CLUB FOOT
*Clubfoot also known as "Talipes equinovarus" is a congenital foot deformity. *That affects about 1 in 1,000 births.
*Males are more affected than female.
*It's characterized by:
1. *Inward turning* of the foot (varus)
2. *Upward turning* of the heel (equinus)
3. *Inward rotation* of the ankle (inversion)
Causes:
- Genetics
- Environmental factors
- Abnormal fetal development
Symptoms:
- Foot deformity
- Difficulty walking
- Pain
- Limited mobility
Treatment:
Management
* CTEV can be managed by three methods:
1. Conservative management.
2. Surgical management.
3. Management by external fixators.
1.conservative management
* It is the treatment of choice in infants less than 6 months of age. The recommended regime is a Kite's method
* Steps
* . Forefoot adduction: An attempt is made to correct this deformity first by stabilizing the heel with one hand and the other hand thumb is placed on the talus, and using the talus as the fulcrum, the forefoot is slowly abducted and everted.
2. Inversion: This is corrected next by the method mentioned above and by exerting pressure over the undersurface of the 4th and 5th metatarsal heads.
3. Equinus: This is the last to be corrected. The hand is placed beneath the foot and is raised into dorsiflexion.
Manipulation and retention: For children over 2 months of age, mere manipulation will not be sufficient. After carrying out the manipulation by the above mentioned methods, retention of the correction achieved is obtained by strapping in mild cases, splinting with Denis Browne splint or by applying on above knee POP casts. They are changed and reapplied every fortnightly for 6 months.
Surgical management
1. Soft tissue procedure
2. Bony procedure
3. Triple arthrodesis
4. Talectomy.
Management by external fixation
*Ilizarov method and
*Joshi's external stabilization system
Early treatment can significantly improve outcomes, allowing individuals with clubfoot to lead active and normal lives
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