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Living with Clubfeet

Parents know immediately if their new born has a clubfoot. Some will even know before the child is born, if an ultrasound was done during the pregnancy. A clubfoot occurs in approximately one in every 1,000 births, with boys slightly outnumbering girls. One or both feet may be affected. In most cases, having a clubfoot deformity at birth doesn’t delay a child’s walking, as long as proper treatment is received from birth. Frequent cast changes gently guide the malleable new born bones into the proper position. Previously surgery was frequently required to repair this deformity; however, that’s no longer true.

Cause

Doctors still aren’t certain why it happens, though it can occur in some families who had clubfeet. In fact, your baby’s chance of having a clubfoot is twice as likely if you, your spouse or your other children also have it. Less severe infant foot problems are common, and are often incorrectly called clubfoot.Newborn with Clubfoot

Symptoms

The appearance is unmistakable: the foot is turned to the side, and it may even seem as if the top of the foot is where the bottom should be. The involved foot, calf, and leg, is smaller and shorter than the normal side. It is not a painful condition. But if it is not treated, clubfoot will lead to significant discomfort and disability by the teenage years.

Type of Defects

The type of defect a child has can affect them when they start walking. A number of children have bilateral clubfoot. In some cases, clubfoot is caused by disorders such as spina bifida, where damage to the spinal cord can lead to limited movement or paralysis. Fixing the clubfoot won’t allow a child to walk if he has another condition that interferes with his lower limb function.

Walking Problems

If your child receives timely and proper treatment and has idiopathic clubfoot, meaning he has no other associated conditions, they would probably walk at a normal age. Most children with clubfoot walk normally and can participate in sports after treatment. The most common abnormalities noted in adults who had clubfoot surgery were mild to moderate restriction from pain, ankle weakness, and reduced range of motion in the foot and ankle.

Treatment

NonsurgicalBrace for a child with a clubfoot

Treatment should begin right away to have the best chance for a successful outcome without the need for surgery. A particular method of stretching and casting, known as the Ponseti method, has been responsible for correction. With this method, the doctor changes the cast every week for several weeks, always stretching the foot toward the correct position. The heel cord is then released followed by one more cast for three weeks.

Once the foot has been corrected, the infant must wear a brace at night for two years to maintain the correction. This has been extremely effective but requires the parents to actively participate in the daily care by applying the braces. Without the parents’ participation, the clubfoot will almost certainly recur. That’s because the muscles around the foot can pull it back into the abnormal position.

The goal of this, and any treatment programme, is to make your new born clubfoot (or feet) functional, painless, and stable by the time he or she is ready to walk. If however your baby wears a cast, watch for changes in skin colour or temperature that may indicate problems with circulation.

Surgical

On occasion, stretching, casting and bracing are not enough to correct your baby’s clubfoot. Surgery may be needed to adjust the tendons, ligaments and joints in the foot/ankle. Usually done at 9 to12 months of age, surgery corrects all of your baby’s clubfoot deformities at the same time. After surgery, a cast still holds the foot while it heals. This is so because it’s also possible for the muscles in your child’s foot to try to return to the clubfoot position, and special shoes or braces will likely have to be used for up to a year or more after surgery. Surgery may result too in a stiffer foot than nonsurgical treatment, particularly as the years go by.

Without any treatment, your child’s clubfoot will result in severe functional disability. With treatment, your child should have a nearly normal foot. He or she would be able to run and play without pain and wear normal shoes. However, the corrected foot will still not be perfect. You should expect it to stay 1 to 1 1/2 sizes smaller, and somewhat less mobile than the normal foot. The calf muscles in your child’s clubfoot leg will also stay smaller.

Your feet mirror your general health . . . cherish them!

 

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