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Examination of A Case of Ctev: Chief Complaints

This document summarizes the examination of a case of clubfoot, or congenital talipes equinovarus (CTEV). It outlines the chief complaints, history, physical exam findings, measurements, scoring systems, diagnosis, and suggested investigations. The key information provided includes bilateral clubfoot deformity since birth, inability to walk on the feet, associated anomalies being evaluated, family history, and a full examination of foot posture, range of motion, and radiological scoring of the severity. The diagnosis is identified as idiopathic or syndromic CTEV requiring further lab tests and imaging.

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675 views3 pages

Examination of A Case of Ctev: Chief Complaints

This document summarizes the examination of a case of clubfoot, or congenital talipes equinovarus (CTEV). It outlines the chief complaints, history, physical exam findings, measurements, scoring systems, diagnosis, and suggested investigations. The key information provided includes bilateral clubfoot deformity since birth, inability to walk on the feet, associated anomalies being evaluated, family history, and a full examination of foot posture, range of motion, and radiological scoring of the severity. The diagnosis is identified as idiopathic or syndromic CTEV requiring further lab tests and imaging.

Uploaded by

adi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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EXAMINATION OF A CASE OF CTEV

Name XXXX

Age DOB

Sex Birth weight,

CHIEF COMPLAINTS :- 1) Deformity of the foot/feet -? Since birth

2) Unable to walk plantigrade since? When (older children)

H/PI;- elaborate on deformity – type (club foot),onset(since birth)Duration(since


birth)Progressive(neurogenic)( or not), any correction attempted (neglected-virgin, recurrent or
resistant<treated> find out why? non compliance with brace, shoes or follow up , scarring due to
surgery )

Unable to walk plantigrade since when?,Any Associated with callosities,

Any associated anomalies of the face(plagiocephaly),upperlimbs, lowerlimbs ,trunk and spine(scoliosis ),


hips(DDH) and knees(Dislocations)(arthrogryposis).

NEGATIVE HISTORY ;-breech presentation, first born, spina bifida , maternal drugs intake- thalidoamide,
epilepsy drugs, twins ,packaging problems ( bicornuate uterus, short stature of mother ,tall father –short
mother), syndromic- mobius, Larsen syndrome ,weidmann beckwith , pierie robin syndr

FAMILY HISTORY- any other sibling suffering same anomalies

Developmental history- any delay ?

GPE; - Screen for spina bifida, hips for DDH, arthrogryposis(tubular hands and legs)

GAIT; - if the child is walking look if he is walking on the lateral border of foot , with equinus at ankle at
foot in Supination , painless, or painful(callosities),assisted or unaided, short limb gait.

ATTITUDE AND DEFORMITY;-

Child in supine or sitting posture with hips in flexion, knee in flexion, ankle in equinus ,fore foot in
adduction ,heel in varus, and deformity resembles a club hence club foot deformity .

INSPECTION ;-

Anteriorly ;-Asis is at same level and patella at same level ,ankle in equinus,talar head
prominent,dorsally, forefoot in adduction and Supination , great toe is short,foot is short,
chubby,rigid(in atypical club foot ) skin is stretched over the ankle.
Medially;-foot is adducted and supinated deep medial crease, short medial border of foot,medial
malleolus is less prominent .

Laterally ;-ankle in equinus ,lateral borderof foot is long , any presence of callosities,

Posteriorly;-ankle in equinus , tendoachilis is taut, calf appears small, deep posterior crease,small size of
heel .

PALPATION; - confirm inspectory findings particularly feel for the talus Antrly ,deep creases medially
and Posteriorly and empty heel

MOVEMENTS ;-

ACTIVE AND PASSIVE ;–

PASSIVE ANKLE MOVEMENTS –DF limited, foot -Pronation and eversion limited , heel valgus limited

ACTIVE MOVEMENTS – scratch the lateral border of foot to check if eversion possible – to check
peroneus brevis is working or not. For future Tib Antr transfers.

MEASUREMENTS; – SCORING OF FOOT – PIRANI AND BENSAHEL-DIMEGLO SCORING


DIMEGLO SCORING AND CLASSIFICATION

EXAMINATION OF DISTAL NEUROVASCULAR STRUCTURES;-

DIAGNOSIS; – ANATOMICAL; – FOOT AND ANKLE INVOLVED

PATHOLOGICAL; - CTEV – IDIOPATHIC/ SYNDROMIC/ NEUROGENIC /

INVESTIGATION ;-

LABORATORY ;- HB,WBC, TCDC,

RADIOLOGICAL ;- X-RAYS

SPECIAL INVESTIGATIONS ;- CT SCAN IN OLDER FEET

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