47
KELAINAN BAWAAN MUSKULOSKELETAL

KELAINAN BAWAAN

Embed Size (px)

DESCRIPTION

aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaassssssssssssssssssssssssssssssssssssddddddddddddddddddddddddddddddddddddddddddddddddddddddfffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb

Citation preview

KELAINAN BAWAANMUSKULOSKELETAL

CONGENITAL DEFORMITIES

• PRESENT AT BIRTH

• MAY NOT BE APPARENT UNTIL THE CHILD IS OLDER

• DEVIATIONS OF NORMAL EVOKE SUSPICION

• OTHER ORGAN SYSTEM SHOULD BE EVALUATED TO RULE OUT OTHER GENETIC AND CHROMOSOMAL DISORDERS

CONGENITAL DEFORMITIES OF THE LOWER EXTREMITIES

DEVELOPMENTAL DYSPLASIA OF THE HIP

• CONGENITAL DYSPLASIA OF THE HIP

• CONGENITAL DISLOCATION OF THE HIP

• CONGENITAL SUBLUXATION OF THE HIP

• LIGAMENTOUS LAXITY IS DETECTABLE AT BIRTH

• NEONATES ARE ASYMPTOMATIC

• LIMP, WADDLING GAIT PATTERN, OR A LIMB LENGTH DISCREPANCY

• BARLOW TEST

• ORTOLANI MANEUVER

• GALEAZZI SIGN

COXA VARA

• DECREASE IN THE NORMAL NECK-SHAFT ANGLE OF THE FEMUR

• ASSOCIATED WITH CONGENITAL SHORT FEMURAL PROXIMAL FOCAL DEFICIENCY

• ABDUCTOR MUSCLE WEAKNESS, TRENDELENBURG GAIT ABNORMALITY, LIMB LENGTH DISCREPANCY

CONGENITAL DISLOCATION OF THE KNEE

• HYPEREXTENSION OF THE KNEE AT BIRTH

• ASSOCIATED ABNORMALITIES SUCH AS HIP DISLOCATION OR CLUBFOOT

CONENITAL DISLOCATON OF THE PATELA

• MAY NOT APPARENT FOR SEVERAL MONTHS AFTER BIRTH

• PERSISTENT FLEXION CONTRACTURE OF THE KNEE AND EXTERNAL ROTATION OF THE LEG

• THE PATELLA MAY NOT BE PALPABLE IN ITS DISLOCATED LATERAL POSITION

POSTEROMEDIAL BOWING OF THE TIBIA

• LIMB LENGTH DISCREPANCY

• THE BOWING IMPROVES WITH GROWTH

ANTEROLATERAL BOWING OF THE TIBIA

• MIGHT OR MIGHT NOT APPARENT AT BIRTH

• OFTEN ASSOCIATED WITH NEUROFIBROMATOSIS

• PROGRESSES TO CONGENITAL PSEUDOARTHROSIS OF THE TIBIA

CALCANEOVALGUS FOOT

• MARKED DORSOFLEXION OF THE ANKLE

• DEFICIENT ACTIVITY OF THE PLANTAR FLEXORS

• LIPOMYELOMENINGOCELE OR SOME OTHER NEUROLOGIC CONDITION

CONGENITAL VERTICAL TALUS

• RIGID FLATFOOT DEFORMITY

• IDIOPATHIC, FAMILIAL, OR ASSOCIATED WITH NEUROMUSCULAR OR CHROMOSOMAL ABNORMALITIES

CONENITAL SHORT FIRST METATARSAL

• SHORTHENING AND OFTEN ASSOCIATED WITH HALLUX VARUS

• PROBLEM WITH SHOE WEAR

CONGENITAL CURLY TOE

• FLEXION AND MEDIAL ROTATION OF THE TOE

POLYDACTYLY

• THE PRESENT OF ACCESSORY TOE

CLUBFOOT

• CONGENITAL TALIPES EQUINOVARUS (CTEV)

• PLANTAR FLEXION(EQUINUS)OF THE ANKLE, ADDUCTION(VARUS) OF THE HEEL, HIGH ARCH(CAVUS) AT THE MID FOOT, AND ADDUCTION OF THE FOREFOOT

• DD/ NEUROMUSCULAR CLUBFOOT, ARTHROGRYPOSIS, CONGENITAL CONSTRICTION SYNDROME

• WALK ON THE TOP OR DORSOLATERAL ASPECT OF THE FOOT

TREATMENT

• MANIPULATION AND CASTING

• SURGERY

CONGENITAL DEFORMITY OF THE UPPER EXTREMITY

SYNDACTYLY

• THE LACK OF NORMAL SEPARATION BETWEEN FINGERS OR TOES

• VARY FROM WEB OF SKIN TO A BONY FUSHION (SYNOSTOSIS)

• GROWTH MAY CAUSE PROGRESSIVE DEVIATION OF THE CONJOINED FINGERS

CONGENITAL RADIO-ULNAR SYNOSTOSIS

• THE PROXIMAL ENDS OF THE RADIUS AND ULNA FAIL TO SEPARATE

• INABILITY TO PRONATE AND SUPINATE THE FOREARM

CONGENITAL DISLOCATION OF THE RADIAL HEAD

• MOST COMMONLY DEVELOPS POSTERIORLY AND TYPICALLY BILATERAL

• ELBOW DEFORMITY AND LIMITED MOTION

• THE DISLOCATED RADIAL HEAD OFTEN PRESENT AND PALPABLE PROMINENCE ON THE LATERAL SIDE OF THE ELBOW

CONGENITAL DELETION OF THE LOWER EXTREMITIES

• LIMB LENGTH DISCREPANCY INCREASES AS THE CHILD GROWS

• PATIENT CAN BE QUITE FUNGTIONAL WITH A POSTHESIS

FIBULAR HEMIMELIA

• CONGENITAL ABSENCE OF THE FIBULA

TIBIAL HEMIMELIA

• CONGENITAL ABSENCE OF THE TIBIA

PROXIMAL FEMORAL FOCAL DEFICIENCY

• DYSGENESIS OF THE PROXIMAL FEMUR WITH COXA VARA AND/OR PSEUDOARTHROSIS OF THE FEMORAL NECK

• SHORTENING OF THE FEMUR IS MARKED

CONGENITAL DELETION OF THE UPPER EXTREMITIES

HYPOPLASIA/ABSENCE OF THE THUMB

• HYPOPLASTIC THUMB MAY BE SMALL, OR THIN DUE TO DEFICIENT DEVELOPMENT OF THE THENAR MUSCULATURE

RADIAL HEMIMELIA

• RADIAL CLUB HAND

ULNAR HEMIMELIA

TRANSVERSE DEFICIENCY OF THE FOREARM

• CONGENITAL BELLOW ELBOW AMPUTATION

• CONGENITAL CONSTRICTION BAND SYNDROME