Clubfoot is one of the most common birth defects in the feet. They are characteristically distorted, so the deformation is found right after the baby is born. Sometimes it can already be noticed during pregnancy during an ultrasound scan, and parents have time to learn more about the condition and start appropriate treatment right after delivery.
Clubfoote have a specific shape, always several features occur simultaneously. The equine position is characterized by the fact that the heel is raised upwards and the toes are unnaturally pointing downwards due to the too short Achilles tendon. At the same time, the heel is turned inwards (this is the so-called varus position), and the shortened tendons and ligaments make the foot look contracted. Added to this is the fact that the sole rises upwards, and at the same time the muscle contractures affect the appearance of the calves, which are thinner. Clubfoot is the most complete picture of clubfoot, because it actually resembles the bottom of a golf club. The condition usually affects both feet (less often one), and the defect is more common in boys than in girls.
Clubfoot: diagnosis and treatment
The causes of clubfoot are not fully known. Some doctors indicate that the reason may be incorrect positioning of the baby's foot in utero, which means that it does not develop properly. Others believe that bone malformations and muscle imbalances are responsible for the defect. Most often the disease occurs spontaneously, however, it happens that clubfoot accompanies other diseases, e.g. spina bifida. Regardless of the cause of the defect, it must be remembered that the sooner the treatment is started, the better the results are. If it is revealed already during pregnancy during an ultrasound scan, parents have time to find out about the condition and find a specialist who will take care of the baby immediately after delivery. This is important, because in the case of a newborn, the treatment consists mainly in the elimination of contractures in soft tissues and ligaments.
The foot of a newborn baby is the easiest to correct, because the cartilaginous structure of the bones is still flexible. The doctor adjusts it to the correct position, athen it stabilizes by immobilizing it. At the same time, every part of the defect must be rehabilitated, including the horse's position, varus position, addition of the forefoot, excessive hollowing of the longitudinal arch of the foot.
Depending on the severity of the defect, the results should be visible within a few months. However, if the treatment is delayed, the time to correct the defect may be longer.
Clubfoot: Ponseti's method
The method of non-surgical treatment of congenital clubfoot was developed by prof. Ignacio Ponseti in the 1950s. What is it?
At the beginning, the foot is stretched, it is brought into the correct position, and then a series of plaster dressings are applied. When the foot is finally in its optimal position, the next step is to eliminate the horse's position.
Under local anesthesia, the Achilles tendon is cut, which allows the foot to be bent, and then casts are put on again. After a maximum of 12 weeks, it is no longer necessary to put them on, and only the foot abduction brace is used to prevent recurrence of the defect. If the child starts learning to walk at this time, the splints are only used at night. It is usually used until the age of four or more.
Older children can wear special orthoses, i.e. stabilizers. Nonsurgical methods of clubfoot treatment bring great results, although sometimes the defect is so complicated that only surgery gives a chance for full recovery. It is usually performed after the age of six in order not to disturb the proper growth of the foot.
ImportantUnder the watchful eye of a specialist
Patients who have undergone clubfoot treatment must be under the care of a specialist for a long time. Sometimes the disease recurs, especially when the foot is still growing and is not fully formed. The doctor will quickly notice any signs of relapse, such as walking on the outer side of the foot or on the toes, which may indicate a shortening of the Achilles tendon. That is why it is so important to follow all medical recommendations (including wearing orthopedic shoes, splints or a stabilizer). An orthopedist may also recommend a spine check-up, because it happens that incorrect foot positioning affects the spine and may cause its degeneration.