Management of talipes equinovarus (TEV) deformity – 5 year experience in Dhaka Shishu (Children) Hospital

Md. Saif Ullah1, KMN Ferdous2, Shawkat Ara2

Abstract

Background : Congenital clubfoot (talipes equinovarus) is one of the treatable
common congenital anomalies in Bangladesh. But due to some social reason a good
number of patients come late for treatment.
Objectives: The aim of this study was to observe the result of the treatment of TEV
at early age and to improve the quality of life of the affected growing children, thereby
to prevent future deformity.
Methods: A retrospective study was carried out in Dhaka Shishu (Children) Hospital,
during the period of July, 2002 to June, 2007. The study included children with nonrigid
and rigid TEV deformity from birth to 3 years of age. The patients with resistant
rigid deformity were excluded from the study. Total 216 cases with 376 feet of rigid
and non-rigid type of TEV were reviewed. The cases were examined at each follow-up
(1 month or 2 months interval) after correction of the deformity conservatively with
serial plaster or surgery.
Results: The results were catagorized as good, fair and poor. Good results were
obtained in case of all non-rigid types of club foot and 49.8% of rigid type by manual
stretching and serial plaster. Out of 92 operated feet (all were rigid type) good results
were found in 83 and fair results in 9 cases.
Conclusion: Conservative as well as surgical approaches are the methods of treatment
of clubfoot deformity. Early interventions give satisfactory results in managing clubfoot
deformity. Stretching and serial plaster at appropriate time is the most effective
method and has significant better outcome. Surgical treatment is not the only
treatment but it is an important method of treatment of clubfoot deformity.

Keywords: Talipes Equinovarus, Early Childhood, Manual stretching, Serial plaster,
Operative correction.

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