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Gait abnormalities

Normal Walking Requires:

  • Locomotor generator - C.N.S
  • Two legs the same length
  • Joints that are not stiff
  • Power

See Gait Analysis

Causes of Limp (abnormal gait) in Childhood:

Short Leg    Pain (antalgic limp)    Instability of joints    Stiffness of joints   
Muscle weakness   Muscle incoordination    Proprioceptive disturbances    Hysteria

1. Short Leg Limp

  • Difficult to discern at maturity If discrepancy is less than 2cm
  • Limp may be disguised by pelvic tilt, holding ankle of short leg in equinus and hip and knee of long leg in flexion

2. Antalgic Limp

  • Stance phase shortened
  • More gentle heel-strike in painful limb

3. Unstable Hip Limp - Trendelenburg Gait

  • Instability may result from changes in
  • 1. Fulcrum - DDH
  • 2. Lever - short neck
  • 3. Motor - gluteus medius weakness e.g. polio, OP

4. Stiff Hip Gait

  • Increased motion of pelvis on lumbar spine during swing
  • N.B.- limp minimal if hip stiff (fused) in 25o flexion

5. Stiff Knee Gait

  • Pelvis raised during swing phase so heel will clear floor

6. Gluteus Maximus Weakness

  • Hip In hyperextension so centre of gravity behind joint


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