Congenital Talipes Equino Varus
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This document provides information about Congenital Talipes Equinovarus (CTEV), also known as clubfoot. It begins with an anatomical overview and defines CTEV as a congenital deformity comprising four components: cavus of the midfoot, adduction of the forefoot, varus of the hindfoot, and equinus of the hindfoot. These deformities cause the foot to take the shape of a golf club, leading to the term "clubfoot". The document then discusses the classification, clinical features, radiological assessment, etiology including primary and secondary causes, and goals of treatment. Non-operative treatment involves serial casting using the Ponsetti method to gradually correct the deformity.
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CTEV basics
Club foot, or congenital talipes equinus varus, is a complex three-dimensional deformity of the foot with four main components: equinus, varus, adductus, and cavus. It has an incidence of about 1 in 1,000 live births. Treatment involves serial manipulation and casting, most commonly using the Ponseti method, with the goal of correcting all deformity components to achieve a functional, plantigrade foot. Maintenance treatment with a foot abduction brace is also required to prevent recurrence of the deformity. Surgery may be needed for resistant, relapsed, or neglected clubfoot cases and involves soft tissue releases to address all pathological structures.
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CTEV UG
This document provides an outline on clubfoot (CTEV), including its epidemiology, causes, anatomy, pathoanatomy, clinical features, imaging, and treatment. CTEV is a relatively common birth defect affecting 1-2 per 1000 births. It involves four deformities: cavus, adductus, varus, and equinus (CAVE). The causes are unknown but may involve genetic or positional factors. Treatment focuses on serial manipulation and casting, especially the Ponseti method, to gradually correct the deformities in a specific order and avoid the need for invasive surgery. The goal is to produce a functional, plantigrade foot.
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Club foot, or congenital talipes equinus varus, is a complex three-dimensional deformity of the foot with four main components: equinus, varus, adductus, and cavus. It has an incidence of about 1 in 1,000 live births. Treatment involves serial manipulation and casting, most commonly using the Ponseti method, with the goal of correcting all deformity components to achieve a functional, plantigrade foot. Maintenance treatment with a foot abduction brace is also required to prevent recurrence of the deformity. Surgery may be needed for resistant, relapsed, or neglected clubfoot cases and involves soft tissue releases to address all pathological structures.
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stabilizer of patella during initial 30 degree of flexion.
More than 18 techniques of reconstruction described.
Runs in layer 2 on medial aspect of the knee.
Origin- 1.9mm anterior/3.8 mm distal to adductor tubercle.(Laparade JBJS- Am.07)
Insertion – proximal 2/3 of patella
Along Distal edge of VMO
Broad insertion over 28.2+_ 5.6 mm over proximal 2/3 patella.
Average length 59.8mm +_ 4.8mm.
Passive- Trochlear constraints
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Patellar engagement
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Ctev
This document summarizes congenital talipes equinovarus (clubfoot) including its epidemiology, classifications, clinical assessment methods, and treatment approaches. Clubfoot is more common in boys and often bilateral. It involves four main deformities: equinus, varus, adduction, and cavus. Treatment options include serial casting using the Ponseti method (non-operative) or soft tissue release surgery. The Ponseti method involves weekly cast changes to gradually correct the deformities followed by a percutaneous Achilles tenotomy in resistant cases. Bracing is then used to maintain the correction. Surgery is reserved for resistant or recurrent clubfeet.
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1) Elbow dislocations are most commonly posterior dislocations, which occur due to a combination of hyperextension, valgus stress, arm abduction, and forearm supination.
2) Treatment depends on whether the dislocation is simple or complex, with associated fractures or ligament injuries requiring operative management like open reduction and repair of soft tissues.
3) The terrible triad of elbow injuries involves a dislocation with fractures of the radial head and coronoid process, requiring restoration of stability through fixation of the fractures and repair of collateral ligaments.
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This document provides an overview of limb length discrepancy, including leg length inequality and angular deformities. It discusses the causes, impact, assessment, and prediction of leg length inequality in children. Key points include:
- Leg length discrepancies of 0.5-2cm are common, while over 2.5cm can cause back/joint pain due to abnormal gait.
- Causes include congenital factors, trauma, infection, or irradiation damaging growth plates.
- Assessment involves history, exam including blocks under the short leg, and imaging like radiography or CT to measure discrepancy.
- Several methods can predict remaining growth, like the Anderson-Green-Messner charts or Moseley straight-line graph
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This document discusses acetabular defects and their reconstruction. It begins by describing common causes of acetabular deficiency like dysplasia, trauma, and loosening. Surgical goals are to restore hip mechanics, re-establish bone coverage of the acetabular component, and achieve rigid fixation. Preoperative planning involves imaging like x-rays and CT scans to evaluate the pattern and severity of bone loss. The Paprosky classification grades acetabular defects based on the amount of bone loss and ability to achieve cementless fixation. Different reconstruction techniques are described depending on the defect type, including various cup designs, bone grafting, and structural allografts.
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- Anatomy of the acetabulum and its components
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- Management considerations including operative vs non-operative treatment and various surgical approaches
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امراض القدم عند الاطفال Pediatric foot 1, البروفيسور فريح ابوحسان - استشاري ...
امراض القدم عند الاطفال Pediatric foot 1, البروفيسور فريح ابوحسان - استشاري ...Prof Freih Abu Hassan البروفيسور فريح ابوحسان
جراحة العظام / علاج العظام في الاردن / افضل دكتور عظام في الاردن / افضل اخصائي عظام في الاردن / استشاري عظام/افضل استشاري عظام في الاردن /جراحة عظام / /عمليات تطويل العظام في الاردن / اطباء العظام في الاردن / دكتور طب عظام في الاردن / الاطباء في الاردن / خلع ورك / عمليات اليزاروف في الاردن /علاج الكسور /خلع الولادة / تركيب المفصل / اوجاع العظام /افضل طبيب عظام اطفال في الاردن / استشاري اطفال عظام في الاردن / /علاج خلع الكتف / علاج التواء الكاحل / التواء الكاحل / علاج الام العظام / علاج هشاشة العظام / ارقام اطباء عظام في الاردن / مشاكل العظام والمفاصل /مستشار جراحة العظام والمفاصل والكسور/مستشار جراحة عظام الأطفال.
تشوه القدم عند الاطفال ، انحراف قدم الطفلDr tarek ankle pain1
The document provides an overview of foot and ankle anatomy, including the 26 bones and 30 joints of the ankle and foot complex. It describes the three arches of the foot - transverse, medial longitudinal, and lateral longitudinal. Key ankle and foot joints are identified along with their range of motion. Common movements like plantarflexion, dorsiflexion, inversion, and eversion are defined. Physical examination techniques for the foot and ankle are outlined, including inspection, palpation, range of motion testing, and special tests. Common injuries and conditions like shin splints are also mentioned.
Club foot
This document discusses clubfoot, including types based on cause and treatment stage. It describes the Ponseti method for treating clubfoot, which involves manipulation, serial casting, and bracing. The key steps of the Ponseti method are outlined, including manipulation techniques to correct cavus, adductus, varus, and equinus deformities. Tenotomy of the Achilles tendon is recommended in most cases after the foot has been sufficiently manipulated. Serial casting holds the corrections, and foot abduction braces must be worn long-term to prevent recurrence. Early recurrence is usually due to noncompliance with bracing, while late recurrence involves more complex surgery.
Flat foot and Cavus foot
Pes cavus and pes planus are foot deformities characterized by high and low arches, respectively. Pes cavus, or a high arched foot, can be congenital or acquired and results in clawing of the toes. Pes planus, or a flat foot, is caused by the collapse of the medial longitudinal arch. Both conditions can cause foot, ankle, and leg pain and abnormal shoe wear. Treatment involves orthotics, physical therapy, and sometimes surgery to correct muscle imbalances and bony deformities.
ARCHES OF FOOT.pptx
The document summarizes the structure and function of the arches of the foot. It discusses the three arches - medial longitudinal, lateral longitudinal, and transverse. The arches add elasticity and help absorb shock when walking or running. They are maintained by the wedge-shaped bones, ligaments tying the bones together, and muscles suspending the arches. Issues like flat feet and high arches are also summarized, along with treatments for different foot problems.
Congenital talipes equino varus (CTEV)
It is also known as club foot, due to its resemblance with a "Golf Club". It is most often present at birth.
CONGENITAL TALIPES EQUINOVARUS (CLUBFOOT) Physiotherapy Dr. Apurva Dafne
The document provides information on congenital talipes equinovarus, or clubfoot. It begins with definitions and epidemiology, noting the deformity involves ankle equinus, heel varus, and forefoot adduction. Causes are multifactorial and genetic. The deformity's severity can be classified using Dimeglio or Pirani systems.
Pathoanatomy details anatomical changes including deviations of the talus, calcaneus, and other bones. Management sections cover Ponseti's non-surgical approach using serial casting and manipulation, with percutaneous tenotomy sometimes needed. Compliance with bracing is essential to prevent high relapse rates. Other approaches like functional physiotherapy are also summarized.
Club foot
This document provides information about congenital talipes equinovarus, or clubfoot. It begins with definitions and descriptions of the deformities associated with clubfoot. It then discusses the epidemiology, causes, bony abnormalities, pathological anatomy, clinical features, classifications systems including Pirani and Dimeglio, treatment including serial casting and the Ponseti method as well as surgical options. Radiographic images are included to illustrate the deformities. The goal of treatment is to produce a plantigrade, supple foot that functions well, and the Ponseti method is now the standard non-operative treatment approach.
Ctev
Congenital talipes equinovarus, or clubfoot, is a birth defect affecting the foot and ankle. It occurs in approximately 1 in 1000 live births. The deformity involves equinus (plantar flexion) of the ankle, varus and inversion of the heel, and adduction and supination of the forefoot. Non-surgical treatment involves serial casting and manipulation based on the Ponseti method. This involves weekly cast changes to gradually correct the deformity, often including a percutaneous Achilles tenotomy. Surgical treatment is reserved for resistant cases and involves soft tissue releases and occasionally bony procedures. Proper bracing after correction is critical to prevent relapse of the deformity. With appropriate treatment
Arches of the foot and plantar fascitiis
A detailed description of the anatomy, physiology of arches. Plantar fasciitis is covered thoroughly from Mann's foot and ankle surgery book.
Congenital vertical talus
This document discusses pediatric foot deformities, specifically congenital vertical talus (CVT). CVT is an irreducible dorsal dislocation of the navicular on the talus present at birth. It can be associated with neuromuscular disorders or occur in isolation. Treatment involves serial casting and manipulation to stretch soft tissues, followed by surgical release and pinning of the talonavicular joint along with Achilles lengthening. Complications include failure to diagnose early when reconstruction is less predictable, requiring salvage procedures like triple arthrodesis.
Club foot
This document provides an overview of clubfoot, including its history, classification, evaluation, and management. Some key points:
- Clubfoot is a congenital foot deformity characterized by equinus, adduction, and varus. Dr. Scarpa made early contributions to conservative management in the 18th century.
- Classification systems evaluate reducibility and deformity severity. Management involves serial casting or soft tissue releases for mild cases, and more extensive soft tissue and bone procedures for severe deformities. Surgical options include posteromedial release, McKay procedure, and triple arthrodesis.
- External fixation frames can also be used in a minimally invasive approach to gradually correct deformities.
CLUB FOOT PRESENTATION.pptx
Club foot, also known as talipes, is a condition where one or both feet are twisted into an abnormal position. The causes are generally multifactorial and may include genetic and environmental factors. Clinical features are usually obvious at birth and can be assessed using the Pirani scoring system. Treatment primarily involves the Ponseti method of serial casting to correct deformities in the order of cavus, adduction, varus, and equinus. This is often followed by an Achilles tendon release. Bracing is then used long-term to prevent recurrence of the deformity. For more severe cases, soft tissue releases or bony procedures such as osteotomies may be required.
Orthotics aruncb
The document discusses various orthotic devices used in orthopaedics. It defines orthotics as externally applied devices that modify the structural and functional characteristics of the neuromuscular and skeletal systems. It then describes common orthotic devices used to immobilize, support, correct deformities, assist movement, and relieve weight bearing for various parts of the body including the upper extremities, lower extremities, spine, and hips. Examples provided include ankle-foot orthoses, knee-ankle-foot orthoses, cervical collars, and braces used to treat clubfoot and scoliosis. Materials and terminology for orthotic devices are also discussed.
Pes planus / Flat Foot
Collapse of medial longitudinal arch, with the entire sole of the foot coming into complete or near-complete contact with the ground.
Books Refered :
Text Book Of ANATOMY - Vishram Singh
Joint Structure And Function – Cynthia Norkin
Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
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امراض القدم عند الاطفال Pediatric foot 1, البروفيسور فريح ابوحسان - استشاري ...
امراض القدم عند الاطفال Pediatric foot 1, البروفيسور فريح ابوحسان - استشاري ...
CONGENITAL TALIPES EQUINOVARUS (CLUBFOOT) Physiotherapy Dr. Apurva Dafne
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Congenital Talipes Equino Varus
- 1. CTEV Dr M GURU TEJA
- 2. Anatomy • Hindfoot -calcaneum, talar • Midfoot -cuboid, navicular, cuneiform • Forefoot - metatarsals, phalanges
- 4. Congenital Deformity is presentsince Intrauterine life Apparently since birth
- 5. TALUS + PES = TALIPES PERTAINING TO FOOT 1. TALUS • It isoneof the tarsal bone • AkaAnkle bone 2. PES • Pes(Latin) =foot(English) Talipes
- 6. Equino Derived from Equine(Latin) =horse i.e. ahorse who walks on toes
- 7. Varus It comprises of 2 deformities 1. INVERSION of foot at talo-calcaneal joint 2. ADDUCTION of foot at mid-tarsal joints especiallly Talo-navicular joint due to Varus deformity sole faces inwards Supination = Equinus + Varus
- 8. CTEV - 4 deformities: C A V E 1.Midfoot : Cavus (longitudinal arch of footis exaggerated) 2.Forefoot : Adduction 3.Hindfoot : Inversion orVarus 4.Hindfoot : Equinus
- 9. Due to All the above mentioned deformities shape of foot appears as a GOLFCLUB. Therefore ,CTEVis commonly knownas “Clubfoot”
- 11. Etiology Primary (Idiopathic ) Secondary 1) Primary Germ plasm theory 2) Arrested fetal devolopment 3) Genetic 4) Neuromuscular imbalance 5) Retractile fibrosis Syndromic - Arthrogryposis multiplex congenita(AMC) - CDH Neuropathic - Meningomyelocoel - Spina bifida
- 12. Classification
- 14. Clinical Features • Sole facing inwards • Heel is small and high • Deepcreasesappear posteriorly and medially • Abnormal thin calf
- 15. Radiological
- 16. 2 imp angles a) Talo-calcaneal angle b) Talo-1st Metatarsal angle
- 18. THK u
- 19. TREATMENT
- 20. Our Aim To produce and maintain aplantigrade, pain free & supple foot that will functionwell
- 22. NonOperative Operative • Serial Manipulative and Casting (Ponsetti’s method) • -Posteromedial tissue release and tendon lengthening • -medial opening or lateral column- shortening osteotomy, or cuboidal decancellation • -triple arthrodesis • -tallectomy
- 23. IGNACIO PONSETTI The goal of World Clubfoot Day is to raise awareness about clubfoot disability and its prevention using the Ponseti method
- 24. TECHNIQUEWHY ??? 100 % Effective CURE Trained health care personel GOLD – STANDARD NORMAL PRODUCTIVE LIFE 2 phases a) CORRECTIVE PHASE a) MAINTANENCE PHASE
- 25. Serial Manipulative andCasting (Ponsetti’s method) • Goal - rotate foot laterally around the fixed talus • Order of correction(CAVE) - midfoot cavus - forefoot adductus - hindfoot varus - hindfoot equinus
- 26. HOW NEVER PRONATE – ROCKER BOTTOM FOOT 5-7 serial casts above knee WHEN as early as 1st week of life change cast every 5-6 days
- 28. FULL TIME (24 hrs)-1st 3 months FULL NIGHT (12 hrs)- 3-4 years
- 30. PIRANI SCORING
- 31. MID FOOT SCORE HIND FOOT SCORE
- 32. Surgical management - SOFT TISSUE RELEASE
- 34. Surgical – BONY
- 37. THANK U
Editor's Notes
- Ankle origin to bend Wrist origin – to rotate
- Idiopathic – disease of its own - affects only the foot /rest of body normal
- The goal of World Clubfoot Day is to raise awareness about clubfoot disability and its prevention using the Ponseti method.