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  #1  
Old 08-09-2012
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Rheumatology/Orthopedics Child with Adductus Foot Deformity!

A male infant is born to a primigravid woman whose pregnancy was uneventful. The delivery was uncomplicated. Physical examination of the newborn reveals deformity of the feet, specifically adduction of the anterior aspect of the foot with a convex lateral border and concave medial border. The ankle movement: are normal, and passive and active movement of the foot overcorrects the deformity into abduction. AP radiographs reveal mild adduction of the metatarsals at the tarsometatarsal articulation, and an increased angle between the 1st and 2nd metatarsals. What is the best next step in the management of this patient?

A. Reassurance
B. Immediate casting
C. Surgical correction at age two
D. Surgical correction within the first month of life
E. Orthosis

***please if anyone understands, what this kid has...please explain
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Old 08-09-2012
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Looks like Club foot. Immediate casting is the next step.
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Old 08-09-2012
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Seen immediately at birth i say it is club foot as well, and they need to be casted (50%) correct this way and the rest will require surgery after 8 months of age (after trying with the cast) but before the second year of life.
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Old 08-09-2012
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Quote:
Originally Posted by tyagee View Post
A male infant is born to a primigravid woman whose pregnancy was uneventful. The delivery was
uncomplicated. Physical examination of the newborn reveals deformity of the feet, specifically adduction of
the anterior aspect of the foot with a convex lateral border and concave medial border. The ankle movement:
are normal, and passive and active movement of the foot overcorrects the deformity into abduction. AP
radiographs reveal mild adduction of the metatarsals at the tarsometatarsal articulation, and an increased
angle between the 1st and 2nd metatarsals. W hat is the best next step in the management of this patient?
A. Reassurance
B. Immediate casting
C. Surgical correction at age two
D. Surgical correction within the first month of life
E. Orthosis
this is the type I metatarsus adductus--no treatment is required until 4 yrs of age......after 4 yrs ,do surgery to correct it......
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  #5  
Old 08-09-2012
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Reassurance ---for type I metatarsus adductus
Immediate casting ----CTEV
Orthosis ---for type II metatarsus adductus upto 4 yrs...if correects then OK, otherwise do surgery if not corrected upto age 4......
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Old 08-09-2012
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Quote:
Originally Posted by K06100 View Post
Reassurance ---for type I metatarsus adductus
Immediate casting ----CTEV
Orthosis ---for type II metatarsus adductus upto 4 yrs...if correects then OK, otherwise do surgery if not corrected upto age 4......

damn there wasnt any hindfoot and feel for it
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Old 08-09-2012
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Follow the protocol: 1. streatching and manipulation of the foot 2. serial of plaster of casts, malleable splints or taping 3. Surgery is indicated if conservative tx did not work at 3-6 months of age.
So the initial tx is 1 and 2. So i would say B.
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this is the type I metatarsus adductus--no treatment is required until 4 yrs of age......after 4 yrs ,do surgery to correct it......
Cn u put some lighting m addicts?
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Quote:
Originally Posted by tyagee View Post
Cn u put some lighting m addicts?
1.type I metatarsus adductus--the foot deformity overcorrects by active and passive movements into abduction.thus it tends to correct spontaneously and no treatment is necessary.

2.type II metatarsus adductus--the foot deformity corrects into neutral position by active and passive movemtnts of foot.this is managed with orthosis or corrective shoes and sometimes plaster casts if the initial t/t gives no results.

3.type III metatarsus adductus--is characterised by rigid feet and do not correct ,these r managed with serial casts.

surgery is done if (all forms) don't correct by 4 yrs of age.......
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