Notes on orthopaedic examination of Cerebral Palsy cases

Selection of .wmv videos (do not run on a Mac)

Table of tests and signs for different conditions and regions. Has many obscure eponymous tests

Illustrated account of elbow examination

Foot & ankle examination
Look
Feel
Move
Ankle
Subtalar
Midtarsal
TMTJ
1st MTPJ
Muscle tests
Stability Tests
Other Tests
Syndosmosis
Block Test
Achilles Tendon

Brief bio of Jules Froment and account of Froment's sign - we hold out a folded newspaper to the patient; he is asked to pull it hard with the strong hand and then with the affected hand, while we pull it fairly firmly away. This is what is observed: on the healthy side the thumb is in contact with the object gripped all the way along-the distal phalanx is extended or only slightly flexed. On the paralysed side the thumb resembles a flying buttress, the distal phalanx is markedly flexed and no matter what force is used it only holds the object by the very tip of the pulp. Very often there is a gap between the thumb and the newspaper, or, to be more exact, between the thumb and the side of the palm. (It is necessary to pull hard: the grip with the fixed thumb is only pathological when the grip is forcible).

Hand examination
Look
Feel
Move
Elson's test
Neurological testing
Functional tests
Pulses - Allens test
Intrinsic Tests
Measuring finger joint motion
Extensor Apparatus - Diagram
Extensor Compartments

Patient must be suitably undressed (down to underwear)>br> First examine patient standing and then lying down.
Look, feel, move and special tests.

Account of Knee Examination
Look
Move
Feel
Special Tests
Ligaments
Menisci
Patellofemoral joint

SUMMARY
* Equipment Needed
* General Considerations
* Motor
o Observation
o Muscle Tone
o Muscle Strength
o Pronator Drift
* Coordination and Gait
o Rapid Alternating Movements
o Point-to-Point Movements
o Romberg
o Gait
* Reflexes
o Deep Tendon Reflexes
o Clonus
o Plantar Response (Babinski)
* Sensory
o General
o Vibration
o Position Sense
o Subjective Light Touch
o Dermatomal Testing
+ Discrimination

Account of the Pivot Shift sign for ACL deficiency

POSTEROLATERAL INSTABILITY
= when stress testing the lateral tibial plateau rotates posteriorly in relation to the femur with lateral opening of joint associated with knee dislocation (see below)

Closed rupture of the middle slip of the extensor hood of a finger is easily missed until the late appearance of a buttonhole deformity. Early diagnosis gives the best chance of satisfactory treatment, but Boyes' test becomes positive only at a late stage. A new test is described in which, from a 90 degrees flexed position over the edge of a table, the patient tries to extend the proximal interphalangeal joint of the involved finger against resistance. The absence of extension force at the proximal joint and fixed extension at the distal joint are immediate signs of complete rupture of the central slip. The theoretical basis and the method of performing the test are discussed.(full text)

Tips for the short case examination (for fellowship exam)

Look
Feel
Move
Special tests
Impingement
Rotator cuff integrity
Instability