Week 3 - Talipes Equinovarus

Question 1

what is talipes Equinovarus also known as?

Answer 1

clubfoot

Question 2

what is talipes Equinovarus?

Answer 2

congenital deformity of the foot due to abnormal in utero alignment of the joints between the talus, calcaneous and navicular

Question 3

what happens in talipes Equinovarus?

Answer 3

the abnormal alignment of the talus, calcaneous and navicular results in contractures of the soft tissues resulting in a deformity

Question 4

what does talipes Equinovarus look like?

Answer 4

deformity consisting of:

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

Question 5

what are the risk factors for talipes Equinovarus?

Answer 5

male gender
family history
breech presentation
oligohydramnios (low amniotic fluid content)
occasionally part of another skeletal dysplasia

Question 6

how is talipes Equinovarus treated?

Answer 6

early splintage (ponseti technique) - commenced as soon as possible after birth
many require a tenotomy of the achilles tendon to maintain full correction
once full correction achieved child is placed in a brace until age 3/4 to prevent recurrence

Question 7

how is the brace used?

Answer 7

boots attached to a bar

worn 23 hrs a day for 3 months and used during sleep until age 3/4

Question 8

what is the ponseti splinatge technique?

Answer 8

deformities corrected progressively in stages and held in plaster casts with 5-6 weekly cast changes

Question 9

what can happen is talipes Equinovarus is not diagnosed early?

Answer 9

can result in fixed deformity where the child walking on the outside of the foot
difficult to correct and requires extensive surgery