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Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [ 1 ] especially in the femur and tibial bones, but can also occur genetically at birth.
Knee: genu varum (from Latin genu = knee) — the tibia is turned inward in relation to the femur, resulting in a bowlegged deformity. Ankle: talipes varus (from Latin talus = ankle and pes = foot). A notable subtype is clubfoot or talipes equinovarus, which is where one or both feet are rotated inwards and downwards. [6] [7]
A malunion is when a fractured bone does not heal properly. Some ways that it shows is by having the bone being twisted, shorter, or bent. Malunions can occur by having the bones improperly aligned when immobilized, having the cast taken off too early, or never seeking medical treatment after the break. [1]
Common causes of knock-knee in adults include arthritis of the knee and traumatic injuries. Toe: hallux valgus (from Latin hallux = big toe) – outward deviation of the big toe toward the second toe, resulting in bunion. Wrist: Madelung's deformity – deformity wherein the wrist bones are not formed properly due to a genetic disorder.
Genu valgum, commonly called "knock-knee", is a condition in which the knees angle in and touch each other when the legs are straightened. [1] Individuals with severe valgus deformities are typically unable to touch their feet together while simultaneously straightening the legs.
The degree of knee extension (the angle between the thigh and shank in a walking cycle) has decreased. The changing pattern of the knee joint angle of humans shows a small extension peak, called the "double knee action," in the midstance phase. Double knee action decreases energy lost by vertical movement of the center of gravity. [1]
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The examiner's fingers monitor the medial joint space for gapping while placing the opposite hand on the ankle. The knee is placed in 20° of flexion. The examiner then uses their own thigh as a fulcrum at the knee and applies a valgus force (pulling the foot and ankle away from the patient's body).