clubfoot presentation

1. CLUB FOOT

2. Definition:
 Club foot is a deformity of whole foot
that is present at birth.
 There are several types of club foots
which are collectively known as
‘talipes’ (as it involves the talus)
 Most common : talipes equino varus (in
which child is born with foot pointing
down and twisted inwards at an angle)
 Occurs in 1 in 1000 births.
 Affects both males and females.
 Can be unilateral or bilateral.

3. Types:
 VARUS: Inward rotation (walk
on ankle)
 VALGUS: Outward rotation
(walk on inner ankle)
 CALCANEOUS: Upward rotation
(walk on heels)
 EQUINES: Downward rotation
(walk on toes)

4. The Pirani Score is a
simple and reliable
system to determine
severity and monitor
progress in the
Assessment and
Treatment of Clubfoot

8. Diagnostic procedures:
ULTRASONOGRAPHY X-RAY CT-SCAN

9. Treatment:
Stretching and casting
(Ponseti method)
Stretching and taping
(French method)
Surgery
Brace

10. Ponseti Method:
 The Ponseti method consists
of 2 equally important
phases: the corrective phase
and the maintenance phase
and consist of serial
manipulation, casting and
tenotomy of the Achilles
Tendon. This is followed by the
use of foot abduction brace to
prevent the occurrence of
relapse.
 Gold standard

11. French method:
 The French functional physical
therapy method consists of daily
manipulations of the newborn's
clubfoot by a specialized
physical therapist, stimulation of
the muscles around the foot and
temporary immobilization of the
foot with elastic and nonelastic
adhesive taping.

12. Surgery:
 A percutaneous Achilles tenotomy (often abbreviated perc TAL) for clubfoot
is a procedure that lengthens the Achilles tendon and helps to improve flexibility
of the ankle.
 The surgical procedure usually consists of releasing and lengthening the
tight tendons/joint capsule of the foot. Many surgeons prefer to make two
separate incisions, a posteromedial incision, and a small lateral incision.
However, it is also possible to have one circumferential incision.

13. Brace:
The Denis Browne bar, also known as the Denis Browne
splint or foot abduction orthosis, is a medical device used
in the treatment of club foot.
Foot bracing is crucial for the maintenance of correction
of clubfoot deformity after casting using
the Ponseti technique
'abduction brace', which holds the legs apart.
Changed every week.

14. Pharmacologic
agents:
 NSAIDS (ibuprofen)
 MANAGEMENT FOR PAIN.

15. THANKYOU.