# A nurse is assessing a newborn with suspected congenital clubfoot (talipes equinovarus). Which assessment finding would be most characteristic of this condition? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=542360 > language: ko > subject: Child Health ## 문제 A nurse is assessing a newborn with suspected congenital clubfoot (talipes equinovarus). Which assessment finding would be most characteristic of this condition? ## 보기 1. The foot is positioned in dorsiflexion with the toes pointing upward 2. The foot appears normal but becomes rigid when manipulated 3. The foot is turned outward away from the midline of the body 4. The foot is turned inward and downward with the sole facing medially **✔ 정답** **정답: 4** ## 해설 Congenital clubfoot (talipes equinovarus) is characterized by the foot being turned inward and downward with the sole facing medially. Other options describe different foot positions not typical for this condition. ## 심화 해설 Understanding Congenital Talipes Equinovarus (Clubfoot) When assessing a newborn for a suspected congenital foot deformity, it is essential to recognize the classic structural presentation. Congenital talipes equinovarus (CTEV), commonly known as clubfoot, is a complex pediatric orthopedic condition present at birth [1]. The name itself provides a precise anatomical description of the deformity. The term "talipes" refers to the ankle and foot, "equino-" indicates a plantarflexed position resembling a horse's stance, and "-varus" describes an inward turning of the heel and sole. Therefore, the most characteristic finding is a foot that is rigidly fixed in a position of plantarflexion (downward pointing) and inversion (inward turning), causing the sole to face medially. This is a structural deformity, not simply a positional one, meaning the foot cannot be passively manipulated into a neutral or normal position. Let's analyze the assessment findings to build your clinical reasoning skills for the NCLEX-RN. Analysis of Assessment Findings * Correct Answer (Option 4): The foot is turned inward and downward with the sole facing medially. This finding directly correlates with the pathognomonic components of the deformity: the equinus (downward) and varus (inward) deviations. The primary goal of treatment methods like the Ponseti technique is to sequentially correct these deformities, with the equinus component often being the final and most critical step addressed, sometimes requiring a percutaneous Achilles tenotomy [2,3]. * Option 1: The foot is positioned in dorsiflexion with the toes pointing upward. This describes a calcaneovalgus deformity, which is the opposite of clubfoot. In clubfoot, the heel is elevated and the forefoot is drawn down into plantarflexion, not dorsiflexion. A tight, contracted Achilles tendon is a hallmark of the equinus deformity and is the target of tenotomy procedures during Ponseti casting [2,3]. * Option 2: The foot appears normal but becomes rigid when manipulated. This finding is inconsistent with CTEV. In a true clubfoot, the deformity is visibly obvious at birth. The foot does not appear normal; it is rigidly fixed in the deformed position and cannot be passively corrected. The rigidity is constant, not triggered by manipulation. * Option 3: The foot is turned outward away from the midline of the body. This describes a valgus deformity, where the foot is everted. In clubfoot, the forefoot is adducted and inverted (varus), turning it inward toward the midline, not outward. This distinction is a critical point of assessment and is fundamental to understanding the "varus" component of talipes equinovarus . Clinical Connection for NCLEX-RN Your assessment of the newborn's foot position directly informs the diagnosis and urgency of treatment. The Ponseti method, the gold standard for conservative management, involves a series of casts that gradually correct the deformity, starting with the cavus, adductus, and varus components, and finally addressing the equinus [1,2]. Recognizing that the foot is fixed in an inward and downward position is the foundational assessment cue that triggers this specific, multi-step treatment pathway. The rigidity of the deformity, particularly the equinus caused by a tight Achilles tendon, is a key indicator that a simple positional issue is not present and that serial casting and possible surgical release are required [3,4].References (research sources) - [1]Management of Relapsed, Residual, and Resistant Idiopathic Congenital Talipes Equinovarus.Research articleAnsari MO, Siddiqui YS, Harun F, Rana T, Hari K, Abbas M. (2026) · DOI: 10.13107/jocr.2026.v16.i01.6716 ## 임상 시나리오 Assessing Congenital Talipes EquinovarusKey Findings and Clinical Differentiation The hallmark of clubfoot is a rigid deformity where the foot is fixed in plantarflexion (equinus) and inversion (varus), causing the sole to face medially. This is a structural defect, not a positional preference. Differentiate from calcaneovalgus, where the foot is dorsiflexed and everted. Clubfoot will not passively correct to a neutral position, and the affected foot and calf are often smaller. CautionDo not mistake rigidity for normal newborn flexibility. Early referral for Ponseti casting is critical, ideally within the first 1-2 weeks of life, to achieve optimal outcomes. ## 핵심 개념 - **Talipes Equinovarus** — A congenital deformity where the foot is fixed in plantarflexion (equinus) and inversion (varus), with the sole facing medially. - **Equinus** — Plantarflexion of the foot, resembling a horse's stance, causing the toes to point downward. - **Varus** — Inward angulation or turning of a bone or joint; in clubfoot, the heel and sole turn inward toward the midline. - **Ponseti Method** — The standard non-surgical treatment for clubfoot involving serial casting, Achilles tenotomy, and bracing to sequentially correct the deformity. - **Calcaneovalgus** — A positional foot deformity where the foot is dorsiflexed and everted, often resolving spontaneously, and is the opposite of clubfoot. ## 같은 주제 문제 - [A nurse is assessing a newborn diagnosed with congenital clubfoot (talipes equinovarus). W…](https://mymerci.kr/pages/nclex_q.php?qn_id=542358) - [A nurse is assessing a newborn with suspected congenital clubfoot (talipes equinovarus). W…](https://mymerci.kr/pages/nclex_q.php?qn_id=542359) - [A nurse is caring for a 3-month-old infant with congenital clubfoot who is being treated w…](https://mymerci.kr/pages/nclex_q.php?qn_id=542361) - [A nurse is caring for a 2-week-old newborn with congenital clubfoot who is scheduled for s…](https://mymerci.kr/pages/nclex_q.php?qn_id=542362) - [A nurse is caring for a 6-month-old infant with congenital clubfoot who is being treated w…](https://mymerci.kr/pages/nclex_q.php?qn_id=542363) - [A nurse is caring for a 3-month-old infant with congenital clubfoot who is scheduled to be…](https://mymerci.kr/pages/nclex_q.php?qn_id=542364) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._