WHAT IS CLUBFOOT?
Clubfoot is a common birth defect that affects one in one thousand babies. At birth, one or both feet are twisted inward and pointing down. This is not painful, and can be corrected during the early stages of child growth and development.
Tendons are tissues that connect muscles to bones, and help hold the foot in position. A person with clubfoot has shorter tendons, causing the foot to be pulled abnormally to the point of bone deformity. A normal foot’s sole faces downward, making a 90-degree angle with the ankle, while a mild or severe clubfoot may appear as if it is nearly upside down. Clubfoot can involve one or both feet.
Clubfoot has no significant impact on a child until he or she begins to walk. Without treatment, the foot or feet will remain twisted, leading to limited mobility and lifelong disability. Additionally, individuals with an untreated clubfoot would not be able to wear the same shoes as people who do not suffer from this problem. Since children who do manage to walk with this debilitation walk on the outsides of their feet, they are more prone to thick calluses, chronic pain, and foot infections.
CAUSES OF CLUBFOOT:
- There is no definite cause, although there are a lot of factors that may contribute to this ailment.
- It does not arise from the positioning of the fetus in the womb.
- It is twice as likely in boys as in girls.
- Family history plays a role in determining the seriousness of clubfoot; the more members in a family with detected clubfoot, the greater the percentage is for it to occur.
- A pregnancy affected by an infection, drug abuse, or cigarette usage may be a possible reason, but the mother’s personal actions are usually unassociated with the foot abnormality.
DIAGNOSIS OF CLUBFOOT:
- The deformity is usually confirmed by a physical exam.
- It can also be tested through X-rays.
- Sometimes, ultrasounds can validate clubfoot; even though it cannot be cured before birth, an early diagnosis can help prepare parents for treatment plans.
TREATMENT OF CLUBFOOT:
- The Ponseti Method, the most common treatment option, normally begins during the baby’s first two weeks of life; this process is effective almost 100% of the time, and does not require an operation.
- The impaired feet are gently stretched and manipulated towards a more anatomically normal position. They are held in place by a long leg plaster cast that is applied from the toes to the groin. The cast(s) stay(s) on for approximately 4-7 days and thereafter removed.
- The procedure of stretching and casting is repeated roughly 5-8 times until the heel cord, or the tendon that connects the heel to the calf muscle, is adequately stretched before having the last cast applied, which needs to be left on for 2-3 weeks.
- An alternative technique, known as the French method, is the process where stretching, taping, and splinting is utilized daily to hold the feet in place until the following day’s manipulation. After a few months, the number of sessions gradually decreases so that full correction is conceivable.
- If these two main methods fail, the children’s family may have no other choice but to consider surgery.
Often times, clubfoot relapses without proper care and attention after the stretching and casting process, so it is important to wear a brace that prevents reversion to the abnormality. This brace is required to be worn 23 hours a day for 3 months, as parents are to take the necessary precautions to ensure that their infant matures to be a healthy, active adult in the future.
To discuss this condition with Dr. Mara Karamitopoulos, pediatric orthopedic surgeon, please contact 718-283-7400.