Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Congenital talipes equinovarus (CTEV) ++ 754.51 Congenital talipes equinovarus ++ Q66.0 Congenital talipes equinovarus ++ 4B: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Impaired Posture +++ Description ++ Three malformations of the foot/ankle complex seen at birthPlantarflexion (ankle or hindfoot equinus)Inversion (rearfoot varus)2Adduction (forefoot varus or metatarsus adductus)2 +++ Essentials of Diagnosis ++ Idiopathic, though can be hereditaryNeurogenicAssociated with syndromes such as arthrogryposis and Larsen syndrome3Postural or positional; not a true club foot +++ General Considerations ++ Two categories: flexible or rigidResults from abnormally shaped tarsal bones that cause ligament and joint changesOften associated with myelomeningocele4May result from arthrogryposis +++ Demographics ++ Incidence 1 to 2 per 1000 infants2:1 male-to-female ratioHispanics at greater riskAsians at least risk50% bilateralOccurs most often in first-born infants +++ Signs and Symptoms ++ Either flexible or rigid deformities of the foot including plantarflexion, adduction, and inversionContracted intrinsic muscles of the footVertical talus +++ Functional Implications ++ Unable to stand with flat foot or bear weight on the involved side +++ Possible Contributing Causes ++ Genetic: siblings 30 times more likely to also have club foot Environmental: in-utero complications, such as too little amniotic fluid (oligohydramnios) or abnormal fetal positioningDwarfismMyelomenigocelePolioCerebral palsy +++ Differential Diagnosis ++ Metatarsus adductusPostural club footTarsal coalitionsSkew footStreeter’s dysplasia +++ Imaging ++ X-ray to assess bone alignment ++ All patients with CTEV should be referred to an orthopedic surgeon for possibleSerial casting5Stretching and splintingSurgical repair (15 to 50%)Ponseti method involving manipulation and casting6Night splint after correction ++ Unable to stand independentlyUnable to ambulateDecreased passive and active ROM for dorsiflexion, abduction, and eversion ++ Goniometric measurements ++ Serial casting Gentle passive ROM to stretch soft tissue and correct alignmentNeurodevelopmental treatment to achieve age-appropriate motor milestones in conjunction with serial casting or splintingFacilitate weight-bearing while sitting on bench or chairFacilitate weight-bearing with supported standing or while standing at furniturePre-gait training activities and gait trainingManual therapy; mobilize the talonavicular joint by moving the navicular laterally and the head of the talus medially ++ Patient will be able to:Demonstrate full passive and active ankle and foot ROM to maximize functionStand at furniture for 5 to 10 minutes while playingCruise at furniture to increase mobilityAmbulate with 2 hands held for household mobilityAmbulate with 1 hand held as primary method of mobility... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.