2025 – PAGE 415 – ORTHOPEDICS AND SPORTS MEDICINE
CLUB FOOT (AKA TALIPES EQUINOVARUS or EQUINOVARUS DEFORMITY)
Club foot (AKA talipes equinovarus or equinovarus deformity) presents as a foot deformity noted in infancy. It is caused by an internal rotation and contraction of the Achilles tendon. Treat by stretching + serial casts + possible surgical release, preferably done by 1 year of age.
IMAGE: www.pbrlinks.com/CLUBFOOT1
MNEMONIC: equinovaRus. If you can remember that vaLgus is the outward L shape, you should be able to then recall what a vaRus deformity is and choose the correct answer.
PES CAVUS
Pes cavus patients have high plantar arches. Associated with Friedreich Ataxia, Marie-Charcot-Tooth, and Hurler Syndrome.
IMAGE: www.pbrlinks.com/PESCAVUS1 (copyright free)
MNEMONIC: Pes cavus = high ARCHES. Imagine eating at a burger place called Gold Arches with your family. Their logo has two giant gold ARCHES, like two feet with high arches. Now say, “Eating at the Gold ARCHES made my Family Ataxic and made me HURL.”
- KEY: Family Ataxic = F.A. = Friedreich Ataxia. HURL = Hurler
PES PLANUS
Pes planus patients have flat plantar arches. If incidentally found, no intervention is needed.
IMAGE: www.pbrlinks.com/PESPLANUS1
SLIPPED CAPITAL FEMORAL EPIPHYSIS (SCFE)
Children get slipped capital femoral epiphysis (SCFE) from a Salter Harris Type I fracture at the growth plate (physis), in which the EPIphysis slides off of the growth plate. May present with referred KNEE pain with a normal knee exam, and a leg that is externally rotated at the hip. Obtain AP “frog leg” views of the hips. This is usually seen in an obese adolescent male. Treat with immobilization, avoidance of weight-bearing, and possibly surgical pins.
IMAGE/PEARL: Note that this can be VERY subtle. Before and after repair: https://bit.ly/nOLGoA (copyright free)
PEARL/MNEMONIC: Imagine ICE CREAM starting to fall off of an ICE CREAM CONE. When looking at the image, be sure to look for the EPIphysis (or ice cream), to be FALLING OFF MEDIALLY!
PEARL: A fairly large percentage of children (> 15%) can go on to have a contralateral SCFE.
PEARL: Unrelated to SCFE, but if you are not sure what to do on an orthopedic question, and “Image contralateral side” is given as an answer choice, pick it!