Paediatric Orthopaedic Cases

Shanaka Serevirathna - tiptoe walking is a condition where the child is unable to make heel contact with the floor during the initial stance phase of walking, and it can be caused by various factors including idiopathic toe walking and neuromuscular conditions.

- Neuromuscular conditions, such as cerebral palsy and Duchenne muscular dystrophy, are common causes of tiptoe walking.

- When evaluating a patient with tiptoe walking, it is important to take a detailed medical history, perform a thorough physical examination, and consider investigations such as blood tests for CK levels, MRI scans, and neurophysiological studies.

- Treatment for idiopathic toe walking may involve reassurance and regular follow-up, while conservative measures like stretching, casting, orthotics, and chemodenervation can be considered if the condition persists. In some cases, surgical interventions like Achilles tendon lengthening may be necessary.

- Intoeing is another condition characterized by excessive internal rotation of the hips and inward-turning feet during walking. It can be caused by various factors, including foot abnormalities, tibial torsion, and femoral anteversion. Management options depend on the age of the child, severity of symptoms, and associated functional or cosmetic disabilities, and can range from reassurance and observation to surgical interventions like proximal femoral osteotomy or distal tibial osteotomy.

This teaching video is specifically helpful for candidates preparing for the following Orthopaedic Exams : FRCS , European Board (FEBOT) , SICOT Diploma and Arabic Boards

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