Introducing
Your new presentation assistant.
Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.
Trending searches
1
Clubfoot
What is clubfoot ?
- A congenitally deformed foot. Idiopathic deformity of unclear etiology, which is most common musculoskeletal birth defect.
- The foot is turned in sharply so that the person seems to be walking on his or her ankle.
- Also known as talipes equinivarus.
- In clubfoot, the tissues connecting the muscles to the bone (tendons ) are shorter than usual.
Incidence :
1. Clubfoot affects boys more frequently than
girls.
2. Defect oft en accompanies other defects (e.g: spina bifida).
3. Clubfoot may be unilateral or bilateral.
Etiology :
1. There is increased incidence in some families, but no genetic markers have been identified.
2. Some cases of clubfoot appear to result from fetal
malposition while in utero and/or intrauterine
restriction resulting from oligohydramnios.
Pathophysiology :
1. Over 90% of cases of clubfoot are classified as
talipes equinovarus : a foot that is plantar flexed
and pointed inward.
The remaining 10% are classified as:
2. Although many neonates’ feet appear malaligned, clubfoot is only diagnosed when the feet resist being moved into proper alignment.
1. Talipes equinovalgus:
plantar flexed and
pointed outward.
2. Talipes calcaneovarus:
dorsiflexed and pointed
inward.
3. Talipes calcaneovalgus:
dorsiflexed and pointed
outward.
Diagnosis :
1. Clinical picture, i.e., the inability to move the
neonate’s foot into correct alignment is suggestive.
2. Definitive diagnosis is determined by x-ray and /
or ultrasound.
Treatment :
1. Serial casting.
a. Every 1 to 2 weeks beginning shortly after
birth, casts are applied to the affected foot,
incrementally moving the foot into proper
alignment.
i. Casts must be removed and reapplied
frequently because of the rapid growth of
the neonate.
ii. Th e goal of the serial casts is to stretch
ligaments and tendons on the inner aspect
of the foot.
b. Bracing often follows casting.
2. Surgery may be needed if correction is not
achieved through casting.
3. Physical therapy may be prescribed.
Nursing considerations :
1. Risk for Injury/Pain related to cast compression.
a. Educate the parents regarding the importance
of monitoring the child who has been casted
for signs of neurovascular compromise .
b. Educate the parents regarding age-appropriate
pain assessment.
c. Administer a safe dosage of an appropriate
analgesic, as needed.
d. If surgery is performed, monitor surgical site
for REEDA, and report abnormal findings.
2. Knowledge Deficit/Risk for Ineffective Coping of parents.
a. Provide parents the opportunity to verbalize
grief, anger, and frustration over birthing a
child with a physical defect.
b. Carefully explain to the parents the rationale for each treatment method.
Reference :
- Margot R.Deseno. (2015). Pediatric nursing. F.A. Davis company. philadelphia.
- Tom Lissauer, Graham Clayden. (2012). IIIustrated Texbook of Paediatrics.4th edition.Mosby Elsevier.
presented by :
Layla Alshammri.
Lamya Alshahri.
Ahad Bin Nassar.
Anwar Abed.
Laaly Abed.
Najwa Alasmari.