CLUBFOOT ( TalipesEquinoVarus/ TEV) - Is a complex deformity of the whole foot present at birth.

- Involves bone deformity and malposition with soft tissue contracture.

CLUBFOOT
ETIOLOGY
Arrested fetal development in the fibular stage Anomalous tendon insertion Genetic Factors Neurogenic Factors (Spina bifida) and other nueurologic impairments Oligohydramnios Diminished Vascular Circulation

Distal limb amniotic banding

Affects the alignment of the foot Abnormal nerve conduction Restriction of

Fluid leaks during prenatal period vascular supply fetal movements

Disruption of the branches of

Forms a constrictive limb around the utero through anterior tibial artery Cutting of the circulation to the lower limbs

Reduced perfusion

Deformed foot occurs

Calcaneus, navicular and cuboid bones are medially rotated

Axially rotated outward and pointing inwards

Foot Deformity

Clubfoot

TYPES OF CLUBFOOT 1. Equinus (Plantar Flexion) 2. Calcaneus (Dorsiflexion) 3. Varus (Foot turns inward) 4. Valgus (Foot turns outward)

There is often a deep crease on the buttom of the midfoot

The foot and the calf are smaller in affected limbs, which is more obvious in a child with a clubfoot on only one side

All clubfeet are not of the same severity, although all have the same general appearance. The feet are twisted inward so that the top of the foot is where the bottom should be.