What is Congenital Talipes Equino Varus (CTEV)?

CTEV (Congenital Talipes Equino Varus) is commonly known as clubfoot. The cause of this condition is unknown but thought to be related to the baby’s position in the womb.

Your baby will have either one foot or two feet that are turned inwards.

There are two types of CTEV: postural and structural

• Postural CTEV is when there is muscle imbalance and / or tightness. There is usually no bone or joint involvement.
• In Structural CTEV there is involvement of the bone and joints of the foot.

Both types of CTEV will require some physiotherapy intervention.

Your doctor may refer your child to see a physiotherapist either as an outpatient or while your baby is still in the ward after delivery.

What Happens At The First Appointment?

The physiotherapist will assess your child’s condition, prescribe exercises and stretches that you will have to continue at home several times a day.

How Often Do I Have To Come Back For A Physiotherapy Review?

The interval between therapy sessions are between 2 and 8 weeks and this is dependent on the severity of your child’s condition.

What Happens At Subsequent Therapy Sessions?

You will be asked to demonstrate the exercises that you have been doing at home. Your child’s feet will be reassessed and new exercises may be given depending on your child’s progress.

Other than exercises and stretches, your child might require taping, strapping, splinting, casting or the prescription of special shoes.

How Is The Treatment For Structural CTEV Different From That Of Postural CTEV?

In addition to exercise and stretches, a child with structural CTEV may need a long course of serial casting. Surgery is sometimes required to correct the foot’s position.

After surgery or casting, your child will be prescribed special shoes, which may have a metal bar between them to keep your child’s feet in an optimal position. The duration of which he has to wear the shoes will depend on the doctor.

How Long Do I Have To Keep Doing The Exercises?

The physiotherapist will assess your child at every session and discharge your child from therapy when your child’s condition resolves.

When Will My Child Be Discharged?

Your child will be discharged from physiotherapy when the feet no longer turn inwards and he/she is able to put weight through feet in a neutral position.

Why Does My Child Cry When I Do The Stretches?

Your child cries because the exercise puts his foot in an unusual position. To experience the stretch, bend at the ankle bringing your foot towards your head. This reproduces the stretch that your child feels. It can be uncomfortable but is not painful.

Why Was I Told Not To Put My Baby In A Walker?

Infants, when placed in a walker, tend to tip-toe and turn their feet inwards. This may worsen their CTEV and is thus not an optimal position for recovery of CTEV.

Congenital Talipes Calcaneo Valgus (CTCV)

Children with CTCV have feet that are turned up and out. A different set of exercises and stretches will be taught.

On The Day Of Your Appointment

• Please come to the department 15 minutes before the scheduled time for registration.
• Remember to bring along your child’s birth certificate and health booklet for the first appointment.

IMPORTANT: Do not feed your child just before the appointment. If necessary, feed your child at least 30 min before the appointment.

Each therapy session lasts between 5 and 30 minutes depending on the severity of your child’s condition.

Please reschedule the appointment in advance if you are unable to attend. We need at least 3 days’ notice. When you call us, please have your child’s Birth Certificate or Patient Reference No. with you as we need it to locate your child’s appointment.

Professional Fee

Our charges follow the payment status of your referring ward or specialist clinic in KKH.

• Private charges range from $26.00 – $51.00 depending on the duration of therapy.
• Subsidised charges range from $12.00 - $24.00 depending on the duration of therapy.
• Non-resident charges range from $28.60 - $56.10 depending on the duration of therapy.

What Else Can I Do To Help My Child?

We encourage you to be actively involved in the therapy intervention of your child. Your therapist might require you and other care-givers of the child to participate actively during the therapy session. Home exercise programmes will be given to you. You are encouraged to carry them out at home to ensure that your child benefits maximally from each therapy session.

Useful links:

Children's Clinics | General and Ambulatory Paediatrics | Rehabilitation | Prepare your child for healthcare experiences

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