2. CONGENITAL TALIPES

PRE-OP MANAGAMENT










2) Physical preparation



-Consent taken from parent, doctor and witness.




-Investigation: i) X-ray foot AP/Lateral view.



ii) Blood;FBC and GSH









-NBM with i/v drip 1/5 saline(0.18%) branula 24G.




-Refer GA doctor(patient fix for operation or not)


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COMPLICATION NOT TREATMENT









i.Disruption pattern walking








ii.Disruption of posture








iii.Oeteoartritis








iv.Ulceration of foot






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COMPLICATION AFTER


OPERATION







i.Wound infection











ii.Plaster sore










iii.Neurovascular bundle damage cause



foot drop






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CONGENITAL TALIPES




CALCANEOVALGUS





(CTCV)






























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CONGENITAL TALIPES


CALCANEOVALGUS (CTCV)







• A benign soft tissue contracture deformity of the foot


characterized by hindfoot eversion and dorsiflexion


• contracture without congenital deformity or dislocation is

considered hallmark of disease







• Etiology


• usually a positional deformity of the foot caused by intrauterine

"packaging"









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PHYSICAL EXAM









• excessively dorsiflexed hindfoot that is passively correctable



• dorsal surface of foot can rest on anterior tibia



• looks similar to vertical talus



• differs on exam in that vertical talus has a rigid hindfoot


equinus/valgus and rigid dorsiflexion through midfoot


• vertical talus also has mid-foot valgus, with a medial prominant


talar head.









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TREATMENT









1. Nonoperative



a. observation & passive stretching exercises



• indications


➢ if foot can be plantar-flexed beyond neutral



• outcomes


➢ typically resolves spontaneously by 3-6 months













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TREATMENT









b. casting



• indications


➢ if foot cannot be plantar-flexed beyond neutral



• outcomes


➢ severity of initial deformity has no relation to final outcome


















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COMPLICATIONS









1. Leg Length Discrepancy



• LLD a possible sequela when calcaneovalgus foot is associated

with posteromedial bowing of the tibia


• the most common surgery needed for posterior medial bowing is

to address the LLD


2. Flexible flatfoot deformity



• occurs several years after the resolution of the foot deformity












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Q&A






























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Below are the relation between


anatomical and deformity on child with


CTEV, except





a) Midfoot - cavus



b) Forefoot - cavus



c) Hindfoot - varus



d) Hindfoot - equinus





















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Early non surgical treatment for


CTEV is







a) Splinting



b) Serial casting



c) Dennis brown shoes



d) Archilles tendon lengthening





















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