Brief Pathoanatomy of CTEV. Just fun project for class seminar

1. PATHOANATOMY
Made by –
Dr. Kanwal Bajaj
IX Sem

2. DEFORMITY IN BONES
1.Bones are smaller than normal
2.Neck of the talus is angulated 
Talus faces down and medially
3.Calcaneum is small, concave
medially

3. DEFORMITY IN JOINTS
1. EQUINUS:
• Primarily at ankle joint
• Other tarsal joints also contribute
2. INVERSION:
• Primarily at sub-talar joint
• Inverted calcaneum takes the whole foot  Sole
faces medially
3. FOREFOOT ADDUCTION :
• At mid-tarsal joints (Mainly talonavicular joint)
4. FOREFOOT CAVUS :
• d/t Excessive arching of foot at mid-tarsal joints

4. MUSCLES AND TENDON
• Muscles of calf are under developed 
following muscles-tendon units are
contracted:
1. POSTERIORLY  Tendoachilles
2. MEDIALLY (3 Muscles )
• Tibialis posterior
• Flexor digitorum longus (FDL)
• Flexor hallucis longus(FHL)

5. CAPSULES AND LIGAMENTS
• All ligamentous structures on postero-medial aspect of
foot are shorten
• Structures affected are:
1. POSTERIOR (3 Structures) :-
A.Posterior capsule of ankle joint
B. Posterior capsule of sub-talar joint
C. Posterior talo-fibular and calcaneo-fibular
ligament
2. MEDIAL (3 Ligaments ) :-
A. Talo-navicular ligament
B. Spring ligament
C. Deltoid ligament

6. 3.PLANTAR:-
A. Plantar fascia
B.Plantar ligaments
4.OTHERS :-
A. Interosseous ligaments
between talus and calcaneum

7. SKIN
• It develops adaptive shortening
on medial side of sole
• Deep creases present on medial
side
• Dimples on lateral aspect of ankle
and mid foot

8. SECONDARY CHANGES
• Occurs if child starts walking on
deformed feet
• Weight bearing exaggerates
deformity
• Callosities and bursae develop
over bony prominences on lateral
side of foot

9. THANK YOU