Paediatric Ankle & Foot Problems

Question 1

what is talipes equinovarus

Answer 1

clubfoot

congenital deformity of foot due to utero abnormal alignment of joint between the talus, calcaneus and navicular

Question 2

what gender more effected by clubfoot

Answer 2

boys

Question 3

what causes clubfoot

Answer 3

genetic link
more common in breech presentation
oligohydramnios (low amniotic fluid content) is another risk factor and it is occasionally part of another skeletal dysplasia

Question 4

what does the clubfoot deformity consist of

Answer 4

ankle equinus (plantarflexion)
supination of forefoot
varus alignment of forefoot

Question 5

what is the treatment of clubfoot

Answer 5

early splintage by ponseti technique

Question 6

how does the ponseti technique work

Answer 6

held in plaster casts with 5 or 6 weekly cast changes
80% of children require tenotomy of achilles to maintain full correction
once corrected, child placed in brace consisting of boots attached to bar which worn 23 hours a day for 3 months an used during sleep till age 3-4

Question 7

what may be required in cases resistant to splintage

Answer 7

surgery

Question 8

why is hallux valgus surgery risky in adolescence

Answer 8

risk of recurrence of deformity later in life