Clubfoot treatment at Kids Orthopedic, Kolkata
As a congenital deformity, clubfoot or congenital talipes equinovarus (CTEV) can affect a child’s one foot or both feet. The affected foot of a child looks like
being rotated internally at the ankle. The child further finds it difficult to place the sole of the foot flat on the surface.
Hence, a child with clubfoot looks like walking on the side of his feet or on his ankles. However, the characteristics and symptoms of club foot differ from one
child to another. The parents must start treatment for clubfoot immediately to avoid major problems as the child grows.
About one out of every 1,000 babies is born with a foot that’s twisted. It may curl sideways with the toes bent at a funny angle. Or, it might have an odd shape and point in the wrong direction, so that it appears to be crooked, or even nearly upside down. Doctors call this clubfoot.
Most babies who are born with clubfoot are healthy in all other ways; about 1 in
3 of them have it in both feet.
Clubfoot doesn’t cause pain, but if it’s not treated, it can make it hard for a child to walk without a limp. It’s easy to correct in most cases, so most children don’t have long-lasting effects.
Can It Be Prevented? Clubfoot happens because the tendons (bands of tissue that connect muscles to bones) and muscles in and around the foot are shorter than they
should be.
Symptoms
In clubfoot, the tendons on the inside of the leg are shortened, the bones have an unusual shape, and the Achilles tendon is tightened.
If left untreated, the person may appear to walk on their ankles or the sides of their feet.
In an infant born with clubfoot: • the top of the foot twists downwards and inwards • the arch is more pronounced and the heel turns inward • in severe cases, the foot may look as if it is upside-down
• the calf muscles tend to be underdeveloped • if only one foot is affected, it is usually slightly shorter than the other,
especially at the heel
Risk factors for clubfoot 1. Gender. Two-thirds of babies with clubfoot are male. 2. Family history. Babies with a parent or sibling who had clubfoot are twice as
likely to get it. 3. Lifestyle choices. If you smoke or use illegal drugs while you’re pregnant, you raise your baby’s chances of being born with it. 4. Other birth defects. In some cases, it’s linked with other another condition a baby is born with, such as spina bifida.
5. Too little amniotic fluid during pregnancy. This surrounds your baby in the womb. If there’s not enough, your baby’s chances of being born with clubfoot
are higher.
Causes Clubfoot is mainly idiopathic, which means that the cause is unknown. Genetic factors are believed to play a major role, and some specific gene changes have
been associated with it, but this is not yet well understood. It appears to be passed down through families.
It is not caused by the fetus' position in the uterus.
Sometimes it may be linked to skeletal abnormalities, such as spina bifida cystica, or a developmental hip condition known as hip dysplasia, or
developmental dysplasia of the hip (DHH).
It may be due to a disruption in a neuromuscular pathway, possibly in the brain, the spinal cord, a nerve, or a muscle.
Environmental factors may play a role. Research has found a link between the incidence of clubfoot and maternal age, as well as whether the mother smokes
cigarettes, and if she has diabetes.
A link has also been noted between a higher chance of clubfoot and early amniocentesis, before 13 weeks of gestation during pregnancy.
Diagnosis The condition is immediately visible at birth.
It can also be detected before birth by ultrasound, especially if both feet are affected. If it is detected before birth, no treatment is possible until after the baby is born.
Whether the condition is detected during pregnancy or after birth, doctors
will recommend more tests to check for other health problems, such as spina bifida and muscular dystrophy.
X-rays may help to observe the deformity in more detail.
Treatment The causes and symptoms of clubfoot differ from one child to another. The
orthopaedic treat the congenital deformity in a number of ways. But they always decide the right clubfoot treatment method based on the symptoms and causes.
Initially, the orthopaedic treat clubfoot through Ponseti method which includes both stretching and casting.
However, they perform invasive surgery if the nonsurgical treatment failed. They try to straighten the twisted foot by lengthening the child’s tendons through surgery.
Dobbs Clubfoot (CTEV) Dynamic Bar
Bar Attribute Regular (over 12 months), Small (under 12 months old)
Clubfoot Shoes for Dobbs Bar
Static Foot Abduction Brace (Steenbeek) for Clubfoot (CTEV)
Recovery The recovery period of clubfoot treatment differs based on the treatment option. The nonsurgical treatment methods require the child to wear special shoes and
braces fulltime till the clubfoot is cured. Also, the child has to perform a variety of stretching exercises on a daily basis.
However, the parents must make the child wear special shoes and braces or perform stretch exercise based on the doctor’s direction. On the other hand, the child will in
a cast for up to two months, and wear a brace for about one year after the surgery. The cast and brace will prevent the clubfoot from coming back.
Paediatric orthopaedics is a specialized branch of orthopaedics surgery which deals with musculoskeletal problems (bone, joint and muscle) in a child who is
still growing. It also includes musculoskeletal problems of young adults, which are squeal of their childhood disease.
Dr. Soumya Paik treats with Culbfoot in children.