Due to significant advancements in medicinal science, almost every other disease comes with a cure and so does Club Foot. But before jumping to its possible treatments, let us look a little too deep and try to understand what exactly it is, its signs, risk factors, and complications.
What does Clubfoot mean?
In scientific terms, it is defined as a condition of an infant where his/her foot or feet are rotated inside right at the ankle joint. Also referred Talipes Equinus/Equinovarus and Congenital Talipes Equinovarus (CTEV), it could never be acquired, and depending on the severity it can be mild to severe range.
As far as science has informed us, the male gender and the babies with parents at least one having a clubfoot are more prone to be born with a clubfoot deformity. Adding to your surprise, let us tell you two most of the famous personalities born with clubfoot. These are The Claudius-Roman emperor and Steven Gerard-English soccer player!
Do you think, the infant with a clubfoot feels pain? If yes then you are mistaken because a person usually does not experience any discomfort or pain during a normal-paced walk. Although it is a painless deformity in infancy but if you haven’t started any treatment, the foot will be left deformed for life making the person never be able to walk just like normal beings.
Well, most people think that clubfoot is a result of an inappropriate fetus’ position inside the uterus. BUT, it is a big NO!
The clubfoot can be caused by multiple reasons but fetus position is definitely not one of these. No matter, what the fetus’s position is, it will never lead to the CTEV deformity of making the feet turned internally.
What are the Causes?
Now the question is if not fetus position then what can be the possible causes behind the Clubfoot.The answer is “idiopathic”. In most of the cases, the cause is unknown. Well, there can be other explanations:
- Neurogenic clubfoot involving CNS, for instance, due to spina bifida at birth or because of cerebral palsy in late childhood.
- Syndromic clubfoot caused due to underlying syndrome. Common examples are arthrogryposis, constriction band syndrome, tibial hemimelia, and diastrophic dwarfism.
- Genetic factors can be an important aspect, as well. Some specific gene changes can be associated passed down through generations.
- Skeletal abnormalities
- Neuromuscular pathway disruption
- External OR environmental influences for instance smoking, tobacco, drug or medication abuse by the mother.
- Besides, if the mother has diabetes, there are high chances.
- The risk of clubfoot is higher in the case of amniocentesis in the early 13 weeks of gestation
An infant born with clubfoot
Do you know in most of the cases, almost 50%, both feet of the infant are typically affected? And if the deformity has influenced only foot, you would find that leg a little shorter in comparison to the other, especially at the level of the heel.
Well, the common presentation of the foot will be:
- The foot twisted downwards and inwards from the top
- The soles facing each other
- The heels turning inward
- More definite and high-lined arch
In severe cases, apart from the above-mentioned features
- Underdeveloped calf muscles tend to be underdeveloped
- The foot appears upside-down
- Unusually/Abnormally shaped bones
- Tightened Achilles tendon
Club foot types
- Isolated clubfoot – The most common category and the child bears no other distinctive medical issues or life-threatening syndromes
- Non-isolated clubfoot – The patient will show the presence of other health complications and neuromuscular disorders in combination with Clubfoot. In case of having a neuromuscular problem, this condition can get worse and shows maximum clubfoot may be more resistant to the treatment, needing an expanded course of nonsurgical handling, or several surgeries.
It can be diagnosed right at the time of birth as it becomes evidently visible when the physical examination is conducted.
This condition can be identified before the baby is born through fetal screening ultrasound. If the foot imbalance is pretty significant, it means the baby has a clubfoot. The ultrasound can be performed as early as 12 weeks gestation. Another option to get to a clear diagnosis is the use of X-rays imaging which is a painless procedure.
But, even if your baby has been diagnosed, you will not be able to do anything. The parents have to wait for the club foot treatment, till the baby is born.
Treatment is usually started after several weeks, two, of birth because of the advantageous tissue’s elasticity. Babies can get fussy in the beginning but instructions must be followed harshly to make the feet functional again and pain-free. The clubfeet are typically corrected within 6-8 weeks assuming the proper care and tender manipulations with timely plaster cast placements.
In most cases, surgery is not required. The doctors are always advised to select the treatment on the basis of a child’s functional foot anatomy along with the biological response of ligaments, muscles, and bone.
Selected as a primary way of cure the baby’s foot is only manipulated with the hands to correct the bend in the Ponseti technique. Followed by the plaster casting from the toes till thigh, it keeps the foot in the right position. All it takes is a session per week. And at each visit, the foot is amended a little more
In case the baby shows tightening of the Achilles tendon, minor surgery might be required. Once the treatment is completed, a patient must wear special boots for a maximum of three months all day. After 3 months, the club foot boots must be worn only at night till the child reaches the age of four., The reason? To prevent relapse.
Based on regular foot stretching, the treatment involves exercising and massaging on daily basis. In the initial three months, therapy sessions should be supervised by the physical therapist. Well, once the child has completed 3 months of foot movement therapy the taping and splinting are usually continued till the child turns 2 years.
Surgery is a considerable option only if no other CTEV treatment is found successful. Unfortunately, it might cause overcorrection, stiffness, and pain as the post-surgical complications.
Less extensive surgery – Targeting only affected tendons and deformed joints.
Major reconstructive or invasive surgery – Targeting multiple soft tissues, and foot joints that are corrected with pins lasting for 4-6 weeks, followed by the casting for a maximum of the extra 4 weeks