Club foot, also known as congenital talipes equinovarus, is a deformity where the foot is twisted inward and downward. It occurs in about 1 in 1000 live births and is more common in boys. Causes may include genetic factors or excessive pressure on the fetus. Club foot is classified based on the direction the foot is twisted. Treatment involves manipulation and casting, known as the Ponseti method, to gradually correct the deformity in most cases. For resistant cases, surgery may be needed to reshape bones. Nursing care focuses on skin integrity during casting and addressing parental anxiety or potential body image issues.

1. Club foot(Congenital
Talipes Equinovarus)
BY:
Mr. Ganesh V. Naik
II Year MSc(N)
Pediatric dept.
SDMINS Dharwad

2. INTRODUCTION
Talipes Equinovarus is a deformity of the foot
and ankle that a child can be born with this
problem. The term “tallipes” was coined by
little in 1839. He derived it from the Latin
“Talus”(ankles) and pes( foot)

3. DEFINITION
Clubfoot is a complex deformity of foot result
of complicated interrelationship between bone,
ligaments and muscles.

4. INCIDENCE
• It occurs in one out of 1000 live birth.
• Boys affected twice more than girls

5. CAUSES
• Hereditary-defective gene
• Excessive pressure of amniotic fluid on fetus
causes excessive pressure of uterine wall on
fetus.
• Mechanical cause(Uterine compression)
• Arrested fetal development
• Circulatory failure to calf and foot muscles
• Irradiation(maternal) during pregnancy.

6. CLASSIFICATION
Talipes Equinovarus:
95% all cases
In this condition, the foot is fixed in plantar
flexion and deviates medially that is the heal is
elevated.
If the condition is not corrected , the child
walks on the toes and the outer boarder of
the foot.

8. Conti..
Talipes Calcaneovalgus:
In this the foot is dorsiflexed and deviates
laterally that is the heel is turned outward from
the midline of the body and the anteriar part of
the foot is elevated on the outer border.
If not corrected the child walks on the outwardly
turned heel and the inner border of the foot.
These conditions may be unilateral or bilateral

10. Conti..
• Other less commonly observed types are:
Talipes varus: Due to the heel’s being turned
inward from the midline of the leg. Only the
outer portion of the sole rests on the floor
Talipes valgus: Due to the heels being turned
outward from the midline of the leg. Only the
inner side of the sole rests on the floor

12. Talipes valgus

13. Conti…
Talipes Equinovalgus: Due to the heels being
elevated and turned outward from the midline
of the body.
Talipes calcaneovarus: Due to the heels being
turned towards the midline of the body and
anterior part of the foot being elevated . Only
the heels rests on the floor.

15. TERMS
• Talipes: Foot and ankle
• Varus: Bending inward
• Valgus: Bending outward
• Equinus: Toes are lower then heel.
• Calcaneous: Toes are higher than heel

16. CLINICAL MANIFESTATIONS
• Usually clubfoot is painless in children.
• Discomfort and become a noticeable
disability.
• The foot will remain twisted out of shape and
the affected leg may be shorter and smaller
than the other.
• Poor child growth and development.
• Body image disturbance

17. Conti…
• The calf muscles are generally
underdeveloped
• Stiff rigid, foot of varying degrees.

18. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• Ultrasound scanning during pregnancy
• X-rays

19. MANAGEMENT
Non operative management:
• Two catagories of clubfoot are identified.
Easy or correctable clubfoot: which is
corrected with manipulation , casting and
splintage alone.
Resistant clubfoot: It is that which responds
poorly to splintage and manipulative
treatment. It requires operative management

20. Conti…
• Ponseti method is popular manipulation method
to correct clubfoot.
• This is not painful or uncomfortable for the child.
• In this method the specialist manipulates(holds,
stretches and moves) the child’s foot with their
hands into a position in which the foot deformity
is put right (corrected) as much as possible.
• Once in this position plaster cast is put on to hold
the child’s foot in position .The whole process
may done 4 to 10 times

21. Casting

22. Conti..
Surgical management
In children younger than 5 years , correction
can be achieved with soft tissue procedure.
Children older than 5years require bone
reshaping eg. Dorselateral wedge excision of
the calcaneocuboid joint or osteotomy of the
calcaneum to correct varus.
Lateral wedge torsectomy or triple fusion is
required if the child is older than 10 years.

23. Conti..
Nursing management:
Impaired skin integrity related to application
of casts
Parental anxiety related to club foot
High risk for body image disturbance related
to deformity of club foot

24. Thank you