Definition of CTEV (Congenital talipes Equinovarus)
Congenital talipes Equinovarus (CTEV) or so-called Clubfoot is a common term used to describe a common deformity in which the legs changed from its normal position which is common in children. CTEV is covering flexion deformity of the ankle, inversion of the legs, adduction of the forefoot, and media rotation of the tibia (Priciples of Surgery, Schwartz). Talipes derived from the talus (ankle) and pes (foot), suggesting an abnormality in the leg (foot) which causes the sufferer to walk on his ankle. Equinovarus being derived from the word equino and varus (bent towards the inside / medial).
Congenital talipes Equinovarus is a foot deformity in line twisted heel leg and foot plantar flexion experience. This situation is accompanied with a higher edge in the foot (supination) and the shift of the anterior part of the foot so that it rests on the medial axis of the vertical leg (adduction). With this type of foot arch higher (cavus) and foot in an equinus (plantar flexion). Equino congenital talipes varus is a condition in which the foot in plantar flexion position talocranialis, because musculus tibialis anterior is weak, Inversion ankle because musculus peroneus longus, brevis and Tertius weak, subtalar and midtarsal Adduction.
Causes of Congenital talipes Equinovarus
- Causes of Congenital talipes Equinovarus until now not known for sure but allegedly are associated with : Persistence of fetal positioning, Genetic, amniotic fluid in the amniotic too little during pregnancy (oligohydramnios), Neuromuscular disorder (sometimes found along with other abnormalities such as Spina bifida or dysplasia of the pelvis). There are several theories that may be linked to CTEV :
- Chromosomal theory , among others : germinativum defect of cells that are not fertilized and appear before fertilization .
- Embryonic theory , among others : primary defect that occurs in cells that fertilized germinativum (quoted from Irani and Sherman) which implies a defect occurs between conception and 12 weeks of pregnancy.
- Autogenic theory, the theory of development is hampered, among other temporary barriers of development that occurs on or around the week of the 7th to the 8th gestation. At this time there is a clear clubfoot deformity, but when these obstacles occur after 9 weeks, there was a clubfoot deformity is mild to moderate. The development of the theory of constraints associated with changes in genetic factors, known as the "Cronon". "Cronon" This is the right time to guide the progressive modification of any structure of the body during development. Therefore, clubfoot occurs due to disruptive elements (local and general) that cause changes in genetic factors (cronon).
- Fetus theory, namely the development of a mechanical block due to intrauterine crowding.
- Neurogenic theory, the primary defect in neurogenic tissue.
- Amiogenic theory, that the primary defect occurs in the muscle.
- Edward syndrome, which is a genetic disorder of chromosome number 18.
- Outside influences such as the emphasis on when the baby is still in the womb because at least the amniotic fluid (oligohydramnios)
- Can be found along with other congenital abnormalities such as spina bifida.
- Ecstasy use by the mother during pregnancy.
