Clubfoot is a congenital contucture of the joint of the foot.The main clinical sign of congenital talipus equinovarus are:
- Equinus (plantar flexion of the foot in the ankle joint)
- Supination (the plantar surface of the foot is turned inward)
- Forefoot adduction (the anterior part of the foot is displaced medially)
Congenital clubfoot presents in two clinical forms,namely Typical (75 percent) and Atypical (25 percent).
In addition to the deformity of the foot children with congenital clubfoot have a leg rotated inward and restricted movement of the ankle joint.The degree of deformity is a aggravated as soon as the child begins to walk,and skin on the outer border of the foot becomes rough,and callosities develop with bursae.
1)-Mechanical theory-due to abnormal intraterine position of the fetus.
2)-Ischaemic theroy-ischaemia of calf muscles during intrauterine life resilts in contracture,leading to foot deformities.
3)-Genetic theory-some genetically related disturbances in the development of foot leads to deformity.
-Methods of maintenance of the correction:
a)-CTEV splints:-These are splints made of plastic,molded in such a way that when tied with straps,it keeps the foot in ercorrected position
b)-Denis-brown splint (db) splint:- This is a splint to hold the foot in the corrected position.It is used throughout the day before the child starts walking.Once he starts walking,a DB splint is used at night and CTEV shoes during the day.
c)- CTEV shoes:-These are modified shoes used once a child starts walking.The following modification are made in the shoes:
-Straight inner border to prevent forefoot adduction.
-Outer shoes raise to prevent foot inversion.
-No heel to prevent equinus.
This shoes are used until the child is 5 years old.
CLUBFOOT OR CTEV (congenital talipes equinovarus ) and splint
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