Congenital Foot Deformities PDF

Congenital Deformities of Foot Talipes deformities/Clubfoot TalipesEquinovarus It is characterised by forefoot adduction with a varus and equinus of rearfoot. Deformities/Clinical features: 1. Plantarflexed and inverted position of foot 2. Forefoot is adducted 3. Variable rigidity...

Congenital Deformities of Foot Talipes deformities/Clubfoot TalipesEquinovarus It is characterised by forefoot adduction with a varus and equinus of rearfoot. Deformities/Clinical features: 1. Plantarflexed and inverted position of foot 2. Forefoot is adducted 3. Variable rigidity 4. Mild calf atrophy Physical Therapy Treatment: 1. Manipulation - The sequence of correction is:  the forefoot adduction  the heel varus  the equinus 2. Casting (The Ponseti method of casting) - This may be begin from the 1st day of life to several weeks after birth. The foot is pushed and twisted into an over corrected position. The cast is then applied in order to hold the foot into that position. This may be uncomfortable for the child. Casts are usually changed every two weeks. Splints or braces may be used after a few years of casting the feet.  Denis Brown splint  Jones strapping 11 1  After undergoing months of casting as treatment for his bilateral clubfeet, patient will have to wear the bracing bar for 23 hours a day for about 3 months and then only at night for two to four years. A Clubfoot casting TalipesEquinovalgus This condition is a rare one. In this condition, Foot is everted and plantarflexed. Physical Therapy Treatment:  Manipulation – Reduction of deformity is done by manipulation  Casting – Done to maintain the joints in neutral position and applied for several weeks. Usually, casting is changed once in 2 weeks. TalipesCalcaneovarus This condition is a rare one. In this deformity, the entire foot is dorsiflexed and inverted. Physical Therapy Treatment:  Manipulation – Reduction of deformity is done by manipulation  Casting – Done to maintain the joints in neutral position and applied for several weeks. Usually, casting is changed once in 2 weeks. 2  12 TalipesCalcaneovalgus In this deformity, Foot is in exaggerated position of dorsiflexion - valgus force at Sub-talar joint with calcaneus in valgus position and forefoot abducted. Dorsal aspect of foot is in contact with anterior tibia. This deformity, typically is flexible (congenital vertical talus is not). Physical Therapy Treatment:  The Prognosis is excellent and spontaneously reduces when weight-bearing occurs.  Occasionally serial casting needed  Post operative Physiotherapy treatment for Talipes deformities 1. Scar mobilization 2. Passive exercises 3. Passive stretching 4. Strapping with daily manipulations 5. Muscle strengthening Flatfeet/Pesplanus/pronated foot It is defined as flattening of arches of foot. Physical Therapy Treatment: 1. Shoe modifications  Thomas heels  Rigid heel counters  Heel raise  Medial heel flare  Moving heel medially 2. In-shoe modifications  Heel wedges  Arch cookies  Triplane wedges 3. Foot orthoses  prefabricated orthoses  high medial flange devices  gait plates 3  13 4. Adjunct therapy  stretching (especially if