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Clubfoot 160530145415 PDF
Clubfoot 160530145415 PDF
Clubfoot 160530145415 PDF
Presented By :-
Sushant
INTRODUCTION
Talipes :- Latin talus (ankle) + pes (foot).
Equino :- indicates the heel is elevated (like a horse's)
varus :- indicates it is turned inward.
It is a congenital malformation of the lower
extremity that affects the lower leg, ankle, and foot.
Club foot, also called congenital talipes equinovarus
(CTEV), is a congenital deformity involving one foot
or both. The affected foot appears to have been
rotated internally at the ankle.
Without treatment, people with club feet often
appear to walk on their ankles or on the sides of
their feet. However with treatment, the vast
majority of patients recover completely during early
childhood and are able to walk and participate in
athletics.
Approximately half of people with clubfoot have it
affect both feet, which is called bilateral club foot.
It occurs in males twice as frequently as in females.
Because of poverty, lack of education and
socioeconomic reasons many of our children (more
than 60%) are neglected and remain untreated.
3 basic components:-
(i) ankle joint plantarflexed/equines
(ii) subtalar joint inverted/varus
(iii) forefoot adducted
Mainly three bones are affected ;
1.TALUS
2.CALCANEUS
3.NAVICULAR
By the time we detect them during camps, they are
already grown up (5 to 18 years of their life). With
this age bones are deformed to great extent and
deformities become severe and rigid which are
difficult to correct.
Also there is a large group of children who get
inadequate treatment and deformities recur.
3 basic components :-
(i) ankle joint plantarflexed/equines
(ii) subtalar joint inverted/varus
(iii) forefoot adducted
INCIDENCE
The overall prevalence of clubfoot was 1.29 per 1,000
live births, with 1.38 among non-Hispanic whites, 1.30
among Hispanics, and 1.14 among non-Hispanic blacks
or African Americans.
In India, out of those children who have born with this
deformity only 20- 25% of children from urban areas,
get proper care and treatment and get cured of the
disease. Rest of the children either remains untreated
(neglected); or even if some of them are treated, they
get recurrences and remain disabled for the life.
children with clubfoot born per year:
30,000(india)
DEFINITION
Clubfoot describes a range of foot abnormalities
usually present at birth (congenital) in which a
baby's foot is twisted out of shape or position.
In clubfoot, the tissues connecting the muscles to
the bone (tendons) are shorter than usual. The
term "clubfoot" refers to the way the foot is
positioned at a sharp angle to the ankle, like the
head of a golf club.
Despite its look, however, clubfoot itself doesn't
cause any discomfort or pain.
Infant with unilateral clubfoot Infant with bilateral clubfoot
CAUSES
The cause of clubfoot is unknown (idiopathic). But
scientists do know that clubfoot is not caused by the
position of the baby in the womb (fetus).
In some cases, clubfoot can be associated with
other abnormalities of the skeleton that are present
at birth (congenital), such as spina bifida.
Clubfoot can also be the result of problems that affect
the nerve, muscle, and bone systems, such as stroke or
brain injury.
Extrinsic associations include teratogenic agents
(eg, sodium aminopterin), oligohydramnios, and
congenital constriction rings
CAUSES…..
It has been proposed that idiopathic CTEV in
otherwise healthy infants is the result of a
multifactorial system of inheritance .
syndromes involving chromosomal deletion.
The environment plays a role in causing clubfoot.
Studies have strongly linked clubfoot to cigarette
smoking during pregnancy, especially when there
already is a family history of clubfoot.
RISK FACTORS
Risk factors include:
Sex. Clubfoot is more common in males.
Family history. If either one of the parents or their
other children have had clubfoot, the baby is more
likely to have it as well. It's also more common if the
baby has another birth defect.
Smoking during pregnancy. If a woman with a family
history of clubfoot smokes during pregnancy, her
baby's risk of the condition may be 20 times greater
than average.
RISK FACTORS……
Casting
OTHER BRACES & CASTS…..
Wheaton
Brace
Dennis Brown
Bar
2. Stretching and taping (French method)
This approach is also called the functional method or the
physiotherapy method. Working with a physical therapist,
parents:
Move the foot daily and hold it in position with adhesive
tape .
Use a machine to continuously move the baby's foot while
he or she sleeps .
After two months, cut treatment back to three times a week
until the baby is 6 months old .
Once the shape is corrected, continue to perform daily
exercises and use night splints until the baby is of walking
age .
This method requires a much greater time commitment
than does the Ponseti method. Some caregivers combine
the French method and the Ponseti method.
Surgery
In some cases, when clubfoot is severe or doesn't
respond to nonsurgical treatments, babies may
need more invasive surgery. An orthopedic
surgeon can lengthen tendons to help ease the
foot into a better position. After surgery, the child
will be in a cast for up to two months, and then
need to wear a brace for a year or so to prevent
the clubfoot from coming back.
Even with treatment, clubfoot may not be totally
correctable. But in most cases babies who are
treated early grow up to wear ordinary shoes and
lead normal, active lives.
Usually done at 9 to 12 months of age.
PREVENTION
Because doctors don't know what causes clubfoot,
we can't completely prevent it. However, during
pregnancy, things to limit baby's risk of birth defects,
include:
not smoking or spending time in smoky
environments
not drinking alcohol
http://www.webmd.com/a-to-z-
guides/clubfoot-topic-overview
http://www.webmd.com/a-to-z-
guides/clubfoot-topic-overview?page=2
http://en.wikipedia.org/wiki/Club_foot
http://www.mayoclinic.org/diseases-
conditions/clubfoot/basics/
Thank
you