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Proper alignment of the prosthetic foot about the ankle joint causes metabolic cost [48] and gait symmetry at the anatomical hip and knee joints to improve, with hip flexion-extension motion being the most sensitive to alignment. [62] Excessive rotational misalignment of the foot is compensated by internal rotation of the residual hip joint. [63]
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]
Gait abnormality is a deviation from normal walking ().Watching a patient walk is an important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion.
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.
On projectional radiography, the degree of varus or valgus deformity can be quantified by the hip-knee-ankle angle, [7] which is an angle between the femoral mechanical axis and the center of the ankle joint. [8] It is normally between 1.0° and 1.5° of varus in adults. [9] Normal ranges are different in children. [10]
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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).
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