CLUBFOOT

YZ PORAL
ROSHYL JANE GALVE
 HISTORY

• One of the most common congenital

orthopedic anomalies.
• Described by Hippocrates in the year 400
BC.
• Pharaohs Siptah and Tutankhamun had
clubfoot
 DEFINITION
• Congenital talipes equinovarus
•  Range of foot abnormalities usually present at
birth (congenital) in which your baby's foot is
twisted out of shape or position.
• Tissues connecting the muscles to the bone
(tendons) are shorter than usual.
• Fairly common birth defect and is usually an
isolated
• In 50% cases, both feet are affected.
 CAUSE

• Unknown ( Idiopathic )
• Genes
• Environment
SIGNS AND SYMPTOMS

• The top of the foot is usually twisted

downward and inward, increasing the arch
and turning the heel inward.
• The foot may be turned so severely that it
actually looks a if it’s upside down.
• The affected leg or foot may be slightly
shorter.
• The calf muscles of the affected leg are
usually underdeveloped.
 RISK FACTORS

• Family History

• Congenital conditions

• Environment

• Not enough amniotic fluid during pregnancy

 COMPLICATIONS

• Movement

• Length

• Shoe Size

• Calf Size
 PATHOPHYSIOLOGY
Precipitating Predisposing
Factor Factor
1. Family history
1. Lifestyle
of clubfoot.
(smoking, 2. Sex (Male)
alcohol) Distal limb amniotic
2. Environment banding
Amnion forms
constrictive bands
around a limb in utero
Cutting off the circulation to the
limb
Arrest of the fetal development in the fibular
stage

Detective cartilagenious an lace

of the talus

Resulting in further abnormal or

arrested development

CLUB FOOT
 NONSURGICAL
TREATMENTS
Ponseti method - which uses gentle stretching
and casting to gradually correct the deformity.

French method - Another nonsurgical method to

correct clubfoot incorporates stretching,
mobilization, and taping. The French method —
also called the functional or physical therapy
method — is typically directed by a physical
therapist who has specialized training and
experience.
 Ponseti Method
• Manipulation and casting. Your baby's foot is
gently stretched and manipulated into a
corrected position and held in place with a
long-leg cast (toes to thigh).
 Ponseti Method
• Achilles tenotomy. quick procedure (called a
tenotomy), your doctor will use a very thin
instrument to cut the tendon. The cut is very
small and does not require stitches.
 Ponseti Method

• Bracing.  clubfeet have a natural tendency to

recur. To ensure that the foot will permanently
stay in the correct position, your baby will
need to wear a brace (commonly called "boots
and bar") for a few years.
 French Method

the baby's foot must be stretched and

manipulated, then taped to maintain the
range of motion gained by the
manipulation. After taping, a plastic splint
Related images
is put on over the tape to maintain the
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improved range of motion.

       
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Club foot
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 SURGERY
Surgical clubfoot release
 In the past, clubfoot surgery was
performed in a way that did not
differentiate severity. The same
procedure was performed for all
patients. The surgery is tailored to
the deformity.
 Postoperative Nursing
Considerations
- Neurovascular checks at least every 2 hours
- Observe for any swelling around cast edges
- Elevate ankle and foot on pillows
- Pain management (Analgesics)
- Doing stretching exercises with baby
- Putting child in special shoes and braces
- Making sure the child wears the shoes and
braces as long as needed.
 NURSING
MANAGEMENT
• Protect skin integrity. Monitor site of impaired tissue integrity at least
once daily for color changes, redness, swelling, warmth, pain, or other signs
of infection; monitor patient’s skin care practices, noting type of soap or
other cleansing agents used, temperature of water, and frequency of skin
cleansing; and provide gloves or clip the nails if necessary to avoid
damaging the skin with scratches.
• Promote acceptance of body image. Acknowledge and accept an
expression of feelings of frustration, dependency, anger, grief, and hostility;
support verbalization of positive or negative feelings about the actual or
perceived loss; and be realistic and positive during treatments, in health
teaching, and in setting goals within limitations.
• Provide health education. Include the parents in creating the teaching
plan, beginning with establishing objectives and goals for learning at the
beginning of the session; provide clear, thorough, and understandable
explanations and demonstrations; and render positive, constructive
reinforcement of learning.
Prevention

The cause of clubfoot is unknown therefore

we can’t completely prevent it. However,
during pregnancy, things to limit baby’s risk
of birth defects include:
- not smoking or spending time in smoky
environments
- not drinking alcohol
- avoiding drugs not approved by your
physician
 NURSING DIAGNOSIS
• Disturbed body image related to permanent alteration in structure
and function as evidenced by inverted feet, drawn up heels and
adducted forefoot

• Risk for peripheral neurovascular dysfunction related to

mechanical compression as evidenced by presence of braces on
both ankles.

• Risk for impaired skin integrity related to cast application or

traction as evidenced by dry and red on the area of traction

• Risk for impaired parenting related to maladaptive coping

strategies secondary to diagnosis of talipes deformity.