4.5 Knelpuntanalyse

JGZ-richtlijn Extremiteiten

1 Introductie Ga naar pagina over 1 Introductie

1.1 Leeswijzer

1.2 Afbakening

1.3 Verklarende woordenlijst

2 Kennismodule achtergrondinformatie Ga naar pagina over 2 Kennismodule achtergrondinformatie

2.1 Inleiding in extremiteiten

2.1.1 Onderzoeksmomenten

2.1.2 Lichamelijk onderzoek

2.1.3 Looppatroon

2.1.4 Oriënterend neurologisch onderzoek

2.1.5 Betrokken (para)medici en hulpverleners

2.2 Algemene aandoeningen

2.2.1 Tenenlopen

2.2.2 Toeing-in (met de voeten naar binnen lopen)

2.2.3 Hypermobiliteit

2.3 Standsafwijkingen

2.3.1 Polydactylie

2.3.10 Metatarsus primus varus

2.3.11 Krulteen (Curly toes)

2.3.12 Platvoeten

2.3.2 Syndactylie

2.3.3 Camptodactylie

2.3.4 Triggervinger of -duim

2.3.5 O-benen (genua vara) en X-benen (genua valga)

2.3.6 Beenlengteverschil

2.3.7 Klompvoet (pes equinovarus)

2.3.8 Hakvoet (pes calcaneus)

2.3.9 Metatarsus adductus

2.4 Pijnklachten Heupen

2.4.1 Coxitis fugax

2.4.2 Epifysiolysis capitis femoris (Slipped Capital Femoral Epiphysis; SCFE)

2.4.3 Ziekte van Perthes

2.5 Pijnklachten – Knieën – Osgood Schlatter

2.6 Pijnklachten – Voeten – Ziekte van Sever

2.7 Pijnklachten Overig – Groeipijn

3 Totstandkoming richtlijn Ga naar pagina over 3 Totstandkoming richtlijn

3.1 Werkwijze

3.2 Leden van de werkgroep

3.3 Klankbordgroep en meelezers

3.4 Cliëntparticipatie

4 Verantwoording Ga naar pagina over 4 Verantwoording

4.1 Wetenschappelijke bewijsvoering

4.2 Zoekstrategie

4.3 Overwegingen

4.4 Kennislacunes

4.5 Knelpuntanalyse

4.6 Belangenverstrengeling

5 Bijlagen Ga naar pagina over 5 Bijlagen

5.1 Bijlage – Handboeken en websites

5.2 Bijlage – Algemene schoenadviezen

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[1] Pin T, Eldridge B, Galea MP. A review of the effects of sleep position, play position, and equipment use on motor development in infants. Developmental medicine and child neurology 2007;49(11):858-67

https://pubmed.ncbi.nlm.nih.gov/17979866

[2] Engström P, Tedroff K. The prevalence and course of idiopathic toe-walking in 5-year-old children. Pediatrics 2012;130(2):279-84

http://dx.doi.org/10.1542/peds.2012-0225 https://pubmed.ncbi.nlm.nih.gov/22826572

[2] Engström P, Tedroff K. The prevalence and course of idiopathic toe-walking in 5-year-old children. Pediatrics 2012;130(2):279-84

http://dx.doi.org/10.1542/peds.2012-0225 https://pubmed.ncbi.nlm.nih.gov/22826572

[3] Engström P, Van't Hooft I, Tedroff K. Neuropsychiatric symptoms and problems among children with idiopathic toe-walking. Journal of pediatric orthopedics 2012;32(8):848-52

http://dx.doi.org/10.1097/BPO.0b013e31826bec08 https://pubmed.ncbi.nlm.nih.gov/23147630

[3] Engström P, Van't Hooft I, Tedroff K. Neuropsychiatric symptoms and problems among children with idiopathic toe-walking. Journal of pediatric orthopedics 2012;32(8):848-52

http://dx.doi.org/10.1097/BPO.0b013e31826bec08 https://pubmed.ncbi.nlm.nih.gov/23147630

[4] Oetgen ME, Peden S. Idiopathic toe walking. The Journal of the American Academy of Orthopaedic Surgeons 2012;20(5):292-300

http://dx.doi.org/10.5435/JAAOS-20-05-292 https://pubmed.ncbi.nlm.nih.gov/22553101

[4] Oetgen ME, Peden S. Idiopathic toe walking. The Journal of the American Academy of Orthopaedic Surgeons 2012;20(5):292-300

http://dx.doi.org/10.5435/JAAOS-20-05-292 https://pubmed.ncbi.nlm.nih.gov/22553101

[5] Sass P, Hassan G. Lower extremity abnormalities in children. American family physician 2003;68(3):461-8

https://pubmed.ncbi.nlm.nih.gov/12924829

[5] Sass P, Hassan G. Lower extremity abnormalities in children. American family physician 2003;68(3):461-8

https://pubmed.ncbi.nlm.nih.gov/12924829

[6] McCluskey G, O'Kane E, Hann D, Weekes J, Rooney M. Hypermobility and musculoskeletal pain in children: a systematic review. Scandinavian journal of rheumatology 2012;41(5):329-38

http://dx.doi.org/10.3109/03009742.2012.676064 https://pubmed.ncbi.nlm.nih.gov/22639794

[6] McCluskey G, O'Kane E, Hann D, Weekes J, Rooney M. Hypermobility and musculoskeletal pain in children: a systematic review. Scandinavian journal of rheumatology 2012;41(5):329-38

http://dx.doi.org/10.3109/03009742.2012.676064 https://pubmed.ncbi.nlm.nih.gov/22639794

[7] Rikken-Bultman DG, Wellink L, van Dongen PW. Hypermobility in two Dutch school populations. European journal of obstetrics, gynecology, and reproductive biology 1997;73(2):189-92

https://pubmed.ncbi.nlm.nih.gov/9228503

[7] Rikken-Bultman DG, Wellink L, van Dongen PW. Hypermobility in two Dutch school populations. European journal of obstetrics, gynecology, and reproductive biology 1997;73(2):189-92

https://pubmed.ncbi.nlm.nih.gov/9228503

[8] van der Giessen LJ, Liekens D, Rutgers KJ, Hartman A, Mulder PG, Oranje AP. Validation of beighton score and prevalence of connective tissue signs in 773 Dutch children. The Journal of rheumatology 2001;28(12):2726-30

https://pubmed.ncbi.nlm.nih.gov/11764224

[9] Cheng JC, Chan PS, Hui PW. Joint laxity in children. Journal of pediatric orthopedics 1991;11(6):752-6

https://pubmed.ncbi.nlm.nih.gov/1960200

[9] Cheng JC, Chan PS, Hui PW. Joint laxity in children. Journal of pediatric orthopedics 1991;11(6):752-6

https://pubmed.ncbi.nlm.nih.gov/1960200

[10] Remvig L, Jensen DV, Ward RC. Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature. The Journal of rheumatology 2007;34(4):804-9

https://pubmed.ncbi.nlm.nih.gov/17407233

[11] Murray KJ. Hypermobility disorders in children and adolescents. Best practice & research. Clinical rheumatology 2006;20(2):329-51

https://pubmed.ncbi.nlm.nih.gov/16546060

[11] Murray KJ. Hypermobility disorders in children and adolescents. Best practice & research. Clinical rheumatology 2006;20(2):329-51

https://pubmed.ncbi.nlm.nih.gov/16546060

[12] Armon K. Musculoskeletal pain and hypermobility in children and young people: is it benign joint hypermobility syndrome? Archives of disease in childhood 2015;100(1):2-3

http://dx.doi.org/10.1136/archdischild-2014-306556 https://pubmed.ncbi.nlm.nih.gov/25336435

[12] Armon K. Musculoskeletal pain and hypermobility in children and young people: is it benign joint hypermobility syndrome? Archives of disease in childhood 2015;100(1):2-3

http://dx.doi.org/10.1136/archdischild-2014-306556 https://pubmed.ncbi.nlm.nih.gov/25336435

[13] Bauer AS, Bae DS. Pediatric Trigger Digits. The Journal of hand surgery 2015;40(11):2304-9; quiz 2309

http://dx.doi.org/10.1016/j.jhsa.2015.04.041 https://pubmed.ncbi.nlm.nih.gov/26440744

[13] Bauer AS, Bae DS. Pediatric Trigger Digits. The Journal of hand surgery 2015;40(11):2304-9; quiz 2309

http://dx.doi.org/10.1016/j.jhsa.2015.04.041 https://pubmed.ncbi.nlm.nih.gov/26440744

[14] Lincoln TL, Suen PW. Common rotational variations in children. The Journal of the American Academy of Orthopaedic Surgeons 2003;11(5):312-20

https://pubmed.ncbi.nlm.nih.gov/14565753

[14] Lincoln TL, Suen PW. Common rotational variations in children. The Journal of the American Academy of Orthopaedic Surgeons 2003;11(5):312-20

https://pubmed.ncbi.nlm.nih.gov/14565753

[15] Nurzynska D, Di Meglio F, Castaldo C, Latino F, Romano V, Miraglia R, Guerra G, Brunese L, Montagnani S. Flatfoot in children: anatomy of decision making. Italian journal of anatomy and embryology = Archivio italiano di anatomia ed embriologia 2012;117(2):98-106

https://pubmed.ncbi.nlm.nih.gov/23420997

[16] Carr JB, Yang S, Lather LA. Pediatric Pes Planus: A State-of-the-Art Review. Pediatrics 2016;137(3):e20151230

http://dx.doi.org/10.1542/peds.2015-1230 https://pubmed.ncbi.nlm.nih.gov/26908688

[16] Carr JB, Yang S, Lather LA. Pediatric Pes Planus: A State-of-the-Art Review. Pediatrics 2016;137(3):e20151230

http://dx.doi.org/10.1542/peds.2015-1230 https://pubmed.ncbi.nlm.nih.gov/26908688

[17] Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clinical obesity 2015;5(2):52-9

http://dx.doi.org/10.1111/cob.12091 https://pubmed.ncbi.nlm.nih.gov/25808780

[17] Stolzman S, Irby MB, Callahan AB, Skelton JA. Pes planus and paediatric obesity: a systematic review of the literature. Clinical obesity 2015;5(2):52-9

http://dx.doi.org/10.1111/cob.12091 https://pubmed.ncbi.nlm.nih.gov/25808780

[18] Staheli LT, Chew DE, Corbett M. The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults. The Journal of bone and joint surgery. American volume 1987;69(3):426-8

https://pubmed.ncbi.nlm.nih.gov/3818704

[19] Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics 2006;118(2):634-9

https://pubmed.ncbi.nlm.nih.gov/16882817

[19] Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M. Prevalence of flat foot in preschool-aged children. Pediatrics 2006;118(2):634-9

https://pubmed.ncbi.nlm.nih.gov/16882817

[20] Tudor A, Ruzic L, Sestan B, Sirola L, Prpic T. Flat-footedness is not a disadvantage for athletic performance in children aged 11 to 15 years. Pediatrics 2009;123(3):e386-92

http://dx.doi.org/10.1542/peds.2008-2262 https://pubmed.ncbi.nlm.nih.gov/19254974

[20] Tudor A, Ruzic L, Sestan B, Sirola L, Prpic T. Flat-footedness is not a disadvantage for athletic performance in children aged 11 to 15 years. Pediatrics 2009;123(3):e386-92

http://dx.doi.org/10.1542/peds.2008-2262 https://pubmed.ncbi.nlm.nih.gov/19254974

[21] Jane MacKenzie A, Rome K, Evans AM. The efficacy of nonsurgical interventions for pediatric flexible flat foot: a critical review. Journal of pediatric orthopedics 2012;32(8):830-4

http://dx.doi.org/10.1097/BPO.0b013e3182648c95 https://pubmed.ncbi.nlm.nih.gov/23147627

[21] Jane MacKenzie A, Rome K, Evans AM. The efficacy of nonsurgical interventions for pediatric flexible flat foot: a critical review. Journal of pediatric orthopedics 2012;32(8):830-4

http://dx.doi.org/10.1097/BPO.0b013e3182648c95 https://pubmed.ncbi.nlm.nih.gov/23147627

[22] Wenger DR, Mauldin D, Speck G, Morgan D, Lieber RL. Corrective shoes and inserts as treatment for flexible flatfoot in infants and children. The Journal of bone and joint surgery. American volume 1989;71(6):800-10

https://pubmed.ncbi.nlm.nih.gov/2663868

[23] Whitford D, Esterman A. A randomized controlled trial of two types of in-shoe orthoses in children with flexible excess pronation of the feet. Foot & ankle international 2007;28(6):715-23

https://pubmed.ncbi.nlm.nih.gov/17592702

[23] Whitford D, Esterman A. A randomized controlled trial of two types of in-shoe orthoses in children with flexible excess pronation of the feet. Foot & ankle international 2007;28(6):715-23

https://pubmed.ncbi.nlm.nih.gov/17592702

[24] Rome K, Ashford RL, Evans A. Non-surgical interventions for paediatric pes planus. The Cochrane database of systematic reviews 2010

http://dx.doi.org/10.1002/14651858.CD006311.pub2 https://pubmed.ncbi.nlm.nih.gov/20614443

[24] Rome K, Ashford RL, Evans A. Non-surgical interventions for paediatric pes planus. The Cochrane database of systematic reviews 2010

http://dx.doi.org/10.1002/14651858.CD006311.pub2 https://pubmed.ncbi.nlm.nih.gov/20614443

[25] Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. American family physician 2003;68(5):917-22

https://pubmed.ncbi.nlm.nih.gov/13678140

[25] Calmbach WL, Hutchens M. Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. American family physician 2003;68(5):917-22

https://pubmed.ncbi.nlm.nih.gov/13678140

[26] Wiegerinck JI, Yntema C, Brouwer HJ, Struijs PAA. Incidence of calcaneal apophysitis in the general population. European journal of pediatrics 2014;173(5):677-9

http://dx.doi.org/10.1007/s00431-013-2219-9 https://pubmed.ncbi.nlm.nih.gov/24297670

[26] Wiegerinck JI, Yntema C, Brouwer HJ, Struijs PAA. Incidence of calcaneal apophysitis in the general population. European journal of pediatrics 2014;173(5):677-9

http://dx.doi.org/10.1007/s00431-013-2219-9 https://pubmed.ncbi.nlm.nih.gov/24297670

[27] Perhamre S, Janson S, Norlin R, Klässbo M. Sever's injury: treatment with insoles provides effective pain relief. Scandinavian journal of medicine & science in sports 2011;21(6):819-23

http://dx.doi.org/10.1111/j.1600-0838.2010.01051.x https://pubmed.ncbi.nlm.nih.gov/20492591

[27] Perhamre S, Janson S, Norlin R, Klässbo M. Sever's injury: treatment with insoles provides effective pain relief. Scandinavian journal of medicine & science in sports 2011;21(6):819-23

http://dx.doi.org/10.1111/j.1600-0838.2010.01051.x https://pubmed.ncbi.nlm.nih.gov/20492591

[28] Perhamre S, Lundin F, Norlin R, Klässbo M. Sever's injury; treat it with a heel cup: a randomized, crossover study with two insole alternatives. Scandinavian journal of medicine & science in sports 2011;21(6):e42-7

http://dx.doi.org/10.1111/j.1600-0838.2010.01140.x https://pubmed.ncbi.nlm.nih.gov/20673253

[29] Wiegerinck JI, Zwiers R, Sierevelt IN, van Weert HCPM, van Dijk CN, Struijs PAA. Treatment of Calcaneal Apophysitis: Wait and See Versus Orthotic Device Versus Physical Therapy: A Pragmatic Therapeutic Randomized Clinical Trial. Journal of pediatric orthopedics 2016;36(2):152-7

http://dx.doi.org/10.1097/BPO.0000000000000417 https://pubmed.ncbi.nlm.nih.gov/25985369

[30] Cassas KJ, Cassettari-Wayhs A. Childhood and adolescent sports-related overuse injuries. American family physician 2006;73(6):1014-22

https://pubmed.ncbi.nlm.nih.gov/16570735

[30] Cassas KJ, Cassettari-Wayhs A. Childhood and adolescent sports-related overuse injuries. American family physician 2006;73(6):1014-22

https://pubmed.ncbi.nlm.nih.gov/16570735

[31] Chiodo WA, Cook KD. Pediatric heel pain. Clinics in podiatric medicine and surgery 2010;27(3):355-67

http://dx.doi.org/10.1016/j.cpm.2010.03.001 https://pubmed.ncbi.nlm.nih.gov/20691369

[31] Chiodo WA, Cook KD. Pediatric heel pain. Clinics in podiatric medicine and surgery 2010;27(3):355-67

http://dx.doi.org/10.1016/j.cpm.2010.03.001 https://pubmed.ncbi.nlm.nih.gov/20691369

[32] Mohanta MP. Growing pains: practitioners' dilemma. Indian pediatrics 2014;51(5):379-83

https://pubmed.ncbi.nlm.nih.gov/24953579

[32] Mohanta MP. Growing pains: practitioners' dilemma. Indian pediatrics 2014;51(5):379-83

https://pubmed.ncbi.nlm.nih.gov/24953579

[33] Lowe RM, Hashkes PJ. Growing pains: a noninflammatory pain syndrome of early childhood. Nature clinical practice. Rheumatology 2008;4(10):542-9

http://dx.doi.org/10.1038/ncprheum0903 https://pubmed.ncbi.nlm.nih.gov/18762787

[33] Lowe RM, Hashkes PJ. Growing pains: a noninflammatory pain syndrome of early childhood. Nature clinical practice. Rheumatology 2008;4(10):542-9

http://dx.doi.org/10.1038/ncprheum0903 https://pubmed.ncbi.nlm.nih.gov/18762787

[34] Pavone V, Lionetti E, Gargano V, Evola FR, Costarella L, Sessa G. Growing pains: a study of 30 cases and a review of the literature. Journal of pediatric orthopedics 2011;31(5):606-9

http://dx.doi.org/10.1097/BPO.0b013e318220ba5e https://pubmed.ncbi.nlm.nih.gov/21654473

[34] Pavone V, Lionetti E, Gargano V, Evola FR, Costarella L, Sessa G. Growing pains: a study of 30 cases and a review of the literature. Journal of pediatric orthopedics 2011;31(5):606-9

http://dx.doi.org/10.1097/BPO.0b013e318220ba5e https://pubmed.ncbi.nlm.nih.gov/21654473

[35] Baxter MP, Dulberg C. "Growing pains" in childhood--a proposal for treatment. Journal of pediatric orthopedics 1988;8(4):402-6

https://pubmed.ncbi.nlm.nih.gov/3292578

[35] Baxter MP, Dulberg C. "Growing pains" in childhood--a proposal for treatment. Journal of pediatric orthopedics 1988;8(4):402-6

https://pubmed.ncbi.nlm.nih.gov/3292578

[36] Knelpuntenanalyses jeugdgezondheidszorg CBO & Argumentenfabriek 2015

[37] Laurent de Angulo MS, Brouwers-de Jong EA, Bijlsma-Schlösser JFM, Bulk-Bunschoten AMW, Pauwels JH, Steinbuch-Linstra I. Ontwikkelingsonderzoek in de JGZ. Koninklijke van Gorcum BV 2005;ISBN-13: 9789023241911():

[38] Eekhof JAH, Knuistingh Neven A, Opstelten W. Kleine kwalen bij kinderen. Elsevier Gezondheidszorg 2009

[39] Le Cras S, Bouck J, Brausch S, Taylor-Haas A. Cincinnati Children's Hospital Medical Center: Evidence-based clinical care guideline for Management of Idiopathic Toe Walking 2011;Guideline 040():1

http://www.cincinnatichildrens.org/service/j/anderson-center/evidence-based-care/occupational-therapy-physical-therapy/

[40] Staheli LT.. Fundamentals of pediatric orthopedics Lippincott Williams & Wilkins, Philadelphia 2014;ISBN-13: 978-0781774970():

[41] Thackeray C, Beeson P. In-toeing gait in children. A review of the literature. The foot 1996;6():1

[42] Visser J. Pluis of niet pluis. Een leidraad voor de eerstelijns gezondheidszorg. Groningen Telengg drukwerk service 2012

[43] Hefti F. Pediatric Orthopedics in Practice. Springer-Verlag, Berlin Heidelberg New York 2007; ISBN-13: 978-3-540-69963-7():

[44] Neligan PC. Plastic Surgery, volume 6: Hand and upper extremity. Elsevier 2017;6(ISBN-13: 978-0323356305.):

[45] EUROCAT Website Database

http://www.eurocat-network.eu/ACCESSPREVALENCEDATA/PrevalenceTables%20(data%20uploaded%2008/02/2017)

[45] EUROCAT Website Database

http://www.eurocat-network.eu/ACCESSPREVALENCEDATA/PrevalenceTables%20(data%20uploaded%2008/02/2017)

[46] Dijkman RR. Radial polydactyly: double or nothing? Proefschrift, Rotterdam 2016

http://www.publicatie-online.nl/uploaded/flipbook/13797-r-dijkman/index.html#8

[46] Dijkman RR. Radial polydactyly: double or nothing? Proefschrift, Rotterdam 2016

http://www.publicatie-online.nl/uploaded/flipbook/13797-r-dijkman/index.html#8

[47] Meer IM. Vitamine D tekort in een multi-etnische populatie; determinanten, prevalentie en consequenties. Samenvatting proefschrift. Epidemiologisch bulletin 2010;45():3

[48] Richtlijn Primaire Idiopathische Klompvoet Nederlandse Orthopaedische Vereniging 2013

[49] Sluijs JA, Sakkers RJB, Bronswijk JAHM. Praktische Kindergeneeskunde: Kinderorthopedie. Bohn Stafleu van Loghum, Houten 2009

[50] Handleiding bij het meten en wegen van kinderen en het invullen van groeidiagrammen. TNO: Groeidiagrammen. 2010

[51] RIVM: Richtlijn Uitvoering RVP 2017

http://rivm.nl/

[51] RIVM: Richtlijn Uitvoering RVP 2017

http://rivm.nl/

[52] NHG-Standaard Niet-traumatische knieklachten 2016

[53] Wiegerinck JI, Struijs PA, Oudhof B, van Weert HCPM. Hielpijn bij kinderen. Huisarts en Wetenschap 2012;55(6):260

[54] Stakenborg J, Hobma S. Kinderen met hielpijn Huisarts en Wetenschap 2015;58(5):274

[55] Hilbink M, Ouwens M, Kool T. De HARING-tools. Dertien instrumenten voor ondersteuning bij het opstellen, herzien, implementeren en evalueren van richtlijnen. Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen 2013

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