Pediatric Orthotics Flashcards

Metatarsus adductus in an infant is BEST described as:

Answer: Adduction of the forefoot relative to a normally aligned hindfoot

Metatarsus adductus is characterized by medial deviation (adduction) of the forefoot while the hindfoot remains in a neutral or slightly valgus position, giving the foot a C-shaped appearance.

At what Cobb angle range is spinal bracing typically recommended for adolescent idiopathic scoliosis in a skeletally immature patient?

Answer: 25 to 40 degrees

Current clinical guidelines recommend bracing for adolescent idiopathic scoliosis when the Cobb angle is between 25 and 40 degrees in skeletally immature patients to halt progression; curves above 45 degrees are generally referred for surgical evaluation.

A child with a myelomeningocele lesion at the L3-L4 level will MOST likely require which orthotic device to achieve functional ambulation?

Answer: Knee-ankle-foot orthoses (KAFOs) or hip-knee-ankle-foot orthoses (HKAFOs)

An L3-L4 lesion spares hip flexors and knee extensors partially but leaves hip extensors, abductors, and ankle musculature non-functional; KAFOs or HKAFOs are needed to stabilize the knee and ankle for community ambulation.

What is the primary biomechanical purpose of a twister cable orthosis in a pediatric patient?

Answer: Address rotational deformities of the lower extremity, such as internal tibial or femoral torsion

Twister cables apply a rotational force to the lower extremity to counteract intoeing caused by internal tibial or femoral torsion, promoting a more neutral foot progression angle during gait.

Which of the following is a contraindication for using a Pavlik harness to treat DDH?

Answer: Teratologic (irreducible) hip dislocation or failed reduction after 6 months of age

Teratologic dislocations and hips that remain irreducible or present after 6 months of age are contraindications to the Pavlik harness because the harness cannot achieve or maintain reduction in these cases, and failure to recognize this increases risk of avascular necrosis.

Which casting technique is considered the gold standard for capturing subtalar neutral position when fabricating custom pediatric foot orthoses?

Answer: Non-weight-bearing neutral suspension casting

Non-weight-bearing neutral suspension casting holds the subtalar joint in neutral while the forefoot is loaded against the cast, capturing the foot's ideal structural alignment without the deforming effects of body weight.

Which skeletal maturity indicator is used to determine when bracing for adolescent idiopathic scoliosis can be safely discontinued?

Answer: Risser sign grade 4 or 5

The Risser sign grades iliac apophysis ossification from 0 to 5; grades 4 and 5 indicate skeletal maturity, signifying that spinal growth has ceased and the risk of scoliosis progression is minimal, allowing bracing to be discontinued.