Module 7, General Orthopaedist Level

This 1 year and 3 month old female was the product of a normal vaginal delivery at 38 weeks gestation without complications. She was one of twins, and her sister was healthy, without deformity. Soon after birth the infant was noted to have a severe deformity involving the right leg and right foot. Examination of the right lower extremity demonstrates shortening of the right thigh with a 10 degree flexion contracture present in the knee. The knee is noted to be in valgus. The foot is held in a position of severe equinovalgus with absence of the lateral two rays.

Question 7A

Amputation at the Below Knee level is one acceptable option fore long term treatment planning.

Question 7B

The insult which causes this deformity occurs in the first 8 weeks after conception.

Question 7C

Knee is usually in valgus and has a significant amount of instability.

Question 7D

Ankle is usually in severe equinovalgus with a rigid hindfoot.

Question 7E

Anteromedial bowing of the tibia usually has a skin dimple over the anterior aspect of the tibia at the apex of the deformity. As the child grows the bowing of the femur will correct.