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Year : 2021  |  Volume : 36  |  Issue : 3  |  Page : 51-56

Clinical presentation of congenital talipes equinovarus via detailed case scenarios

1 Department of Paediatric Orthopaedics, King George’s Medical University, Lucknow, Uttar Pradesh, India
2 Department of Paediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India
3 Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
4 Department of Orthopaedic Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Ajai Singh
Department of Paediatric Orthopaedics, King George’s Medical University, Shah Mina Rd, Chowk, Lucknow 226003, Uttar Pradesh.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jbjd.jbjd_20_21

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Background: Clubfoot is a developmental deformity stirring at ankle, sub-taloid, and metatarsal joints. This deformity includes three elements: the foot inversion; forefoot-adduction relative to the hindfoot; and equinus position. The need for this case study was to understand the effectiveness of various treatment/management programs. Methodology: The study was performed for relating the severity of congenital talipes equinovarus (CTEV) with the need of Achilles tendon tenotomy (ATT) in the management along with demographic parameters. Overall, 95 patients of both sexes having 159 clubfeet were included. Clinicodemographic data were recorded, and the severity of CTEV was analyzed (Pirani scoring). Patients only presented at the tertiary hospital King George’s Medical University (KGMU), Lucknow for the first time, were included in the study, were provided with the facilities including casting, taping, and in extreme scenarios were projected for surgical interventions. Cases who had already registered under the Rastriya Bal Swastha Karyakram (RBSK) program were projected to the non-government organization “CURE” within the O.P.D. of the Paediatric Orthopaedics Department, KGMU, Lucknow. Via “CURE” the treatment facilities offered to the cases were completely free. Result: The mean age of the included cases was 102.44 days. Out of the 95 included cases with 159 clubfeet, 67.37% were males, and 32.63% were females. The mean of the presenting Pirani score was 3.17, the mean of the pre-ATT Pirani score was 2.72, and the mean of the Pirani score at the completion of management was 0.043. From these 159 clubfeet, 73 feet were subjected to ATT, and the remaining 86 feet were managed via casts only. The mean duration of correction was 6.1 weeks, and the mean of the required number of casts was 4.68. The total relapse observed was 32.70%. These were further managed by re-casting 44.23% and re-ATT, along with re-casting 55.77%. We found that out of 95 cases, 70.53% were rural rest, and 29.47% were urban. Similarly, 64.21% were literate, and 35.79% were illiterate [Table 1] and [Table 2].{Table 1} {Table 2} Special Case Scenarios: The present clinical article is a type of an observational-descriptive case series, with the focus on two different but similar anomaly-based cases. The first case is based on the simple idiopathic CTEV; however, the second one represents the case of complex clubfoot, that s, the patient is suffering from the clubfoot along with other deformities as a secondary anomaly. Conclusion: Clubfoot is a genetic deformity targeting the lower limb, with an effectively high rate of incidence in live births.

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