Club foot

Clubfoot, also known as Congenital Talipes Equinovarus (CTEV), is a congenital deformity affecting one or both feet. The affected foot appears to have been internally rotated at the ankle. People with club feet frequently appear to walk on their ankles or on the sides of their feet if they are not treated. However, with treatment, the vast majority of patients recover completely during early childhood and can walk and participate in athletics just like patients born without CTEV.

It is a fairly common birth defect, occurring in approximately one out of every 1,000 live births. Approximately half of those who have clubfoot have it in both feet, which is known as bilateral club foot. In most cases, it is a limb-specific disorder. Males are twice as likely as females to be affected.

A condition of the same name can be found in some non-human animals, particularly horses, though it is more akin to stepping pointe than sideways.

Causes:

Sometimes clubfoot is simply the result of the baby's position while developing in the mother's womb (postural clubfoot). But, more often than not, clubfoot is caused by an unknown combination of genetic and environmental factors. If someone in your family has clubfoot, your child is more likely to develop it. If your family already has one child with clubfoot, the chances of a second child developing the condition rise.

Because clubfoot can be associated with other conditions such as spina bifida, having it at birth can indicate further health problems. As a result, as soon as clubfoot is discovered, the infant should be screened for other health issues. Clubfoot can also be caused by problems with the nerve, muscle, and bone systems, such as a stroke or brain injury.

Signs and symptoms:

Clubfoot is painless in a baby, but it can cause discomfort and become a visible disability later in life. Clubfoot does not heal on its own if left untreated. The twisted foot will remain twisted, and the affected leg may be shorter and smaller than the other. As the child grows, these symptoms become more noticeable and problematic. There are also issues with shoe fitting and participation in normal play. Treatment that begins soon after birth can aid in the resolution of these issues.

Diagnosis:

The diagnosis of clubfoot is usually made immediately after birth by simply looking at the foot. The doctor will then decide whether or not to x-ray the foot or feet to see how the internal structures are positioned. In some cases, the disease may be detectable prior to birth using ultrasound. If both feet are affected, it may be more noticeable. The ability to identify clubfoot before live birth can benefit the child by allowing different treatments to be explored.

Treatment

There are numerous treatment options for a child who has been diagnosed with clubfoot. To take full advantage of the baby's bones and joints' flexibility, treatment should begin as soon as possible after diagnosis. This allows for better manipulation in the attempt to achieve a normal foot. The Ponseti method appears to produce better results than the Kite method and comparable results to a traditional technique.

This required manipulation by people trained in the serial casting technique, followed by the provision of braces to keep the feet in a plantigrade position. Following serial casting, a foot abduction brace, such as a Denis Browne bar with straight lace boots, ankle-foot orthoses, and/or custom foot orthoses (CFO), may be used. Manipulation is followed by serial casting, most commonly by the Ponseti method, in North America. Foot manipulations usually begin within the first two weeks of life.

• French method:
  With young bones, the French method, also known as the "functional method" or "physiotherapy method," is easiest to apply.
• Ponseti method:
  This treatment involves stretching. The foot is repositioned to its normal position, and then a cast (the "Ponseti cast") is applied to it. For several months, the baby's foot is constantly repositioned and placed back into a cast. After being in a cast for the duration of the procedure, the doctor will surgically lengthen the heel cord (aka Achilles tendon). After the foot has been realigned, routine stretching is required for maintenance.
• Surgery:
  In severe cases, surgery may be the only option for correcting the foot after all non-invasive treatment options have been exhausted. Although surgery does not guarantee complete recovery, most babies who have undergone the procedure have retained their normal feet. To ease the foot into position, a surgeon will go in and lengthen the muscles and tendons. When the cast is removed following surgery, a brace is to be worn to prevent the foot from returning to its original position.