Clubfoot

CLUBFOOT CLUBFOOT (Talipes Equinovarus)

-is a general term used to describe a range of unusual positions of the foot. This is present at birth and affects the foot and/or ankle. There is no known cause for clubfoot, and it is twice as common in male children as it is in female children.

• Most type of clubfoot are present at birth which can happen in one foot or in both feet. In almost half of affected infants, both feet are involved. • Although clubfoot is painless in a baby, treatment should begin immediately. Clubfoot can cause significantly problems as the child grows, but with early treatment most children born with clubfoot are able to lead a normal life

• The frequency of congenital clubfoot is approximately 1 per 1,240 live births. In children there is a subtle imbalance in muscle forces in the lower leg resulting in the foot deformity. Often, the foot is ‘kidney- shaped”. About 50% of the time, both feet are affected with clubfoot

What causes Clubfoot? • Although there is no known cause of

congenital clubfoot, some doctors believe the use of drugs or alcohol during pregnancy or the presence of other diseases can cause it. • In some cases, clubfoot is just the result of the position of the baby while it is developing in the mother’s womb

What are the symptoms?

Clubfoot is painless in a baby, but it can eventually cause discomfort and become a noticeable disability. Left untreated, clubfoot does not straighten itself out. The foot will remain twisted out of shaped, and the affected leg may be shorter and smaller than the other. These symptoms become

• Clubfoot present at birth can

indicate further health problems, since clubfoot is associated with other conditions such as spina bifida. For this reason, as soon as clubfoot is identified, it’s important that the infant be screened for other health conditions. Clubfoot can also be the result of problems that affect the nerve, muscle, and bone

How is Clubfoot diagnosed? Ultrasound done while a fetus is developing can sometimes detect clubfoot. It is more common for your health professional to diagnose the condition after the infant is born, though, based on the appearance and mobility of the feet and legs. In some cases, especially if the clubfoot is due just to the position of the developing baby, the foot is flexible and can be moved into a

In other cases, the foot is more rigid or stiff, and the muscles at the back of the calf are very tight. X-rays to confirm the diagnose are usually not helpful, since some of the foot and ankle bones in an infant are not fully ossified ( filled in with bony material) and do not show well on x-ray

How is Clubfoot treated? Treatment for clubfoot usually begins soon after birth, so the foot grows to be stable and positioned to bear weight for standing and moving comfortably. Nonsurgical treatment such as casting or splinting are usually tried first. The foot (or feet) is moved (manipulated) into the most normal position possible and held (immobilized) in that position until the next treatment.

In the U.S this is usually done with a cast, but in some countries strapping with adhesive tape or splinting is more common. This manipulation and immobilization procedure is repeated every 1 to 2 weeks for 2 to 4 months, moving the foot a little closer toward a normal position each time. Some children have enough improvement that the only further treatment is to keep the foot in the corrected position by splinting it as it grows.

2 common methods of manipulation and casting: Traditional in traditional treatment, one position of the foot at a time is treated with manipulation and casting. Usually, the inward direction of the front of the foot is corrected first. If the foot is not responsive, major surgery is performed to further straighten the foot.

Ponseti method in this method ,two problems w/ foot position (the front part of the foot being turned in and up) are corrected at once. Toward the end of the series of castings, if the whole foot is pointing down, children treated with this method still require a minor surgery to lengthen the tight Achilles tendon. This is usually an outpatient procedure.

Recent research indicates that the Ponseti method is successful in most children clubfoot if treatment is started immediately and if the health professional’s instructions for bracing are followed after casting is finished. One study indicated that 94% of children treated with traditional casting will require major corrective surgery within the first year of life, while only35% of children treated with the Ponseti method will require this major surgery. by: jhong antonio

A newborn baby with a club foot or clubbing of his left foot.

A photo of a newborn baby with a clubfoot.

A photo of a newborn baby in the NICU with a bilateral clubfoot deformity.

A two month old infant in a casts as treatment for his bilateral clubfoot deformity

A two month old infant with a bilateral clubfoot deformity who is being treated with casting. Using the Ponseti method, the club foot is manipulated or stretched every 5 to 7 days and the plaster casts are changed. This baby is on one of his last treatments for his clubfeet and will then wear a brace for a few years. The alternative to serial casting is a specialized physical therapy treatment program, in which the child undergoes daily stretching and taping of the club foot by a physical therapist, and eventually, by the parent at home.

A photo of an infant with bilateral clubfeet who has just had several months of casting treatment using the Ponseti method. He will still have to undergo daily bracing for most of the day for many months, but his feet look great…!!!!

This is a photo of an infant in a Denis Browne bar (foot abduction brace) bar after undergoing months of casting using the Ponseti method as treatment for his bilateral clubfeet. He will have to wear the bracing bar for 23 hours a day for about 3 months and then only at night for two to four years.