Talipes

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QUESTION 1 OF 2

A 3 week old girl is referred to the paediatric orthopaedic clinic by the community midwife because her feet appear twisted .
Which of the following statements is correct:

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QUESTION ID: 1250

1. Identifying the deformity on the 20 week pre natal ultrasound scan suggests that this is a flexible / correctable deformity rather than a structural deformity
2. It could be associated with a disease manifested in non progressive multiple joint contractures
3. The child is likely to need surgical intervention in the form of postero-medial release and tendo achilles lengthening
4. You should look for plagiocephaly and torticollis
5. You should rule out fibular hemimelia
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QUESTION 2 OF 2

106 A 6-year-old patient who had a congenital clubfoot deformity treated with Ponsetti method , returns with recurrence of forefoot adduction and midfoot cavus.
Which of the following is the most appropriate answer in his case?

QUESTION ID: 2251

1. A tibialis anterior transfer is often needed in rigid recurrence cases
2. Failure to achieve an adequate tenotomy is a prime reason for recurrence but if recurrence occurs in a patient who had an adequate tenotomy with dorsiflexion of > 15 degrees after the first cycle of treatment, then in those cases a repeat tenotomy is seldom needed.
3. If the deformity recurred but is correctable / flexible deformity then it has better chance of responding to repeat casting
4. In flexible recurrence and after completing the corrective intervention, the foot can be maintained in an ankle foot orthosis and not necessarily in a foot abduction brace / boots and bars.
5. The abduction brace (boots and bars) should be set at 60-70 degrees of abduction with the heels far apart as the patient’s shoulders similarly in all cases primary or recurrent clubfoot
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