CTEV, Genu Varum and Valgum MCQs

Answer- A. Calcaneocuboid, talonavicular and talocalcaneal Joints fused in triple arthrodesis for CTEVare i) Subtalar (tolocalcaneal) joint, ii) Calcaneocuboid joint, iii) Tolonavicular joint.

Poliomyelitis cause acquired club foot deformity. It is not seen at birth. Club foot can be primary or secondary Primary Idiopathic (MC) Secondary Neurological disorders Spina bifida Meningomyelocele Myelodysplasia Poliomyelitis Syndromes Arthrogryposis Multiplex Congenita Larsen's syndrome Reference: Miler's 8th Edition of Review of Orthopaedics, page no. 600

According to Ponseti technique cavus is corrected first. The order of correction is given by the mnemonic - CAVE- Cavus followed by Adductus and varus and equinus is corrected as the last step Treatment is started within 1st week of life. The cavus aspect of the deformity is corrected first, followed by the adduction, then varus and lastly equinus. After every manipulation, an above-knee POP cast is applied, which is changed every 5-7 days. It is usually possible to correct all components of the deformity within 6 weeks. The equinus deformity often remains undercorrected, and can be treated by percutaneous tenotomy of tendoachilles. The cut tendoachilles regenerates spontaneous Reference: Essential orthopedics by Maheshwari 7 th edition page no 210.

Primary (Congenital clubfoot ) : Cases where clubfoot may be present since birth include: Idiopathic (most common type) Neurogenic-Spina bifida Dysplastic-Arthrogryposis multiplex congenital (AMC). Secondary (Acquired clubfoot) : In some diseases a muscle imbalance may result, causing contracture of the posteromedial foot structures leading to a secondary CTEV anytime during life. Paralytic (Poliomyelitis) Post-traumatic-contracted scar on posteromedial aspect Post infective. Spastic (Cerebral palsy). Reference- MAHESHWARI ORTHO 5 TH EDITION PAGE NO 212.