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What is Talipes deformity and Its Assessment:Nursing Case Study

Tuesday, 18 March 2014


Talipes, also called clubfoot, is the most common congenital disorder of the lower extremities. It's marked primarily by a deformed talus and shortened Achilles tendon, which give the foot a characteristic clublike appearance. In talipes equinovarus, the foot points downward (equinus) and turns inward (varus), and the front of the foot curls toward the heel (forefoot adduction).

Talipes occurs in about 1 per 1,000 live births, is usually bilateral, and is twice as common in boys as in girls. It may be associated with other birth defects, such as myelomeningocele, spina bifida, and arthrogryposis. Talipes is correctable with prompt treatment. Treatment begins shortly after birth. It varies from serial casting to splinting to corrective shoes, depending on the severity and type of the deformity. Surgical correction may be needed at a later date.

Pathophysiology
Abnormal development of the foot during fetal growth leads to abnormal muscles and joints and soft tissue contracture. Clubfoot can also occur as a result of paralysis, poliomyelitis, or cerebral palsy. The condition called apparent clubfoot results when a fetus maintains a position in utero that gives his feet a clubfoot appearance at birth; it can usually be corrected manually. Another form of apparent clubfoot is inversion of the feet, resulting from the denervation type of progressive muscular atrophy and progressive muscular dystrophy.

Complications
■ Chronic impairment (neglected clubfoot)
■ Incomplete correctable (when severe enough to require surgery)

Assessment
Health perception and management
■ Other members of family with clubfoot

PHYSICAL EXAMINATION
Musculoskeletal
■ Exaggerated attitudes or positioning of feet
■ Obvious deformity of feet with or without a decrease in the degree of manipulation allowed

Diagnostic studies
■ Foot X‑rays reveal an abnormality of the talus and calcaneus and ladderlike appearance of the metatarsals.

Teaching: Procedure/treatment
■ Specialized treatment or exercises required
■ Cast care
■ Purpose, dosage, administration schedule, and adverse effects of discharge medications
■ Date, time, and location of follow‑up appointments
■ Reasons to call the pediatrician or orthopedist and contact information
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