Professional Documents
Culture Documents
Clubfoot
Clubfoot
I. Definition
Clubfoot is a condition in which one or both feet are twisted into an abnormal
position at birth. The condition is also known as talipes.
It is a general term used to describe a range of unusual positions of the foot. This is
present at birth and affects the foot and/or ankle. There is no known cause for clubfoot,
and it is twice as common in male children as it is in female children. Most type of
clubfoot is present at birth which can happen in one foot or in both feet. In almost half of
affected infants, both feet are involved.Although clubfoot is painless in a baby, treatment
should begin immediately. Clubfoot can cause significantly problems as the child grows,
but with early treatment most children born with clubfoot are able to lead a normal life
II. A.K.A
III. Incidences
Although there is no known cause of congenital clubfoot, some doctors believe the
use of drugs or alcohol during pregnancy or the presence of other diseases can cause
it. In some cases, clubfoot is just the result of the position of the baby while it is
developing in the mother’s womb.
Clubfoot is painless in a baby, but it can eventually cause discomfort and become a
noticeable disability. Left untreated, clubfoot does not straighten itself out. The foot will
remain twisted out of shaped, and the affected leg may be shorter and smaller than the
other. These symptoms become more obvious and more of a problem as the child
grows.
Fixed plantar Flexion (equinos) of the ankle, characterized by the drawn up position
of the heel and inability to bring the foot to a plantigrade (flat) standing position. This
is caused by a tight Achilles tendon.
Adduction (varus), or turning in of the heel or hindfoot.
Adduction (turning under), of the forefoot and midfoot giving the foot a kidney-
shaped appearance.
Abnormal (slightly smaller) size of foot & calf muscles.
The heel cord (Achilles tendon) is tight causing the heel to be drawn up toward the
leg.
• Physical examination.
• Ultrasound
o Ultrasound done while a fetus is developing can sometimes detect
clubfoot. It is more common for your health professional to diagnose the
condition after the infant is born, though, based on the appearance and
mobility of the feet and legs. In some cases, especially if the clubfoot is
due just to the position of the developing baby, the foot is flexible and can
be moved into a normal or nearly normal position
• X-ray - a diagnostic test which uses invisible electromagnetic energy beams to
produce images of internal tissues, bones, and organs onto film.
• Computed tomography scan (Also called a CT or CAT scan.) - a diagnostic
imaging procedure that uses a combination of x-rays and computer technology to
produce cross-sectional images (often called "slices"), both horizontally and
vertically, of the body. A CT scan shows detailed images of any part of the body,
including the bones, muscles, fat, and organs. CT scans are more detailed than
general x-rays.
IX. Management
Treatment for clubfoot usually begins soon after birth, so the foot grows to be
stable and positioned to bear weight for standing and moving comfortably.
Nonsurgical treatment such as casting or splinting is usually tried first. The foot
(or feet) is moved (manipulated) into the most normal position possible and held
(immobilized) in that position until the next treatment.
• Traditional
• Ponseti method
In this method, two problems w/ foot position (the front part of the foot being
turned in and up) are corrected at once. Toward the end of the series of castings, if the
whole foot is pointing down, children treated with this method still require a minor
surgery to lengthen the tight Achilles tendon. This is usually an outpatient procedure.
Recent research indicates that the Ponseti method is successful in most children
clubfoot if treatment is started immediately and if the health professional’s instructions
for bracing are followed after casting is finished. One study indicated that 94% of
children treated with traditional casting will require major corrective surgery within the
first year of life, while only35% of children treated with the Ponseti method will require
this major surgery.
Other Methods
Casting- can be started on the day of birth or within several weeks after birth. In this
procedure, the orthopedist pushes and twists the foot into an over corrected
position and then cast is applied to ensure holding of foot in same manner. (kiting)
Dennis Brown Brace- used when long leg cast is removed after 3 weeks of
treatment. The bar is fit shoulder width apart and worn full time for the 1st 2 months
after the last cast is removed.
Pharmacologic Management:
X. Nursing Diagnosis
XII. Illustration
A photo of a newborn baby with a clubfoot. A photo of a newborn baby in the NICU
with a bilateral clubfoot deformity.
References:
en.wikipedia.org
www.epodiatry.com
www.mercksource.com
www.nlm.nih.gov
www.umm.edu
http://healthline.com/
http://adam.about.com/