Embedded Files
A newborn baby boy is born with deformed feet as shown in the attached clinical photograph.
A. #10. Describe the deformities seen in the clinical picture shown. (3 marks)
Cavus foot
Varus
Equinus
Cavus of midfoot
Adduction of forefoot
Varus of midfoot
Equinus of hindfoot
Adduction of midfoot
Hindfoot valgus?
Hindfoot in varus?
(Any 3, 1 mark each)
B. #11. What is the diagnosis? (1 mark)
Bilateral clubfoot / congenital talipes equinovarus
C. #12. List TWO conditions that this may be associated with. (2 marks)
Spina bifida
Cerebral palsy (yes can)
Arthrogryposis multiplex / distal arthrgryposis
Constriction band syndrome
Diastrophic dysplasia
myelomeningocele???????also Link
Syringomyelia?????
Charcot Marie Tooth?????also LINK
Down syndrome ???
Trisomy 18 ??? teratogen exposure during pregnancy ???
First Child ??
Family History of Clubfoot ??
Serial casting and manipulation with ponseti method with subsequent dennis brown boots (held in abduction)
(Any 2, 1 mark each)
D. #13. How would you treat this baby’s feet in the first instance? (4 marks)
Serial manipulation and casting (3 marks) followed by bracing/foot-abduction brace (1 mark) till the age of 4. Is this???
==>foot abduction orthosis: Dennis-Browne boots
This is the Ponseti technique (1 mark)
Surgery/surgical methods (1 mark)
Student answer "Serial manipulation and casting with Ponseti method for the first 6 weeks, followed by abduction orthosis (Denis-Browne orthosis) until age 4. "
Club Foot Deformity
Cavus foot
Varus
Equinus
Adduction of midfoot
Club Foot Deformity
Cavus foot
Varus
Equinus
Adduction of midfoot
A. #5. Describe the deformities and What is the diagnosis? (4 marks)
Deformities (3 marks)
Equinus (1 mark)
Hind foot varus (1 mark)
Forefoot supination (0.5 mark) & adduction (0.5 mark)
Many students say cavus???????? Supination looks like cavus!!!!!
Diagnosis - Clubfoot / Congenital Talipes Equinovarus (1 mark)
C. #6. Name TWO risk factors for this condition. (2 marks)
Male gender
Smoking during pregnancy
Family history. But what in the family history???
Oligohydramnios
Student's Answer:
Increased maternal age ?? Gestational diabetes??
delivery in breech position? low amniotic fluid index? Family history of the same syndrome??? Spina bifida, arthrogryposis, amniotic band syndrome????? igamentous laxity, cerebral palsy ???Trisomy 18 or Trisomy 21?? Spina bifida?? Low birth weight???
mother with gestational diabetes???
Fetal position (Breech position)???D. #7. What is the initial treatment method? (2 marks)
Ponseti casting / Serial manipulation & castingE. #8. After the initial treatment, what is the surgical procedure that majority of patients require? (2 marks)
TA/Tendon Achilles tenotomy
Student Answer: Percutaneous tenotomy of the achilles tendon. If recurrs at age 3-5, tibialis anterior transfer???
Page updated
Report abuse