By John Anthony Herring (ed.)
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Extra info for Tachdjian’s Pediatric Orthopaedics
What factors are causing the deformity? • Is there associated muscle spasm, local tenderness, or pain with motion? John G. Birch Angular Deformity The description of angular deformities should specify the site of the deformity and the position of the distal segment of the deformity relative to the proximal portion. The specific location of the deformity is denoted by its anatomic name, such as cubitus (elbow, forearm, ulna), coxa (hip), genu (knee), or pes (foot). The direction of the deformity is designated as either valgus or varus, terms that define alignment in the coronal plane.
For every 3 degrees of total shoulder elevation, 2 degrees of elevation represents motion of the glenohumeral joint and 1 degree of elevation comes from the scapulothoracic joint26; see Fig. 3-6, B). When the scapula is immobilized, pure glenohumeral elevation is approximately 90 degrees (see Fig. 3-6, C). At approximately 120 degrees of combined shoulder elevation, the surgical neck of the humerus abuts the acromion process (see Fig. 3-6, D). , 180 degrees) is a combined glenohumeral and scapulothoracic movement.
Changes in patient body position can also affect ROM. Because of this, measurements of the same parameter may vary during the examination. A review by Perry62 showed that ankle dorsiflexion decreased as patients went from the supine position to sitting to standing. In 95% of patients with cerebral palsy, flexion of the knee permitted greater ankle dorsiflexion. To accommodate this variability, the examiner should note at what degree initial resistance is encountered and the total ROM attained with persuasion.