1. Congenital Musculoskeletal Health Problems BY DR: Gehan Mohamed

2. Congenital Musculoskeletal Health Problems • Clubfoot • Developmental dysplasia of the hip • Amelia ,meromelia

3. Clubfoot(talipes) • Talipes Latin talus (ankle) + pes (foot) • Involves bone deformity and malposition in form of a curled shape or twisted position of the ankle, heel, and toes with soft tissue contraction. • May be unilateral or bilateral • Affected foot is usually smaller and shorter, with an empty heel pad and transverse plantar crease • Easily recognized at birth

4. Clubfoot • Congenital malformation of the lower extremity that affects the lower leg, ankle, and foot

5. Clinical types • There are four variations of clubfoot: • talipesvarus: the most common form of clubfoot, the foot generally turns inward so that the leg and foot look somewhat like the letter J ). • talipes valgus, the foot rotates outward like the letter L. • talipesequinus, the foot points downward, similar to that of a toe dancer. • talipes calcaneus, the foot points upward, with the heel pointing down.

7. FOOT DEFORMITIES TalipesEquinovarus 1in 1000 births • TalipesEquinovalgus Club Foot • Etiology • Positonal • Congenital, • Associated with other neuromuscular disorders

8. Etiology • Positional held in a deformed position in utero Flexible on examination • Congenital multifactorial inheritance, envoirnmental

9. TALIPES EQUINOVARUS The common ("classic") form of clubfoot. Talipes Latin talus (ankle) + pes (foot) . Equino- indicates the heel is elevated (like a horse's) -varus indicates it is turned inward. The foot is turned in sharply and the person seems to be walking on their ankle.

10. Equinovarus

11. Equniovarus

12. TALIPES EQUINOVALGUS • Combination of talipesequinus and • talipes valgus,(outward)

13. Therapeutic management • Serial manipulation and casting • If sufficient correction not achieved within 3 to 6 months, surgery is performed • Long-term follow-up

14. Clubfoot Postoperative nursing considerations • Neurovascular checks at least every 2 hours • Observe for any swelling around cast edges • Elevate ankle and foot on pillows • Pain management (analgesics)