Friday, 26 January 2024

Genu Valgum

 Find out age , family history positive if any(Heridatiary Multiple Exostosis/HME, Hypophosphatemic Rickets, Bony Dysplasia ) 

https://www.medicalnewstoday.com/articles/319894

Physical Examination

    Gait 

    Squatting

    Standing - Quadriceps , Patella forward, forefoot , Obvious Genu Valgum Deformity

    Side -        Any scars 

                     Knee in extension

    Back -       Popliteal swelling, comment on calf muscles

                     Heel varus 

Ask patient to lie down 

    Feel -         Temperature normal, no bony/ soft tissue tenderness

                    scar - non-tender , mobile

                    Patella- non-tender, Gliding, Clarke test, Apprehension

    Movement - Knee - Flexion and Extension

                         does deformity disappear with knee flexion

    Measure the deformity 

                        Genu Valgum and Q-angle (knee in 20 degree flexion ? )

     Special tests - LCL, MCL, Obers test 

    Neurovascular tests 

    Lymh node as a routine check up 

    quickly comment on frontal bossing, teeth, ligament and laxity. 


Investigations 

     Standing leg Alignment X-ray

     Tibiofemoral angle as per Saelenius curve

    

Treatment 

    Observe 

    Bracing -still practiced for  mild deformity. 

    Guided Growth - Physeal Staples (advantage -reversible )

    Osteotomy when else fail.


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