For a newborn diagnosed with clubfoot, the initial assessment steps involve a comprehensive postnatal examination, which includes checking the baby's limbs, hands, feet, and digits, assessing their proportions and symmetry NICE NG194.
The general postnatal assessment also includes evaluating the baby's overall appearance, including colour, breathing, behaviour, activity, and posture NICE NG194. A thorough physical examination should cover the head (including fontanelles), face, nose, mouth (including palate), ears, neck, and general symmetry of head and facial features NICE NG194. Additionally, the eyes should be checked for opacities, red reflex, and sclera colour NICE NG194. The neck and clavicles, heart (position, rate, rhythm, sounds, murmurs, and femoral pulse volume), lungs (respiratory effort, rate, and sounds), and abdomen (shape, palpation for organomegaly, and umbilical cord condition) are also part of the assessment NICE NG194. The genitalia and anus should be checked for completeness and patency, and undescended testes in boys NICE NG194. The spine should be inspected and palpated for bony structures and skin integrity NICE NG194. The skin's colour and texture, as well as any birthmarks or rashes, should be noted NICE NG194. The central nervous system assessment includes tone, behaviour, movements, and posture, with newborn reflexes checked only if there are concerns NICE NG194. Hips should be assessed for limb symmetry, using Barlow and Ortolani's manoeuvres NICE NG194. Finally, the baby's cry should be assessed for sound NICE NG194.