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CLUBFOOT ---->
yIt is the abnormal rotation of foot at
Other Name:
Talipes most common type of club foot is Talipes Equinovarus
Types of clubfoot yVarus (inward rotation): would walk on ankles, bottoms of feet face each other yValgus (outward rotation): would walk on inner ankles yCalcaneous (upward rotation): would walk on heels yEquinas (downward rotation): would walk on toes
Risk factors
yGender yFamily history of clubfoot
Causes: y Unknown (idiopathic) y Position of the baby in the uterus y Increased occurrences in those children with neuromuscular disorders, such as cerebral palsy (CP) and spina bifida. y Oligohydramnios (decreased amount of amniotic fluid surrounding the fetus in the uterus) during pregnancy.
INCIDENCE y1 in 1000 livebirths yMost common deformity (95%) is talipes equinovarus yOccurs more frequently in boys than in girls
Signs and Symptoms yHigh arched foot that may have a crease-cross of the sole of the foot yThe heel is drawn up yThe toes are pointed down yThe bottom of the feet (heel) is pointed away from the body, thus the foot is twisted in towards the other foot
may be smaller yThe foot will lack motion and be noticeably stiff yThe calf muscle may be smaller
Pathophysiology Genetic, sex, maternal illness Lifestyle, presentation Arrest in fetal development of skeletal and soft tissues during 9 to 10 weeks of gestation
Diagnostic Test
yPhysical exam yUltrasound yX-ray
Medical Management 1. Exercises 2. Manipulation and Casting (cast is changed perodically to change angle of foot) 3. Denis brown splint (bar shoe): metal bar with shoes attached to the bar at specific angle
Nursing intervention yPerform exercises as ordered. yProvide cast care or care for a child in a brace. yChild who is learning to walk must be prevented from trying to stand; apply restraints as necessary. yProvide diversional activities.
5. Adapt care routines as needed for cast or barce. 6. Assess toes to be sure cast it not too toght. 7. Provide skin care.
Prognosis The long-term prognosis for babies with clubfoot who were treated with the Ponseti Method is excellent. They have had almost no difference in function or pain in their feet when compared to those persons who were born without clubfoot.
Complication A number of secondary deformities may develop in the foot later in life. It is not always clear why these develop, but may be a combination of post-surgical overcorrection & intrinsic problems. These new deformities may include:
yValgus Hindfoot.
relation to the leg.
yCalcaneus at increased
collapsed arch yPersistent rolling of the ankle ySevere residual clubfoot deformity.