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Clubfoot: Overview By Your Doctor
Clubfoot, medically termed as “talipes equinovarus”, is a congenital structural anomaly of the foot evident at birth, affecting about 1 in every 1,000 births. It has been observed to inflict more male infants than the female ones and can be present in one or both feet.
The condition is characteristic of the affected foot twisted laterally at almost right angle, pointing down and inward. Under it the associated tendons are shorter in length than usual. Clubfoot can be confronted from mild to severe degree; it is, therefore, recommended by clubfoot doctors to get it corrected soon after birth before it turns into a lifetime disability.
Although the appearance of clubfoot is quite unpleasant or even ghastly, the condition is painless and causes little disturbance in routine activity in the earlier stages. If left untreated to progress into later stages, it hampers and restricts the affected child’s mobility and gait. It is quite curable, achieving nearly 95% success rate with respect to gaining full foot functionality.
Clubfoot: Causes Leading To It
- Isolated Genetic Inheritance, although there is paucity of sufficient supportive data
- Neuromuscular Disorders such as cerebral palsy or spina bifida
- Oligohydramnios, i.e. insufficient amniotic fluid bathing the fetus within the uterus
- A Solid Family History supporting the development of the condition
- Certain Genetic Syndromes such as Edwards Syndrome
- Environmental Factors such as an expecting lady smoking, contacting an infection or consuming recreational drugs
Clubfoot: Broader Classification
The clubfoot issue is generally grouped under 2 major categories:
- Isolated (Idiopathic) is the type that is most common and develops in children with no other apparent medical issues.
- Non-Isolated is the one that occurs in combination with other health issues or neuromuscular abnormalities such as cerebral palsy, arthrogryposis and spina bifida which offer much resistance to treatment course, requiring longer time period and often repeated invasive methods to attain complete correction.
Clubfoot: Symptoms Leading To Precise Podiatric Diagnosis
- Severe Twisting & Bending occurring with the foot-top bent downward & inward with inwardly twisted heel as well
- Totally Inverted Condition can be observed whereby the affected foot looks reversely attached
- Shorter, Wider Affected Foot Condition, by about 10 mm than the normal foot
- Smaller, Weaker Calf Muscles due to underdevelopment in the affected leg
- Shorter Affected Leg than the normal one
- Achilles Tendon is usually abnormally taut and rigid
Clubfoot: The Treatment Course Devised By Your Specialist
The treatment methods, whether nonsurgical or surgical, are directed at reducing the birth defect to its minimum, imparting a non-aching and normal looking condition to the otherwise ugly looking foot or feet. A fully functional foot with the sole and arch positioned correctly at their respective planes should be the expected and achieved outcome after the treatment procedures have been applied appropriately.
The Nonsurgical Approach: Howsoever the severe clubfoot may appear, the first line of treatment adopted is always avoiding the surgical method and going for other options listed below:
- Ponseti Method that comprises of manipulation & casting, Achilles tenotomy and bracing, all carried out in sequence in the infantile phase
- French Method that involves specialized physiotherapy via stretching, taping and splinting until around baby’s 3rd year of life
The Surgical Approach: The surgical stage is the last resort to attaining normalcy with respect to the clubfoot issue. It is employed under the following compelling circumstances:
- Incomplete Deformity Correction
- Recurring Deformity
- Difficulty By The Parents In Following The Treatment Plan Strictly & Accordingly
- Severe & Stubborn Childhood Deformities
While every effort is made to best avoid extensive surgical methods, deformities that have been partially overcome can be fully done away with through less invasive procedures in later stages.
- The Less Extensive Surgery is targeted at correcting only those joints and tendons that conduce to the deformity.
- The Major Reconstructive Surgery calls for removal or release of multiple soft tissues in the foot until desired correction level is achieved. Thereafter, the foot joints are allowed to acquire stability by fixing them with pins and cast that are not removed prior to 3 months’ continual usage.
Clubfoot: Probable Associated Complications
Clubfoot, undoubtedly, is a complex situation to be in. As such, pre-treatment and post-treatment complications of various types might arise that need to be tackled professionally.
The Pre-Treatment Complications: Clubfoot that goes untreated for years may have grave repercussions on the child’s life.
- Abnormal Walking owing to twisted ankle that causes the child to walk on the ball of the foot, lateral side of the foot or even the foot arch.
- Chronic Arthritis has been usually observed to develop as the condition progresses.
- Walking Compensation & Adjustments cause the calf muscles of the affected side to remain underdeveloped, giving rise to large calluses and sores in the foot leading to an abnormal gait.
- Psychological Impact of an untreated clubfoot condition might impede and restrict the socializing tendency of an individual.
The Post-Treatment Complications: A treated clubfoot may be accompanied with the following ill-effects:
- Smaller Shoe Size of the treated foot by about 1 to 1-1/2
- Slender, Smaller Calf Size on the affected side giving rise to soreness or quick weariness
- Slightly Shorter Leg as a rare proposition
- Restricted Movement with slightly checked mobility of the individual