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Club Foot

Clubfoot, or Congenital Talipes Equino-Varus (CTEV), is the most common congenital foot disorder, affecting 1 in 1000 live births, with a higher prevalence in males. The condition involves various anatomical deformities of the foot and ankle, leading to a functional and aesthetic impact, and can be managed through conservative methods like casting or surgical interventions if conservative treatment fails. Key clinical features include a short Achilles tendon, abnormal foot creases, and potential calf muscle wasting, with radiography used for assessment.

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Priyanka
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47 views16 pages

Club Foot

Clubfoot, or Congenital Talipes Equino-Varus (CTEV), is the most common congenital foot disorder, affecting 1 in 1000 live births, with a higher prevalence in males. The condition involves various anatomical deformities of the foot and ankle, leading to a functional and aesthetic impact, and can be managed through conservative methods like casting or surgical interventions if conservative treatment fails. Key clinical features include a short Achilles tendon, abnormal foot creases, and potential calf muscle wasting, with radiography used for assessment.

Uploaded by

Priyanka
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

CLUB FOOT/

CongenitalTalipes Equino-
Varus
(CTEV)
By- Priyanka BPT 2nd year
CLUB FOOT

Definitions---
* Talipes: Talus = ankle
Pes = foot
*Equinus: (Latin = horse)
Foot that is in a position of planter flexion at
the ankle, looks like that of the horse.
*Varus:means deviated towards midline
CTEV
• MOST COMMON CONGENITAL FOOT DISORDER
• MALES more than FEMALES
• 1/1000 LIVES BIRTHS
CLUB FOOT Types 

CLUB FOOT Types

# Idiopathic (Unknown Etiology) :


CongenitalTalipes Equino-Varus CTEV

# Acquired, Secondary to :
* CNS Disease : Spina bifida,
Poliomyelitis
* Arthrogryposis Multiplex Congenita
* Absent Bone : fibula / tibia
PATHO-ANATOMY
• BONES AND JOINTS
• CALCANEUS : IN VARUS POSITION
• TALUS : DISPLACED MEDIAL AND PLANTARWARDS
• NAVICULAR : MEDIALLY DISPLACED AND ROTATED

• CUBOID: DISPLACED MEDIALLY AND ARTICULATES WITHTHE NON-


ARTICULAR SURFACE OF CALCANEUM ( CUBOID SIGN / LOCKED CUBOID )

• METATARSALS : DEVIATES MEDIALLY AT T-M JOINTS


• DISLOCATION OFTALOCALCANEAL ARTICULATION
• TIBIA – MEDIAL TORSION
PATHO-ANATOMY
• SKIN
• Adapts shortening on the medial side
• Deep creases on the medial side
• Dimples on the lateral aspect

• SECONDARY CHANGES
• Occurs when the child starts walking-exaggerates the deformity
• Callosities and bursae
CLINICAL FEATURES
• Short Achilles tendon
• High and small heel
• No creases behind Heel
• Abnormal crease in middle of the foot
• Foot is smaller in unilateral affection
• Callosities at abnormal pressure areas
• Internal torsion of the leg
• Calf muscles wasting
• Deformities don’t prevent walking
INVESTIGATIONS
• RADIOGRAPHY
• AP VIEW :angle formed b/w
• talus and calcaneum ( NORMAL 30-35)=REDUCED
• Talus and metatarsals ( NORMAL 5 -15 ) = -VE
• Helps to asses angle of varus and forefoot adduction
MANAGEMENT
• The goal of treatment for clubfoot is to obtain a
plantigrade foot that is functional, painless, and stable

A cosmetically pleasing appearance is also an important goal


• CONSERVATIVE
• SURGICAL
• EXTERNAL FIXATORS
CONSERVATIVE
• INFANTS (< 6 MONTHS)
• 1ST 6WEEKS : SERIAL MANIPULATION
AND CASTING

• Corrective casting

• First correction of adductus of midfoot
• Folowed by correction of inversion
• Finally correction of the equinus
SURGICAL TRATMENT
• Indications
• Late presentation, after 6 months of age
• Complementary to conservative treatment
• Failure of conservative treatment
• Residual deformities after conservative treatment
• Recurrence after conservative treatment
EXTERNAL
FIXATORS
• ILIZAROV’S EXTERNAL
FIXATOR FRAME

• JOSHI’S EXTERNAL FIXATOR


FRAME
THANKS

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