technique

Femoral Fractures

Aetiology

Paediatric femoral fracture

 

Varies per age group

 

Trauma

- 60%

 

Non Accidental Injury

- 15 - 30%

- suspect if non walker / < 1 year

- walking status single best indicator of risk

- paediatric team to investigate

- history taking from parent

- consider metabolic investigations

 

Tarsal Coalition

Definition

 

Congenital fibrous, cartilaginous or bony connection of 2 or more tarsal bones

- due to failure of segmentation

 

Peroneal Spastic Flat Foot

- tarsal coalition

- tarsal pain

- reduced STJ motion

- rigid pes planus

- peroneal muscle spasm / tightness

 

Epidemiology

 

Present in 6% of population

- symptomatic in 1% of population

 

Bilateral in 50%

 

Knee Exam

Look

 

Shoes

Walking aids

 

Front

 

Knee alignment 

- physiological valgus

 

Patellar rotation 

- squinting (inwards, increased PFA) 

- grasshopper eyes (high and lateral)

 

Swelling

Quads Wasting

Scars

 

Knee effusion

Diabetic Amputations

Risk FactorsToe gangrene

- DM > 10 years

- chronic hyperglycaemia

- impaired vision or joint mobility

- lack education

- increasing age

- previous amputation

 

Considerations

- blood flow

- soft tissue envelope

- deformities / Charcot collapse

- sensation

- contractures - Achilles tendon, knee, toe