Approximately one infant in every 1,000 births will be born with clubfoot. This is one of the more common feet deformity in which infant’s foot severely turns inward that bottom of feet face sideways or even upward in some cases. clubfoot is however not painful during infancy, but if it remains deformed & is not treated early the child will not be able to walk normally. Majority of children nevertheless are able to enjoy range of physical activities with little or no trace of deformity with proper treatment. Most clubfoot cases are successfully treated using nonsurgical methods which include combination of casting, stretching & bracing techniques which normally begin shortly following birth.
Signs & Symptoms of clubfoot
Most likely based on appearance, doctors will notice clubfoot soon after the child is born & will also advice the most appropriate treatment. Despite the look, clubfoot does not cause any pain or discomfort.
clubfoot may display the following appearance.
- Top of feet is usually twisted inward & downward while increasing arch & turning heels inward.
- Feet may in cases be severely turned so as to appear it as upside down.
- Calf muscles in affected legs usually remain underdeveloped.
- Affected foot may quite often be about 1 centimeter (0.5 inch) shorter than the other foot.
Preparing for clubfoot Initial Consultation
Children born will clubfoot will most likely be diagnosed soon after taking birth. Doctors will most likely refer parents to a pediatric orthopedic surgeon specializing in musculoskeletal problems. It would be a good idea to make a list of questions in the time you have before the meeting.
Consider Asking the Following Questions
- What types of corrective treatments are available for the condition of my child?
- Is surgery required for my child’s condition?
- What type of follow-up care will my child require?
- Do I need to take a second opinion before starting treatment for my child’s condition?
- How complete will my child’s recovery be & will my child have normal gait?
- Can you provide me with brochures or other printed material on this subject?
- What websites will you recommend for me to refer?
It would be advisable to let the doctor know if any family member, including any extended family member, to have had clubfoot. Also let him know of any medical issues or problems you have had during pregnancy. It would also be ideal to check with the doctor if s/he has commonly treated newborns with clubfoot or if you should get referral to another specialist doctor.
Causes of clubfoot
Although cause of clubfoot is yet unknown, scientists are however sure that it is not caused by the position baby undertakes within the womb. Clubfoot can however be associated with other congenital abnormalities of skeleton like spina bifida. Spina bifida is a serious birth defect which occurs when tissue surrounding a developing spinal cord of fetus is unable to close properly. It can therefore only be said that environment plays a vital role in causing clubfoot. Moreover, some studies have strongly linked occurrence of clubfoot to smoking cigarettes during pregnancy, especially in cases where a family history of clubfoot already exists.
clubfoot Risk Factors
- Gender – clubfoot is more common in male children.
- Family History – When either mother or father, or other children have had clubfoot, newly born babies are most likely to have them as well. This is also more common if babies are having another birth defect.
- Smoking During Pregnancy – Risk of clubfoot is 20 times greater than average if women with family history of clubfoot are smoking during pregnancy.
- Insufficient Amniotic Fluid during Pregnancy – Risk of clubfoot increases when very little of amniotic fluid surrounds the baby in the womb.
- Infection or Illicit Drug Usage during Pregnancy – This will further increase risk of babies developing clubfoot.
clubfoot Complications
Typically, clubfoot does not cause any problems until the child learns to stand & walk. Although with some difficulty, children will most likely walk normally when clubfoot is properly treated.
Mild Problems with Treated clubfoot
- Mobility – Child’s mobility can be slightly limited.
- Shoe Size – Affected feet may be up to 1.5 shoe size smaller than normal unaffected feet.
Serious Problems with Untreated clubfoot
- Arthritis – Children are likely to develop arthritis due to untreated clubfoot.
- Poor Self-Image – Unusual appearance of feet may develop concern among children during teen years regarding body-image.
- Inability to Walk Normally – Twist of the ankle will not allow children to walk on soles of the feet. They may walk on balls of feet, outside of feet, or top of feet in severe cases to compensate.
- Problems with Muscle Development – Adjustments in walking may prevent natural growth of calf muscles, cause calluses or large sores on feet & subsequently result in awkward gait.
Tests & Diagnosis for clubfoot
Most often doctors recognize clubfoot soon after birth just by looking at the shape & position of baby’s feet. Doctors may occasionally request X-rays so as to fully understand severity of clubfoot. However, this is not usually necessary. Moreover, it is also possible to clearly see some cases of clubfoot prior to birth during an ultrasound examination especially when clubfoot affects both feet. Although nothing can be done before birth to solve this problem, but knowing existence of this condition will give parents time to learn more about clubfoot & allow them consult appropriate health experts like genetic counselors and/or orthopedic surgeons.
clubfoot Treatment & Drugs
Bones & joints of newborn babies are extremely flexible. Treatment for clubfoot generally begins within 7 – 15 days after birth. Goal of this treatment plan is to improve the way foot looks & works in newborn infants even before they learn to walk so as to prevent long-term disabilities.
clubfoot Treatment Options
- Ponseti Method Stretching & Casting – This is the most common type of treatment for clubfoot involving taking the following steps.
- Move infant’s foot in correct position & subsequently place it in cast so as to hold it in that position.
- Reposition & recast foot once or twice a week & go on for several months.
- Perform minor surgical intervention so as to lengthen Achilles tendon called Percutaneous Achilles Tenotomy towards the end of Ponseti method stretching & casting.
Once shape of foot is realigned, parents are required to maintain this by performing one or more of the following steps.
- Perform stretching exercises with the baby.
- Put special shoes & braces on child’s foot.
- Make sure that children wear shoes & braces as long as it is needed, which usually is full time for 3 months & then only at night for 3 years.
However, parents will need to apply braces according to direction of the doctor for this method to be successful so that feet do not return to the original position. One of the main reasons which sometimes fails this procedure is because braces have not been constantly applied.
- French Method Stretching & Taping – Also known as the Functional Method or Physiotherapy Method, parents with physical therapists must take the following steps.
- Daily, move the affected foot & hold it in position with help of adhesive tape.
- Continuously move the child’s foot while s/he sleeps with help of a machine.
- Reduce treatment to 3 times a week until the baby is 6 months old after 2 months.
- Continue to perform daily exercises & make use of night splints until the baby is fit to walk once the shape of foot is corrected.
However, French method needs a greater time commitment than the Ponseti method. Moreover, some caregivers prefer to combine French & Ponseti methods.
- Surgery for Clubfoot – Especially in cases where clubfoot are severe or do not respond to nonsurgical methods of treatment, babies may require more invasive procedures. Orthopedic surgeons can effectively lengthen tendons so as to help ease feet into better position. Children’s legs will be in casts for up to 2 months following surgery & subsequently will need to wear braces for a year or so in order to prevent clubfoot from returning. Sometimes, clubfoot may not completely correct with any kind of treatments. But in majority of cases where babies have been properly treated early in time will grow up to wear ordinary shoes & lead normal & active lives.
clubfoot Preventive Measures
Clubfoot cannot be completely prevented since medical science does not yet know what exactly causes clubfoot. However, women can take certain actions so as to limit child’s risk of developing birth defects like clubfoot.
- Avoid smoking or spending time in smoke-filled environments.
- Avoid consuming alcohol.
- Avoid drugs which are not approved by doctors.
Affordable Treatment for clubfoot in India
India is an excellent destination for availing a wide spectrum of affordable healthcare solutions including treatment of congenital disorders like clubfoot & Other pediatric ailments. Pediatric orthopedic experts in India are globally renowned & some of the best in the global context. HealthYatra is one of the fastest growing online medical tourism company in India providing high-quality of healthcare procedures at low costs when compared to availability of similar treatments around the world. Associated with top physicians & accredited hospital facilities in the country, HealthYatra services which begin with the first phone call go on to provide assistance in obtaining medical visa, warm reception on arrival, convenient travel & comfortable accommodation, schedule treatment without any waiting period, recuperation & affectionate farewell on successful completion of treatment.
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