Congenital Musculoskeletal Congenital Musculoskeletal Health ProblemsHealth Problems

BYBY

DR: Gehan MohamedDR: Gehan Mohamed

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Congenital Musculoskeletal Congenital Musculoskeletal Health ProblemsHealth Problems

ClubfootClubfoot Developmental dysplasia of the hipDevelopmental dysplasia of the hip Amelia ,meromeliaAmelia ,meromelia

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Clubfoot(Clubfoot(talipes) Talipes Latin talus (ankle) + pes (foot)Talipes Latin talus (ankle) + pes (foot)

Involves bone deformity and malposition in Involves bone deformity and malposition in form of form of a curled shape or twisted position of the ankle, heel, and toes with soft tissue with soft tissue contraction.contraction.

May be unilateral or bilateralMay be unilateral or bilateral Affected foot is usually smaller and shorter, Affected foot is usually smaller and shorter,

with an empty heel pad and transverse with an empty heel pad and transverse plantar creaseplantar crease

Easily recognized at birthEasily recognized at birth

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ClubfootClubfoot

Congenital malformation of the lower Congenital malformation of the lower extremity that affects the lower leg, ankle, extremity that affects the lower leg, ankle, and footand foot

Clinical typesClinical types There are four variations of clubfoot:

(1) talipes varus: the most common form of clubfoot, the foot generally turns inward so that the leg and foot look somewhat like the letter J ).

(2) talipes valgus, the foot rotates outward like the letter L.

(3) talipes equinus, the foot points downward, similar to that of a toe dancer.

(4) talipes calcaneus, the foot points upward, with the heel pointing down.

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FOOT DEFORMITIESFOOT DEFORMITIES

Talipes EquinovarusTalipes Equinovarus 1in 1000 births 1in 1000 births Talipes EquinovalgusTalipes Equinovalgus Club Foot Club Foot EtiologyEtiology PositonalPositonal Congenital,Congenital, Associated with other neuromuscular Associated with other neuromuscular

disorders disorders

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EtiologyEtiology

Positional Positional

held in a deformed position in utero held in a deformed position in utero

Flexible on examinationFlexible on examination Congenital Congenital

multifactorial inheritance, envoirnmental multifactorial inheritance, envoirnmental

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TALIPES EQUINOVARUSTALIPES EQUINOVARUS

The common ("classic") form of clubfoot.The common ("classic") form of clubfoot.

Talipes Latin talus (ankle) + pes (foot)Talipes Latin talus (ankle) + pes (foot)

. Equino- indicates the heel is elevated (like a . Equino- indicates the heel is elevated (like a

horse's) -varus indicates it is turned inward.horse's) -varus indicates it is turned inward.

The foot is turned in sharply and the person The foot is turned in sharply and the person

seems to be walking on their ankle. seems to be walking on their ankle.

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EquinovarusEquinovarus

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EquniovarusEquniovarus

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TALIPES EQUINOVALGUSTALIPES EQUINOVALGUS

Combination of talipes equinus Combination of talipes equinus

andand talipes valgus,(outward)talipes valgus,(outward)

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Therapeutic managementTherapeutic management

Serial manipulation and castingSerial manipulation and casting

If sufficient correction not achieved within 3 to If sufficient correction not achieved within 3 to 6 months, surgery is performed6 months, surgery is performed

Long-term follow-upLong-term follow-up

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Clubfoot Clubfoot

Postoperative nursing considerationsPostoperative nursing considerations Neurovascular checks at least every 2 hoursNeurovascular checks at least every 2 hours Observe for any swelling around cast edges Observe for any swelling around cast edges Elevate ankle and foot on pillowsElevate ankle and foot on pillows

Pain management Pain management (analgesics)(analgesics)