Friday, September 30, 2005

CONGENITAL TALIPES EQUINOVARUS (CTEV) / Club Foot

What is Congenital Talipes Equinovarus (CTEV)?

This is the medical term for a disorder of the foot such as that shown right. The term is derived from;
Congenital: this is a deformity which is present at birth

Talipes: means simply the ankle and foot

Equinovarus: refers to the position of the foot, pointing downwards and inwards.


Talipes equinovarus is the technical term which is sometimes known as 'club foot' and one or both feet may be affected.

Why does it happen?
Congenital Talipes Equinovarus (CTEV) has been known for thousands of years and in communities all around the world. However, no one still knows for sure why it happens. Several factors have been associated with CTEV and there may be a hereditary or genetic component. Also the position of the foot in the womb may have an effect.

Boys tend to be affected more than girls but as CTEV is one of the most common abnormalities at birth, all new-born babies are routinely checked. CTEV can in some cases be associated with other conditions, so your doctor will examine your baby thoroughly, not simply the feet.

How is it detected?
CTEV can be detected pre-natally by ultrasound scan. Further scans to monitor the condition would then be required, though at present there is no way of treating the feet before the birth. Otherwise it is detected around the time of birth as the feet are visibly turned inwards.

Does it hurt?
Even though as parents you may be distressed at discovering your baby has CTEV, your baby will not find the condition painful. That's not to say he or she won't protest strongly when being examined!

How will I cope?
When a diagnosis of CTEV is first made, you may well experience an emotional reaction. Every parent responds differently but most parents experience fear, resentment and anguish to varying degrees. This is a natural reaction when a condition such as CTEV affects one you love. But many, many, children have been affected in the past and there are lots of other parents who have been in the same situation and seen their children grow up to lead full, active lives.

Does CTEV require treatment?
Mild cases of CTEV may not require active intervention but more severe forms will. In the past, when CTEV was left untreated, the growing child would not be able to place his foot/feet flat on the floor when walking. As years passed, a limp and severe foot deformity would develop. Nowadays, health professionals are becoming increasingly skilled in correcting CTEV. With early, effective treatment there is every reason to believe there will be few long term side-effects.

What does treatment involve?
In many cases treatment will begin shortly after birth and the aim is to achieve functional, pain free feet.

Types of treatment may include:

Gentle manipulation
Gentle manipulation and maintenance of the corrected position using any or a combination of the following methods; Adhesive strapping/splints Plaster casts/thermal plastic splints Special boots
Surgery

How long will the treatment last?
Again there is no hard and fast rule and in some severe cases, treatment may be continued until the child starts school. Sometimes further surgery can be needed as the child grows. No matter how successful the treatment, relapse is a possibility which is why your child will continue to be checked throughout their growing years to ensure the deformity does not recur.


How effective will treatment be?
The final outcome will depend on the severity of the deformity and unfortunately not even the doctors treating your child can offer guarantees.

But for the vast majority of children today, effective treatment means that they can do everything that children without CTEV can do. Eric Richard (Sergeant Cryer in ITV's 'The Bill') has CTEV but you'd never know it when he gives chase!



Glossary
When your child is diagnosed with CTEV, you may come across some other terms which are equally unfamiliar to you. Here's some definitions to help you understand what you are being told at the hospital.

Bilateral - affecting both sides (i.e. both feet)

Conservative treatment - exercises and physiotherapy, splinting and plaster casts

Idiopathic - the cause is unknown

Manipulation - manually holding and stretching the foot into an improved position

Oligohydramnios - lack of fluid surrounding the baby in the womb

Orthopaedics - the branch of medicine that deals with bones and joints. Doctors involved here tend to be surgeons and are addressed as 'Mr' rather than 'Dr'

Orthotics - the medical speciality dealing in splints and appliances

Prognosis - the future outcome that is expected

Soft tissue release - an operation carried out to correct the short tendons and ligaments which pull the foot out of position

Unilateral - affecting one side (i.e. one foot)

This article take from : http://www.steps-charity.org.uk/talipes.php

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