Ctev

2,089 views
1,968 views

Published on

0 Comments
4 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,089
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
169
Comments
0
Likes
4
Embeds 0
No embeds

No notes for slide

Ctev

  1. 1.  Congenital Talipes EquinoVarus Club foot Talipes(Latin) – Talus + Pes (Foot)
  2. 2.  Heel - Equinus Hind foot – Varus Fore foot – Adduction & supinationCavus footInternal tibial torsion
  3. 3.  Associted problemsConstricted Annular rings(Streetere’s syndrome)Tibial deficiencyInguinal herniaCDHSpina bifida
  4. 4.  1-2 per 1000 live births Boys : Girls – 2:1 Common in left Bilateral in 50%
  5. 5.  Unknown cause Germ plasm defect Development defect Neurologic/Neural tube defects Abnormal position in utero Arthrogryposis
  6. 6.  Pathoanatomy JointsEquinus ankle & subtalar BonePosterior displacement Lat. MalleolusMedial rotation & inversion talusMedial angulation of neck of talusMedial rotation, equinus CalcaneusMedial rotation, equinus of navicular
  7. 7.  LigamentsContracture of Spring lig.Bifurcarcated Y ligDeltoid lig.Calcaneo-fibular ligTalo fibular lig.
  8. 8.  TendonsTibialis posteriorFHLFDLFDBTendo AchillisAbductor hallucisPlantar aponeurosisTibialis anteriorEHL
  9. 9.  Master knot of Henry’sFibrous sheath envelops FHL&FDLBind the medial & plantar side ofnaviculum
  10. 10.  Present at birth Small, bean shaped foot Ankle in equinus Fore foot adducted & supinated Heel inverted, small & high Cavus foot Deep posterior & medial creases Prominent talar head dorso laterally Tight Tendo achillis
  11. 11.  Antero-posterior ViewKite’s angleTalo-calcaneal anglenormal 20-40 degrees Lateral viewin forced dorsiflextionLine thru longitudinal axis oftalusand that of calcaneumNormal 30 –40 degrees
  12. 12.  AIMTo produce & maintain plantigrade, supple& functionally near normal foot
  13. 13.  Conservative Mx1.Manipulation by parents- 1-2 dayspost birth2.Manipulation and strapping3.Serial corrective castingForefoot adductionHeel varusEquinus
  14. 14.  Surgical MxIndicationsResistant CTEV (after 8-12 wkscons mx)Late presentationRigid CTEVArthrogryposis Time of surgery6-9 months
  15. 15.  Soft tissue proceduresPostero medial releaseTurco’s releaseTA lengthening
  16. 16.  Post Operative managementDennis brown splint/shoes x 3months
  17. 17.  Ilizarov Jess fixator Tripple arthrodesis Dilwyn Evansosteotomy Dwyers osteotomy
  18. 18.  Rocker bottom deformity Recurrence Residual deformity Flat top talus

×