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Abnormal Gait in Children
Aka: Abnormal Gait in Children, Nonantalgic Gait in Children, Steppage Gait, Circumduction Gait, Equinus Gait, Gait Evaluation in Children, Pediatric Gait
- See Also
- Abnormal Gait
- Pediatric Limp
- Clubfoot
- In-Toeing
- Out-toeing
- Metatarsus Adductus
- Congenital Vertical Talus
- Calcaneovalgus Deformity
- Torsional Profile
- Foot Progression Angle
- Thigh-Foot Angle
- Hip Rotation Evaluation in Children
- Types: Antalgic Gait
- Stance phase on unaffected limb is shortened due to pain
- Refusal to bear weight (esp. with limited range of motion, systemic symptoms, fever) suggests Septic Arthritis
- Types: Non-Antalgic Gait
- Steppage Gait
- Cause: Neurologic deficit interferes with foot dorsiflexion
- Hip and Knee Joints are flexed excessively during swing phase (allows toes to clear ground)
- Trendelenburg Gait
- Cause: Developmental dysplasia of hip interferes with hip abduction
- Tests: Trandelenburg Test is positive
- Pelvis tilts downward toward the unaffected side during the swing phase
- Circumduction Gait
- Causes
- Limb-length discrepancy (Galeazzi Sign positive)
- Knee or ankle stiffness due to underlying neurologic or mechanical disorder
- Appearance
- Stance phase: Knee is hyperextended and locked
- Swing phase: Affected leg is abducted or circumducted
- Equinus Gait
- Causes
- Cerebral Palsy
- Achilles tendon tight
- Calcaneal Fracture
- Foot foreign body
- Limb-length discrepancy
- Appearance
- Toe Walking
- Exam: Foot Deformity
- Lateral view
- Normal neonatal foot dorsiflexed >90 degrees
- Rule-out fixed equinus (Clubfoot) position
- Tiptoe walking (foot plantar flexed)
- Tight heel cord
- Plantar view (footprint shape)
- Kidney bean (sole deviated medially)
- Metatarsus Adductus
- Banana (sole deviated laterally)
- Calcaneovalgus Deformity
- PA View (from behind, while in neutral position)
- Heel varus with inverted foot (medial malleoli apart)
- Metatarsus Adductus
- Heel valgus with everted foot (medial malleoli touch)
- Calcaneovalgus Deformity
- Exam: Rotational Deformity
- See Pediatric Limp
- Torsional Profile (Leg Rotation Evaluation in Children)
- Foot Progression Angle (In-Toeing, Out-toeing)
- Thigh-Foot Angle (tibial torsion)
- Hip Rotation Evaluation in Children (Femoral Anteversion)
- Exam: Angular Deformity
- Genu Varum (bow leg)
- Genu Valgum (knock knee)
- References
- Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]