Congenital Talipes Equino Varus (CTEV) Year 5 Sayyid

8/17/2019 Congenital Talipes Equino Varus (CTEV) Year 5 Sayyid

1/27

CONGENITAL TALIPES EQUINO

VARUS (CTEV)

Muhammad SayyidZulwaqar i! Sa"#

$%%$&&'$

#ar ' Gr*u+ &


2/27

( )


3/27

NOMENCLATURE Equinus: (d#ri,#d -r*m.#qui!#/ i0#01 a h*r2# 3 wal42*! 5*#2)0 Thi2 i2 a d#-*rmi5ywh#r# 5h# -**5 i2 67#d i!+la!5ar38#7i*!0 R#,#r2# 3

9al9a!#u2

Varus: :**5 i!,#r5#d a!daddu95#d a5 5h# mid35ar2al ;*i!52 2* 5ha5 5h# 2*l# .-a9#2/i!ward20 R#,#r2# < ,al=u2

Cavus: L*!=i5udi!al ar9h *-5h# -**5 i2 #7a==#ra5#d0R#,#r2# 3 Pla!u2


4/27

CTEV$3> i! $%%% ?ir5h

M @ : (>$)

ila5#ral i! $B& *- 5h# 9a2#2

##l D #qui!u2

E!5ir# hi!d-**5 D ,aru2

Mid -**5 a!d -*r#-**5 D addu95#d a!d 2u+i!a5#d


5/27

ETIOLOGIdi*+a5hi9M#9ha!i9al 5h#*ry ( rai2#d i!5rau5#ri!#+r#22ur# )

I29ha#mi9 5h#*ry (i29h#mi9 9*!5ra95ur#)

G#!#5i9 5h#*ry ( arr#25#d d#,#l*+m#!5)

S#9*!daryParaly5i9 di2*rd#r ( 2+i!a ?i6da1 +*li*)

Ar5hr*=ry+*2i2 mul5i+l#7 9*!=#!i5al

(d#-#95i,# d#,#l*+m#!5 *- mu29l#2)


6/27

PATOANATOMAll 5h# 5i22u# i! 5h# -**5 ha,#d#,#l*+m#!5al a?!*rmali5y

*!#N#94 *- 5alu2 +*i!5 d*w!ward2 a!d d#,ia5#2 m#dially

*dy *- 5alu2 r*5a5#d 2li=h5ly *u5ward


7/27

*i!5Equi!u2 a!4l# a!d 5ar2al ;*i!52

I!,#r2i*! 2u?5alar ;*i!5

:*r#-**5 addu95i*! mid 5ar2al ;*i!52 ( 5al*3!a,i9ular)

:*r#-**5 9a,u2 mid35ar2al ;*i!52


8/27

Mu29l# a!d Li=am#!52 U!d#rd#,#l*+#d1 2h*r5 a!d 9*!5ra95#d0

S4i! 2h*r5 a!d u!d#rd#,#l*+#d

S#9*!dary 9ha!=#2

O99ur wh#! 25ar52 wal4i!= 9all*2i5y a!d ?ur2a a5 la5#ral -**5


9/27

CLINICAL :EATURESU2ually *?,i*u2 a5 ?ir5hF

##+ 9r#a2#2 +*25#ri*rly a!d m#dially0A?2#!9# i!di9a5i!= ar5hr*=ry+*2i2

Cal- i2 a?!*rmally 5hi!0


10/27

H Bilateral -**5 d#-*rmi5y < %J9a2#20

H Size of the foot 2mall#r (i!

u!ila5#ral 9a2#2)0

H :**5 i2 i! equinus, varus andadduction0

H Heel is small i! 2iK#F 5h#9al9a!#um may ?# -#l5 wi5h =r#a5

di"9ul5y0 H Deep skin creases *! 5h# ?a94*- 5h# h##l a!d *! 5h# m#dial2id# *- 5h# 2*l#0

H Bony prominences -#l5 *! 5h#

la5#ral 2id# *- 5h# -**51 5h# h#ad*- 5h# 5alu2 a!d la5#ral mall#*lu20

H Outer side of the foot i2 =#!5ly9*!,#70 Th#r# ar# dim+l#2 *! 5h#*u5#r a2+#95 *- 5h# a!4l#


11/27

:i7#d d#-*rmi5y *r ,aryi!= d#=r##2 *- r#2i25a!9# i!d*r2i38#7i!= a!d #,#r5i!= 5h# -**50 ( 5i=h5 5#!d*a9hill#2a!d +la!5ar -a29ia)

ABw C a!d 2+i!a ?i6da


12/27


13/27

IAGNOSIS#a2y i! 9a2#2 +r#2#!5i!= 2**! a-5#r ?ir5h

5h*2# +r#2#!5i!= la5#1 2#9*!dary 9au2#2 *- 5ali+#2#qui!*3,aru2 d#-*rmi5y mu25 ?# #79lud#d

X-rays *- 5h# -**5 ar# d*!# (AP a!d la5#ral) wi5h 5h#

-**5 i! wha5#,#r 9*rr#95#d +*2i5i*! +*22i?l#

5al*39al9a!#al a!=l#21 i! ?*5h1 AP a!d la5#ral ,i#w21 i!a !*rmal -**5 ar# m*r# 5ha! &'1 ?u5 i! CTEV 5h#2# ar#r#du9#d

3ray2 ar# u2#d a2 ?a2#li!# d*9um#!5a5i*! *- 5h#d#-*rmi5i#2 a!d a m#5h*d -*r a22#22m#!5 *- 9*rr#95i*!a-5#r 5r#a5m#!50


14/27


15/27

RAA22#22 +r*=r#22 a-5#r5r#a5m#!50

AP r#du9# i5#/2 a!=l# (TCa!=l#)


16/27


17/27

R*94#r ?*55*m d#-*rmi5y


18/27

TREATMENTAim *- 5r#a5m#!5+r*du9# a!d mai!5ai! a +la!5i=rad#1

2u++l# -**5 5ha5 will -u!95i*! w#ll0

R#la+2# i2 9*mm*!0


19/27

CONSERVATIVE#=i! 6r25 > day2 *- li-#0

R#+#a5#d ma!i+ula5i*! a!d adh#2i,# 25ra++i!= 5ha5mai!5ai!2 5h# 9*rr#95i*!F

li=h5 +la25#r 9a25$0 :*r#-**5 ?r*u=h5 i!5* r*5a5i*!al ali=!m#!5 wi5h 5h# hi!d-**5

>0 *5h hi!d-**5 a!d -*r#-**5 ar# 5*=#5h#r =radually ?r*u=h5*u5 *- ,aru2 a!d 2u+i!a5i*!

&0 Equi!u2 i2 9*rr#95#d ?y ?ri!=i!= 5h# h##l d*w! a!dd*r2i8#7i!= 5h# -**50 P#r9u5a!#*u2 5#!d* a9hili2 l#!=5h#!i!=0

3ray E!2ur# !* r*94#r3?*55*m d#-#95


20/27


21/27


22/27

OPERATIVE($) 5h# 9*m+l#5# r#l#a2# *- ;*i!5 .5#5h#r2/(>) l#!=5h#!i!= *- 5#!d*!2 2* 5ha5 5h# -**5 9a! ?# +*2i5i*!#d

!*rmally wi5h*u5 u!du# 5#!2i*!0

•L#!=5h#!i!= 5#!d* A9hilli2 a!d 5i?iali2 +*25#ri*r 5#!d*!2

5hr*u=h Z3di,i2i*!20

•i,id# +*25#ri*r 9a+2ul#2 *- 5h# a!4l# a!d 2u?5alar ;*i!52 5*9*rr#95 hi!d-**5 #qui!u20

•R#l#a2# 9al9a!#*36?ular li=am#!51 9*m+l#5# 2u?5alar r#l#a2#0

•R#l#a2# 2u+#r69ial d#l5*id li=am#!5 a!d +r#2#r,# d##+ +ar5

•R#l#a2# 5h# 9*!5ra95ur#2 ar*u!d 5h# 5al*!a,i9ular a!d9al9a!#*9u?*id ;*i!52

•R#l#a2# *ri=i! *- 5h# i!5ri!2i9 mu29l#2 a!d +la!5ar -a29ia -r*m5h# 9al9a!#um0


23/27

•Imm*?iliK# 9*rr#95#d -**5 i! a +la25#r 9a25 wi5h 3

wir#2

•h*??l# ?**52 *r a 9u25*m3mad# a!4l#


24/27

LATE OR RELAPSE

CLU3:OOT A=#d


25/27

IliKar*, m#5h*d

Tri+l# ar5hr*d#2i2


26/27


27/27

TAN OU

Documents

Congenital Talipes Equino Varus (CTEV) Year 5 Sayyid