van 6jaar
1.1.1.1Treatment
- Mostly no treatment
- Insoles in case of : pain, fatigue, wearing off of shoes
- Insoles do not influence the footh form
- Mostly spontaneous healing not always!
- If sever flatfeeth around 8 years, better use insole to prevent pain in future?
,1.1.1.2Pedes plani: natural evolution
- Incidence: 14% ( canadese soldiers)
- Footarch is being formed between 0 and 6 years of age
1.1.1.3Rigid flatfeeth
- Seldom
- Mostly painfull
- Causes : congenital synostoses
o infection
o reuma
o post-traumatic…
- Needs more often operation
Tarsal coalition
Talo-calcaneaire synostoses: difficult to treat
1.1.1.4Pedes plani: operatieve behandeling
1.1.1.5Freiberg: avasculair necrosis metatarsal 2 (or 3)
Pijn in de middenvoet, behandeling met zool, geneest
meestal vanzelf
1.1.1.6Kohler
- = necrosis os naviculare
- Toddlers
, - treatment: symptomatic (ev. insole)
o ontlasting van os naviculare
1.1.1.7Calcaneair apophysitis - Sever’s disease
- Inflammatin of the growth plate of the calcaneus
- 9 - 14 jaar
o Vooral bij sportieve kinderen en vooral sporten waarbij veel gesprongen wordt
- Bilat. 60% - 80%
1.1.2 Pes Cavus
High arch of the footh
- Mostly no pain
- Sometimes hereditary
- Can give pressure on heel and metarsal head: insole
- Be aware of progressieve cavus
- And varus: neurological disease
1.1.3 Progressive cavovarus
- Mostly neurological disease
o Charcot-Marie Tooth (fib.spieratr.)
o Polio
o Spinal dysraphisme tethered cord
- Operation often needed
1.2 CONGENITAL FOOTDISORDERS
1.2.1 Calcaneovalgus
- Packaging defect
1 FOOT AND LOWER LIMB DISORDERS
Survey
- Feeth: Causes of pain in the footh congenital foothdisorders
- Lower limb: rotational and axial deformities
1.1 PAIN IN THE FOOTH
1.1.1 Pes Planus – Flatfoot
- No medial footh arch and valgus of the heel
- Most frequent
- Physiologically till 4 years
- Mostly no complaints of pain
- Sometimes pain or fatigue
- Corrects by standing on toe
Van 2jaar kan nog corrigeren tegen de leeftijd van 6jaar
1.1.1.1Treatment
- Mostly no treatment
- Insoles in case of : pain, fatigue, wearing off of shoes
- Insoles do not influence the footh form
- Mostly spontaneous healing not always!
- If sever flatfeeth around 8 years, better use insole to prevent pain in future?
,1.1.1.2Pedes plani: natural evolution
- Incidence: 14% ( canadese soldiers)
- Footarch is being formed between 0 and 6 years of age
1.1.1.3Rigid flatfeeth
- Seldom
- Mostly painfull
- Causes : congenital synostoses
o infection
o reuma
o post-traumatic…
- Needs more often operation
Tarsal coalition
Talo-calcaneaire synostoses: difficult to treat
1.1.1.4Pedes plani: operatieve behandeling
1.1.1.5Freiberg: avasculair necrosis metatarsal 2 (or 3)
Pijn in de middenvoet, behandeling met zool, geneest
meestal vanzelf
1.1.1.6Kohler
- = necrosis os naviculare
- Toddlers
, - treatment: symptomatic (ev. insole)
o ontlasting van os naviculare
1.1.1.7Calcaneair apophysitis - Sever’s disease
- Inflammatin of the growth plate of the calcaneus
- 9 - 14 jaar
o Vooral bij sportieve kinderen en vooral sporten waarbij veel gesprongen wordt
- Bilat. 60% - 80%
1.1.2 Pes Cavus
High arch of the footh
- Mostly no pain
- Sometimes hereditary
- Can give pressure on heel and metarsal head: insole
- Be aware of progressieve cavus
- And varus: neurological disease
1.1.3 Progressive cavovarus
- Mostly neurological disease
o Charcot-Marie Tooth (fib.spieratr.)
o Polio
o Spinal dysraphisme tethered cord
- Operation often needed
1.2 CONGENITAL FOOTDISORDERS
1.2.1 Calcaneovalgus
- Packaging defect
