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  Club Foot
 What is Clubfoot ?  What are the treatment options for Clubfoot ?
 Why is it called Clubfoot ?  Conservative treatment
 Who is at risk of Clubfoot ?  Surgical Intervention
 What are the causes of Clubfoot ?  What are the complications of Clubfoot ?
 What are the symptoms of Clubfoot ?  Frequently Asked Questions
 How can Clubfoot be diagnosed ?  Glossary
 
What is Clubfoot ?

Clubfoot, medically known as talipes, is a foot deformity present at birth (a congenital deformity) affecting the shape or position of one or both feet.

Why is it called Clubfoot ?

The foot resembles the end of a golf club (hence its name). The most common form of clubfoot is known as 'equinovarus', clubfoot is also known as Talipes Equinovarus or Talipes

Who is at Risk of Clubfoot ?

About one child in 1000 is born with clubfoot, and twice as many boys have it as girls. Familial history is also a positive risk factor.

What are the causes of Clubfoot ?
The exact cause of clubfoot is not known, but the condition may be inherited.
What are the symptoms of Clubfoot ?
Clubfoot is the most common disorder of the legs that children are born with. The deformity can range from mild and flexible deformity to severe and rigid deformity.

Some of the common features include :-

The heel is pointed away from the body and is drawn
upwards.


The foot is twisted in towards the other foot.

The toes are pointed down.

The affected foot and leg, will be stiff and smaller in size, when compared to a normal child.

The calf muscle may be smaller than normal and underdeveloped.

There will be lack of ankle joint motion.
How can Clubfoot be diagnosed ?

Before the child is born, clubfoot can be detected through an ante-natal ultrasound scan.

After birth it can be detected by means of looking at the shape and position of the foot. 

After a diagnosis of clubfoot is made an x-ray of the affected child's foot could indicate the severity of the problem.

A CT scan maybe done in a case of severe deformity. 

What are the treatment options for Clubfoot ?

Treatment is usually started as soon as the deformity is detected after birth.

Mild and flexible deformity - If treatment is started early, the chances of the deformity correcting is high. Usually   conservative treatment is sufficient to correct this type of club foot.

In severe and rigid deformity - the conservative treatment may fail and surgery is usually the next option.

Conservative treatment

The treatment most commonly consists of a series of plaster-castings in the newborn, over a period of several weeks with frequent cast changes to gradually correct the deformity. Ideally, the procedure is started just after birth when the foot is easiest to reshape. Longer delay means greater difficulty in correction.

After the shape of the foot is realigned, it is maintained through exercise, nighttime splints and orthopedic shoes (a specialized boot designed for clubfoot deformity, which maintains the foot in its corrected position and prevents a relapse).

A Conservative treatment approach takes approximately 3 months, however maintaining the correct foot position may require use of braces and additional treatment for years.

For those feet that do not respond to casting, surgery will be required once the child gets a little older (between 6 - 12 months). Hence continued evaluation is recommended until the foot is fully grown.

Surgical Intervention

In children less than 5 years of age - soft tissue correction is done, and the shortened tendons and ligaments causing abnormal position of the foot are released.

In children above 5 years of age - surgical correction - Bone re-shaping and Osteotomy (cutting & removing the bone) of the bones to correct abnormal foot position maybe necessary.

Whatever be the mode of correction for clubfoot, the goal of treatment involves making the feet function and appear as normal as possible, without causing pain.

What are the complications of Clubfoot ?

Some defects may not be totally correctable, but with treatment the appearance and function of the foot can be improved. The treatment may be less successful if the clubfoot is associated with other birth disorders.

Frequently Asked Questions

Which doctor should I see for Clubfoot ?
You should see a orthopedic surgeon. Physiotherapy also has a role in treating club foot

How long should the treatment continue ?
There are chances for the deformity to relapse even though it is corrected. So the child needs continuous check up and treatment through out his growing age.

Can surgery be done immediately to the newborn baby, as soon as the Clubfoot is detected ?
No, surgery is done, only when the conservative treatment fails for the child. The child should be of sufficient size so that the structures like bones, tendons, ligaments, muscles can be identified, during surgery for correction. The right age for surgery is six months of age and above.

What happens if the Clubfoot is left untreated ?
If clubfoot is left untreated, the child's foot will be automatically turned inwards and the child could not be able to place his foot flat on the ground and finds difficult to walk.

Glossary

Congenital - Congenital is a term, which denotes Acquired by Birth.

Talipes - Talipes refers to Ankle and foot. This is a condition of foot caused by shortening of muscles and tendons.

Equino varus - The position of foot pointing downwards and inwards.

Orthopedics - This is a Medical speciality, which is related to the diagnosis and treatment of diseases of Musculo-skeletal system.

Manipulation - This is a treatment, where the doctor manually, holds and stretches the foot to correct the abnormal position.

Deformity - Deformity is a major difference in shape of body or part of a body compared to the normal shape of the body.

Soft tissue operation - This is a surgical operation done to correct the shortened tendons and ligaments of the foot, causing abnormal position of the foot.

Osteotomy - This is a surgical operation where the affected bones are cut and removed.

Splints - Splints are devices, which supports and maintains the corrected position.

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