CTEV Deformity
Photograph of a newborn baby with club. foot deformity
Classification
Pirani
Midfoot - Severity of Medial Crease
Coverage of Talar Head
Curvature of Lateral Border of foot
Hindfoot Rigidity of Equinus
Severity of Posterior Crease
Emptiness of Heel
How to manage this case ?
History from Parents
Examination
Classification
Treatment
Ponseti Cast-Above knee casts -
moulding into corrected position.
change each week, Pirani scoring done during change of cast
starts with manipulation and serial casting
Technique
Ist - Dorsiflex Ist ray , unlock forefoot and midfoot.
elevation of Ist ray leads to supination
2nd- Abduct at midfoot level using head of talus as the fulcrum.
Achillis tenotomy for residual Equinus.
Final Cast applied for further 3 weeks.
Dennis Browne Boots with a bar
23 hours a day for 3 months, then just at night time for 5 years.
Avoids need of surgical release
25 % require TA transfer laterally for inversion in swing after age of 4-5 years.
Thank you for sharin !!!
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