About Clubfoot

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.

Causes

The cause of clubfoot differs from one child to another. But clubfoot can be caused by both genetic and environmental conditions. Some children are born with clubfoot due to growing in their mothers’ wombs in an abnormal position. At the same time, clubfoot is also caused due to problems in a child’s muscle, nerve, or bone system. The parents must get the child screened immediately to assess his health condition and identify the exact cause of the congenital deformity.

Symptoms

Unlike other congenital deformities, clubfoot does not make the child experience pain. But the child will experience discomfort and find it difficult to walk if clubfoot is not treated properly and timely. The most important symptom of clubfeet is the foot looking deformed and twisted like the club of the golf stick. In some cases, the affected leg appears shorter and smaller than the other leg. The symptoms of clubfoot become evident as a child keep growing. If the parents do not start treatment immediately, the child may find it difficult to wear shoes and participate in physical activities.

Diagnosis

Some orthopaedic perform ultrasound to detect clubfoot in advance when the baby is still in the womb. However, most orthopaedic detect clubfoot by observing the appearance and movement of the baby’s feet and legs immediately after birth. While diagnosing clubfoot, orthopaedic focus on both appearance and movement of the affected legs.

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.

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.

Case 1

Parents came to my clinic from remote village with their kid (1year & 2 months age) with neglected club foot deformity (both feet).

I started serial casting by Ponseti technique. It was corrected completely after 6 weekly casts at clinic followed by small scar-less surgery (TA tenotomy).