1. Congenital Musculoskeletal Health Problems BY DR: Gehan Mohamed

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

3. Slide 3 Clubfoot( Clubfoot(talipes)  Talipes Latin talus (ankle) + pes (foot)  Involves bone deformity and malposition in form of with soft tissue contraction.  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. Slide 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: (1) (1) talipes varus: the most common form of clubfoot, the foot generally turns inward so that the leg and foot look somewhat like the letter J ). talipes varusinward (2) (2) talipes valgus, the foot rotates outward like the letter L. (3) (3) talipes equinus, the foot points downward, similar to that of a toe dancer.equinustoe (4) (4) talipes calcaneus, the foot points upward, with the heel pointing down.heel Slide 5

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7. FOOT DEFORMITIES Talipes Equinovarus 1in 1000 births  Talipes Equinovalgus Club Foot  Etiology  Positonal  Congenital,  Associated with other neuromuscular disorders Slide 7

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

9. TALIPES EQUINOVARUS The common ("classic") form of clubfoot. Talipes Latin talus (ankle) + pes (foot) 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. The foot is turned in sharply and the person seems to be walking on their ankle. Slide 9

10. Equinovarus Slide 10

11. Equniovarus Slide 11

12. TALIPES EQUINOVALGUS  Combination of talipes equinus and and  talipes valgus,(outward) Slide 12

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

14. Slide 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)