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物理治疗干预对一名七岁先天性马蹄内翻足儿童的有效性:病例报告

The Effectiveness of Physical Therapy Intervention in a Seven-Year-Old Child With Congenital Talipes Equinovarus: A Case Report.

作者信息

Munjewar Spandan, Somaiya Kamya J, Boob Manali A, Phansopkar Pratik

机构信息

Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Nov 7;15(11):e48423. doi: 10.7759/cureus.48423. eCollection 2023 Nov.

Abstract

Congenital talipes equinovarus (CTEV), a prevalent congenital anomaly, is characterized by the backward bending of the hindfoot, the inward turning of the midfoot, and the turning or tilting of the front foot. The likelihood of experiencing clubfoot is higher in males and among firstborn offspring. Both genetic and environmental elements are recognized as factors that play a role in the occurrence of this developmental irregularity. It is diagnosed clinically because the abnormality has been visible since childhood, where one or both feet point downward and inward. If the deformity is not addressed, tarsal bones and joints will stiffen over time, further causing an inability to walk and stand, causing additional limb deformities. Late presentations are typical in less developed nations because of a lack of awareness, access to care, or a holdup in referral. We have a case of a seven-year-old spastic cerebral palsy (CP) male child with congenital talipes equinovarus. While assessing, we found visible deformities at the knee and ankle joints. Wedge osteotomy and Achilles tendon lengthening surgery were performed. Probably, extensive soft tissue surgery is the best option for treating clubfoot. A physical therapist may use stretching, proprioceptive neuromuscular facilitation (PNF), joint mobilization, and joint compression to enhance the foot's alignment, mobility, and range of motion (ROM) to keep the joint in the correct position. Physical therapy greatly reduced stiffness. The physiotherapy treatment plan we used was highly beneficial in enhancing the patient's quality of life, increasing his level of independence, and enhancing his participation in his activities of daily living (ADLs).

摘要

先天性马蹄内翻足(CTEV)是一种常见的先天性畸形,其特征为后足向后弯曲、中足向内翻转以及前足扭转或倾斜。男性和头胎后代患马蹄内翻足的可能性更高。遗传和环境因素均被认为是导致这种发育异常的因素。由于自童年起就可见到异常,即一只或两只脚向下向内,所以通过临床诊断。如果畸形得不到治疗,跗骨和关节会随着时间推移而僵硬,进而导致无法行走和站立,引发额外的肢体畸形。在欠发达国家,由于缺乏认识、获得医疗服务的机会有限或转诊延误,晚期就诊很常见。我们有一例七岁痉挛性脑瘫(CP)男童患有先天性马蹄内翻足。在评估时,我们发现膝关节和踝关节有明显畸形。进行了楔形截骨术和跟腱延长手术。可能,广泛的软组织手术是治疗马蹄内翻足的最佳选择。物理治疗师可采用拉伸、本体感觉神经肌肉促进法(PNF)、关节松动术和关节按压来改善足部的对线、活动度和运动范围(ROM),以保持关节处于正确位置。物理治疗大大减轻了僵硬程度。我们使用的物理治疗方案对提高患者生活质量、增强其独立水平以及促进其参与日常生活活动(ADL)非常有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfcb/10701696/8abb2bcf68e9/cureus-0015-00000048423-i01.jpg

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