The nurse is caring for an infant with unilateral clubfoot. Which information should the nurse include in parent education about long-term outcomes?
A.
Normal gait is not fully expected.
B.
Growth and development will be delayed.
C.
Heredity influences the outcome of clubfoot.
D.
Correction will require serial casting
The Correct Answer and Explanation is:
The correct answer is D. Correction will require serial casting.
Explanation:
Clubfoot, or congenital talipes equinovarus, is a common congenital deformity that affects the foot and ankle. It can cause the foot to be twisted inward and downward, which, if untreated, can lead to long-term disability. Unilateral clubfoot means that only one foot is affected. Early intervention is key to ensuring a favorable outcome, and treatment often begins in infancy.
Serial Casting:
The primary treatment for clubfoot is serial casting, which is a non-surgical approach known as the Ponseti method. This involves gently manipulating the infant’s foot into a more natural position and applying a cast to hold it in place. The process is repeated weekly, with each new cast gradually moving the foot closer to the correct position. Serial casting is effective in most cases, and treatment usually begins as early as a few weeks after birth to maximize the potential for full correction.
Long-Term Outcomes:
Once the initial casting phase is complete, some infants may need additional interventions, such as a tenotomy (a minor surgical procedure to lengthen the Achilles tendon) or the use of braces to maintain the corrected position. If treatment is started early and followed diligently, most children can achieve a near-normal gait and mobility, and lead active lives without significant long-term limitations. However, ongoing monitoring and follow-up are necessary during growth to ensure the correction remains stable.
Incorrect Options:
- A. Normal gait is not fully expected: With successful treatment, many children achieve a normal or near-normal gait. Therefore, this statement is not accurate in most cases.
- B. Growth and development will be delayed: Clubfoot does not inherently cause delays in overall growth and development.
- C. Heredity influences the outcome of clubfoot: While heredity can play a role in the development of clubfoot, it does not directly influence the treatment outcome.
In summary, serial casting is the cornerstone of clubfoot treatment, and early intervention generally leads to successful outcomes with minimal long-term impairment.