CONGENITAL DEFORMITIES (Pes clavus[claw foot (Pathophysiology (Medical…
Pes clavus[claw foot
Is a deformity of the foot which has high area and is relatively stiff .
This condition is caused by an imbalance between the agonist and antagonist muscles in the foot.
Heredity sensorimotor neuropathies or Charcot-Marie-Tooth syndrome.Spinal tumour or brain tumour, ,spinal tumour,spinal trauma,muscular dystrophy,cerebral palsy,polio,spinal nerve root injury.
Ahigh arch with a medially angulated heel is called pes cavovarus. In cases where the primary deformity is excessive ankle and hindfoot dorsoflexion it is called calcaneovarus.
Non surgical rehabilitation approaches include stretching,weak muscles and strengthening of tight and debridgement of plantar callosities, osseous mobilisation, message, chiroplastic manipulation of foot and ankle and strategies to improve balance.
Soft tissue procedures which are plantar fascia release, Achilles tendon lengthening ,tendon transfer. Osteotomy which are metatarsal,midfoot or calcaneal. Bone stabilising procedures which are triple arthrodesis.
The nurse should assess factors that worsen the pain such as position,swelling,pressure or infection or factors that make the pain less such as position,analgesics and dressings and provide care .Administer analgesics as per prescription.Encourage active range of movement exercises of joints that are not immobilised.
Teach the patient resistant exercises for unaffected extremities. The nurse must assess joints daily for contractures and muscles and monitor vitals signs .Nurse the patient in a cot bed to avoid falls.
The patient must adviced to not push objects and must elevate limb with the pillow to increase venous return and must observe for swelling ,pain and report.
Pes planus[flat foot]
When the entire sole of the foot is in contact or near contact with ground while standing.
Obesity, high blood pressure, diabetes, aging, rheumoid arthritis,
Genetic factors as the flat feet can pass from parents to children in the genes.arthrits,muscular dystrophy
Assessment and common findings
Feet tired easily, painful or achy feet,back and leg pain ,foot movement such as standing on your toes,pain in the heel .
The medial longitudinal arch is made up of the calcaneous,navicular,talus,cuineiforms and first ,second and third metatarsal.The portion that is dysfunctional of the medial longitudinal may result in acquired pes planus.
corticosteroids are used to reduce inflammation and the use of splints and casts to correct the foot.
The fusing of the foot or ankles together. Removing bones ,cutting the shape of the bone, cleaning the tendons's protective coverings, adding tendons in your foot to help balance the pull of the tendons and form arch. Grafting bone to the foot.
The patient is nursed in a comfortable position. Apply ice on the area to relieve pain. Monitor vital signs four houly and Administer the corticosteroids to relieve the inflammation. Restrict the patient to bed rest and .Observe for swelling, pain, bleeding and report abnormalities .The nurse must clean the cast area and observe after for colour. Elevate the leg to increase circulation to the limb.
The patient must be encouraged to apply ice on the foot and a void activities that put excessive stress on the foot like running and avoid soccer and hockey.