Clubfoot

Hey everyone, in this lesson we are going to talk about the diagnosis clubfoot.

Clubfoot is an abnormality that is present at birth. The foot is twisted and shaped abnormally due to shortened tendons. There are a few different types of clubfoot bit and these latin words you see here are used to describe the different types. Talipes means clubfoot. Varus means the feet are turning inward. Valgus, they are turning outward. Equius means the toes are lower than the heels and calcaneus means the toes are higher than the heels.

The most common type is Talipes Equinovarus, which is when the toes are turned inward and pointed down.
The photo here looks like a Talipes calcaneovarus because the toes are pointed in but they are higher than the heel.

Your assessment is very straightforward. In the newborn assessment you just want to take a look at those cute little feet and determine if they are turned or positioned in any abnormal way. It can be either bilateral or unilateral and the affected feet are often small in size.

Clubfoot is mostly treated by something called the Ponseti method. This is when the affected foot is placed in a cast that is changed many times over a 10-12 week period. With each new cast, the foot is slightly repositioned to try and achieve normal positioning. Following this something called a tenotomy may be performed to release the tendons that are too tight. Then the baby has to wear braces on their feet, like the ones in the photo here. These braces have to be worn for 23 hours a day for about 3 months of so. Then they are work at naps and during the night for another 2-3 years.

Nursing care for these kids focuses on coordinating care and educating parents. Because these babies are having casts placed during a time that they are growing so rapidly, the cast can easily become too tight affecting circulation. So we have to teach parents to assess skin and circulation for any problems while undergoing the serial casting. Compliance is super important because if the braces are worn properly these kids will most likely be able to walk, run and play sports even!

Your priority nursing concepts are mobility and human development.
Okay, let’s do a quick recap! Clubfoot is an anomaly present at birth where the foot is twisted due to a short tendon. The most common is talipes equinovarus where the foot is turned inward and the toes are pointed down.

Treatment is a process of serial casting, a tenotomy, and brace wearing that is called the Ponseti method.

Nursing care is focused on making sure that the skin remains intact and circulation to the foot is good.

Patient education is super important because if parents aren’t compliant with the casting and braces then their kid may not have the best outcome.

That's it for our lesson on clubfoot. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!