Clubfoot

August 31, 2018 by  
Filed under Health

A clubfoot is a deformity of the lower leg and foot that occurs during fetal development. Twice as common in males as in females, the abnormality may affect one or both feet. In most cases, the front of the foot turns down and in, and the heel also turns inward. The arch is abnormally high, the ankle joint may be rigid or stiff, and the calf is abnormally small. Most club feet are thought to be a congenital defect in the prenatal development of ankle bones and surrounding muscles. Usually, no cause for the malformation can be identified. However, some medications such as methotrexate, used to treat severe arthritis and psoriasis, have been linked to fetal abnormalities, including clubfoot. There are cases in which the feet appear deformed immediately after birth because of a cramped fetal position in the womb, and they soon assume a normal shape on their own. These are not true clubfeet.

Clubfoot

Diagnostic Studies And Procedures

Sometimes what appears to be a deformed limb may show up on a fetal sonogram, but this is not a reliable test. Diagnosis is usually made when the baby is examined immediately after birth, at which time a clubfoot is easily recognized on the basis of its appearance. X- rays confirm the diagnosis and provide precise information about the placement of the foot and ankle bones.

Medical Treatments

A pediatric orthopedist should be consulted as soon as possible following the baby’s birth, because clubfoot is not a condition that can be expected to correct itself with time or exercises and it is more difficult to correct if allowed to go untreated. Ideally, the foot is manipulated toward a normal position when the baby is a few days old, and the new position is maintained by a cast or a splint covered with an adhesive bandage. During the first few weeks, manipulation and compression are repeated every few days, along with a change of cast or splinting designed to move the foot to a more normal position. By the time the baby is about two months old, the casts are changed at one to two week intervals. When normal positioning of the foot has been achieved, corrective shoes are worn for a time to maintain it. If a deformed foot cannot be coaxed into a normal position by manipulation and casts, surgical correction is necessary. This is done usually when the baby is 6 to 12 months old. With prompt and complete treatment, a child born with a clubfoot can eventually have a normal foot, engage in sports, and wear the same shoes as his peers. But the foot should be evaluated periodically by a pediatric orthopedist to be sure it is still growing normally. Although orthotic devices special shoe inserts are not used for treatment’ they may be recommended later on to help maintain proper alignment of the foot and ankle bones following either type of correction. In some cases, an abnormality in foot development does not become obvious until a baby is a few months old. At that point, the problem is also treated with progressive casting or splinting, corrective footwear, and eventual surgery, if necessary. Even an adult whose deformity was not corrected during childhood can achieve some measure of foot normalcy through operations in which the foot bones are resectioned and then fused.

Alternative Therapies

Although not recommended as a substitute for conventional treatment of clubfoot in infancy, massage therapies may hasten the correction in certain cases. Such treatments should not be undertaken, however, without the approval of the orthopedist who is overseeing the correction.

Self Treatment

Children who are handicapped by their deformity can profit from exercises that are designed to stabilize their gait and prevent fatigue. A physical therapist can demonstrate the routines for parent and child, so that the exercises can be supervised at home. Parents should avoid overprotection of a child with a clubfoot, because it can have a crippling effect on psychological and emotional development.

Other Causes of Foot Deformities

A birth injury or an accident during infancy can result in deformities similar to those of clubfoot, as can neuromuscular disorders, such as cerebral palsy and muscular dystrophy. A clubfoot like deformity may also be one of the manifestations of genetic dwarfism.

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