CTEV (Congenital Talipes Equino Varus) Treatment
What is Clubfoot:
Club foot is also known as Talipes Equino Varus. It is a common condition, in which new born feet points medially and downward. This condition is diagnosed at birth. More common in males than females. Incidence is 1 per 1000 live birth.
Types of Clubfoot:
Club feet can be classified in three different ways –
1) idiopathic, 2) neurological 3) syndromic (related to an underlying syndrome)
1. Postural CTEV 2. Structural CTEV
1-benign (postural) feet, 2- moderate feet 3- stiff feet 4- very sever stiff- stiff feet
Signs and Symptoms of Clubfoot:
- One or both feet in new born
- Stiff, rigid foot deformity
- High heel due to short tendoachilis
- Heel and fore foot both turned in with deep mid sole crease, small feet size
Causes of Clubfoot:Most of the time, causes are not known. But sometimes, they can be a part of a syndrome in which many other systems of the body are affected. In mild variety, it may be due to intrauterine compression; otherwise, usually in moderate to severe variety is because of shortening of muscle, capsule, and bony deformity.
How to Prevent Clubfoot: We can’t prevent the occurrence of ctev because it occurs because of unknown reasons and some time by genetic issues.
Complications of Clubfoot: CTEV, as per say don’t cause crate any trouble except a progressive increase in deformity if not managed initially. If not managed, then the child will learn to stand and walk with a deformed foot. With an increase in age and weight, foot deformity can progress to extent that child can have pain, abnormal walking pattern, and shoe wear and tear
CTEV Treatment Options: The main goal of ctev treatment is to correct the way your child’s foot looks and works before your child learns to walk. ctev treatment start as child born. In the past, very few ctev treatments were there to fix this condition.Postural CTEV is self revolving, but sometimes massage, stretching & manipulation may be required. Other stiff & rigid variety need manipulation and plaster application. Universal ctev treatment process is the Ponsetty methods of manipulation and repeated plaster application for 5-6 times at 7-10 days interval followed by Percutaneous tenotomy & plaster for 1 month. The child has to wear special shoes (Dennis brown splint) day and night till the age of 18 months. Some they need to wear for a longer time. Stretching exercise, planter stimulation, and oil massage are also advised to continue till the child start walking.
Final Outcome:Most of the CTEV can have completely normal feet if correct methods of manipulation, precaution, Longer and persistent use of brace with strict follow-up. Recurrences are common with very stiff and syndromic club feet & the feet of child where strict guideline of wearing shoes were not followed. Recurrence will be of a milder variety if reported early and again can be corrected with same methods of Ponsetty plaster technique. In some cases, these CTEV feet require surgery in the form of muscle joint release, but it is not preferred now due to fear of stiff foot post-operatively. Now a days recurrence are being manage by tendon transfer, osteotomy with before, and afterward plaster application.
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+ 91 9415014994
+ 91 8577873545
+ 91 9455001645
Dr. Jitendra Kumar Jain
Trishla Orthopedic Clinic & Rehab center, 182C / 350A, Tagore Town, Prayagraj (Allahabad) U.P-211002, India