Angular deformities of the lower limp.pptx
- 1. Angular deformities of the lower limp Valgus knee Blount disease
- 2. Valgus knee
- 3. What is the Valgus knee Valgus knee is a condition where the knees angle inward and touch when the legs are straightened. The lower leg (tibia) is angled abnormally outward in relation to the thigh bone (femur). It is common in young children but usually self-corrects with growth.
- 4. Causes of Valgus Knee Normal Development: Common in children between ages 2 and 5, usually resolves by age 7. Injury and Disease: •Damage to the growth plate in the knee •Rickets (Vitamin D deficiency) •Obesity •Arthritis Genetic Predisposition: May run in families
- 5. Symptoms of valgus knee Obvious inward angling of the knees: Knees touch, ankles don't Pain: May or may not be present, depending on the severity or underlying cause Knee pain Hip pain Ankle pain Limp or walking difficulties Reduced range of motion and stiffness
- 6. Diagnosis of valgus knee • Physical exam:  Standing posture: o The inward turn of the knees. o The distance between the ankles while together. o Signs of gait abnormalities.
- 7. • Measuring the Q-angle  Definition: The Q-angle is the angle formed by drawing a line from the ASIS (front hip bone) down to the center of the kneecap (patella) and another line from the kneecap to the tibial tuberosity (bony prominence just below the knee).  Normal Range: Approximately 10-15 degrees in adults.  Valgus knee: A Q-angle exceeding the normal range indicates increased severity of valgus deformity.
- 8. Ligament Stability Tests • Valgus Stress Test: apply gentle outward pressure on the knee while the leg is slightly bent and again fully extended. This tests the integrity of the medial collateral ligament (MCL) on the inner knee.
- 9. •Imaging: •X-rays to assess bone alignment. •MRI may be used in more complex cases to see soft tissue.
- 10. Treatment Surgery: In severe cases or if conservative treatments fail. Osteotomy: Procedure to re-align the bones of the knee. Conservative Approaches: Orthotics (shoe inserts, braces) Physical therapy Weight management, if necessary Treatment of underlying conditions (like rickets) Observation: Most cases in children resolve without treatment.
- 11. Blount disease • What is Blount disease? • Blount disease, also known as tibia vara, is a growth disorder that affects the shinbone (tibia). The condition causes the lower leg to turn inward, resembling a bowlegged appearance.
- 12. • Infantile: Affects children under the age of 4. • Adolescent: Affects children around the start of puberty. • Types of Blount Disease
- 13. Causes: The exact causes of Blount's disease are still not fully understood. However, several risk factors are associated with its development: • Early walking: Children who start walking at an early age may be more prone. • Obesity: Excess weight puts additional stress on the growth plates of the leg. • Family history: There may be a genetic component. • Race: Blount's disease is more
- 14. symptoms Bowlegged appearance: The primary symptom, which tends to worsen over time if left untreated. In-toeing: Feet turn inward. Knee pain: More common in the adolescent form of Blount's disease Limping or an abnormal walking pattern
- 15. Diagnosis •Physical exam: Metaphyseal- diaphyseal angle (MDA): Measured on an X-ray, a key diagnostic indicator. An angle greater than 11 degrees is concerning for Blount disease. •X-rays: To confirm the diagnosis and assess the severity of the bowing.
- 16. Treatment • Treatment of Blount's disease depends on the child's age and the severity of the leg bowing.  Bracing: Often used for young children with infantile Blount's disease. Special braces help realign the leg as it grows.  Surgery: May be necessary for older children and adolescents, or when bracing is unsuccessful. The type of surgery will involve correcting the bone alignment of the leg.
- 17. Done by: Yahya Ghannam Thank you