Clubfoot
Included In This Lesson
Study Tools For Clubfoot
Outline
Overview
- Abnormality present at birth in which the infant’s foot is twisted out of shape due to short tendons.
Nursing Points
General
Assessment
- Described by the position of the foot
- Talipes varus: inward
- Talipes valgus: outward
- Talipes equinus: toes lower than heel
- Talipes calcaneus: toes are higher than heel
- Diagnosed via ultrasound or at birth
Assessment
- Most common- Talipes equinovarus
- Foot is pointed downward and inward
- May be unilateral or bilateral
- Affected foot/feet is usually shorter and smaller
- Assess hips
- Increased risk for hip dysplasia
Therapeutic Management
- Physical therapy should begin right after birth
- Ponseti method
- Serial stretching and casting
- 6-10 weeks
- Tenotomy
- Abduction boots
- 23 hours a day for 3 months
- During night and naps up to 3 years
- Ponseti method
- Surgical treatment if casting is ineffective
- 6-12 weeks of age
- Nursing care
- Assess skin
- Assess circulation
Nursing Concepts
- Mobility
- Human Development
Patient Education
- Importance of compliance with regular cast changes
- Recognizing complications
- Poor circulation due to tight cast
- With physical therapy and surgery, the child should be able to walk
[lesson-linker lesson=221468 background=”white”]
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Clubfoot
Transcript
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!
Plan 1
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Circulatory System
- Nervous System
- Skeletal System
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System