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Paediatric Congenital Clubfoot
Paediatric Congenital Clubfoot
Congenital clubfoot, or talipes equinovarus, is a birth defect in which a newborn’s foot is twisted out of shape or position. The foot is typically rotated inward and downward, making it difficult or impossible for the child to walk normally if left untreated. Clubfoot can affect one or both feet and varies in severity. While it is a severe condition, early treatment often allows babies born with clubfoot to live active, normal lives.
Symptoms
The signs of congenital clubfoot are usually apparent at birth. They include:
Twisted Foot
The foot is turned inward, with the sole facing sideways or even upward.
Smaller Foot
The affected foot is usually shorter or smaller than the other foot.
Stiffness
There is reduced flexibility or movement in the foot and ankle.
Calf Muscle Underdevelopment
The calf muscles on the affected side are often smaller than on the unaffected side.
Abnormal Walking Pattern
If untreated, children with clubfoot may walk on the side or top of their foot.
Causes
The exact cause of congenital clubfoot is not always known, but several factors may contribute to its development:
- Genetic Factors: Clubfoot can run in families, indicating a genetic component.
- Environmental Factors: Conditions in the womb, such as limited space, may increase the risk.
- Neuromuscular Disorders: Certain conditions, such as spina bifida, may increase the risk of developing clubfoot.
Risk Factors
Certain factors increase the likelihood of a child being born with congenital clubfoot:
- Family History: Clubfoot is more common in children who have a family history of the condition.
- Male Sex: Boys are more likely to be born with clubfoot than girls.
- Multiple Births: Clubfoot is more common in twins or multiple pregnancies.
- Maternal Smoking: Smoking during pregnancy has been associated with an increased risk of clubfoot.
- Low Amniotic Fluid (Oligohydramnios): This condition may restrict the baby’s movement in the womb, leading to a higher risk of clubfoot.
Diagnosis
Congenital clubfoot is typically diagnosed shortly after birth, though ultrasound imaging may detect it prenatally. Diagnostic methods include:
- Physical Examination: A doctor will examine the baby’s feet and legs to assess the severity and confirm the diagnosis.
- Prenatal Ultrasound: Clubfoot can often be seen on ultrasound before the baby is born, especially in severe cases. However, a definitive diagnosis is usually made after birth.
- X-rays or Imaging: In some cases, X-rays or other imaging may be used to assess the structure of the bones and joints.
Treatments Provided By Us
Early treatment is critical for correcting clubfoot and preventing long-term complications. The goal of treatment is to improve the alignment of the foot so that the child can walk normally. Treatment usually begins in the first few weeks of life.
Rehabilitation
Rehabilitation is an important aspect of treatment to ensure long-term success.
- Physical Therapy: After casting or surgery, physical therapy may be recommended to help improve muscle strength, flexibility, and range of motion.
- Follow-up Care: Regular check-ups are essential to monitor the child’s progress and detect any recurrence of the condition. Bracing may be required for several years, and in some cases, additional treatment may be needed.
Complications
With proper treatment, most children born with clubfoot go on to lead normal, active lives. However, untreated or poorly managed cases can lead to complications such as:
- Permanent Deformity: Without treatment, the foot remains twisted, causing mobility issues.
- Difficulty Walking: Untreated clubfoot may result in the child walking on the side or top of the foot, leading to abnormal gait and balance issues.
- Chronic Pain: The abnormal alignment of the foot can cause ongoing pain, especially with physical activity.
- Arthritis: Children with untreated or partially treated clubfoot are at increased risk of developing arthritis in the affected foot later in life.
- Recurrent Deformity: Even with successful treatment, some children may experience a recurrence of clubfoot, which will require additional intervention.
When To See A Doctor
Most babies treated early for congenital clubfoot using the Ponseti method experience full correction of the deformity and go on to lead normal lives. However, ongoing monitoring and adherence to bracing protocols are critical to prevent recurrence.
Doctors In-Charge
Specialist Orthopaedic Surgeon
Specialist Orthopaedic Surgeon