CONGENITAL CLUBFOOT

CONGETINAL CLUBFOOT
• The foot is twisted out of the normal shape or position
• The most common type is called Talipses Equinovarus. The foot is pointed downward
and inward

PATHOLOGY
• The cause is unknown – possible related to arrested embryonic development.
• Boys are affected twice as often as girls.
• Deformity of bone and muscle with bilateral or unilateral (more common)
• True Clubfoot: cannot turn and manipulate foot

TREATMENT
• Serial Casting
o Begun shortly (ASAP) after birth when the infants foot is very pliable (flexibility of bones).
o Done is Stages:
 Adduction deformity
 Inversion deformity
 Plantar flexion deformity
o Casting is done to the other extreme hoping to end up somewhere in the middle
o 1-2 week will change position with new cast
o Unless mild will not be just one casting

Alternative Correction
• Dennis-Browne Splint
o After casting or when it is not very severe
o Shoes with steel bats adjusted
o May wear at night
o Nurse does not adjust
o They hurt, when they hit you in the head

Major nursing considerations to be used when caring for a

pediatric/adolescent client with this diagnosis
• Skin / Circulation assessment
• Parent education / Support because they will be doing most of the care
• Regular Cast Change
• Reinforcing orthopedics instructions
• Care of cast or application (Neurovascular checks)
• Encourage to facilitate normal development

NURSING DIAGNOSIS
• (Not at first) Impaired physical mobility R/T deformity of one or both feet
• (Seen at birth) Potential altered parenting R/T fear, difficulty in caring for child in cast
• Potential for injury; neurovascular impairment R/T Casting
o Parent will have to be taught NV checks

Older Child : Casting will not work; surgery as only treatment. Also in severe cases of clubfoot