It is three dimensional deformity of foot involving either one or both feet since birth. The affected foot of a child looks like being rotated internally & downward at the ankle. If left untreated, can cause severe gait abnormality during walking as child walk on outer part of sole and ankle. The child further finds it difficult to place the sole of the foot flat on the surface. Ideally treatment of clubfoot should start as early as possible without delay to avoid major problems as the child grows. Early treatment gives better results.
The exact cause of clubfoot is still not known (Idiopathic). Other reasons for this could be genetic, position of baby in mother womb, neuromuscular disorders etc. The parents must get the child screened immediately to assess his health condition and identify the exact cause of the congenital deformity. There is no correlation in the deformity and other ritual myths like “GRAHAN”
Deformity is obvious and apparent and can be diagnosed immediately after birth. The most important symptom of clubfeet is the foot looking deformed and twisted like the club of the golf stick. But the child will experience discomfort and find it difficult to walk if clubfoot is not treated properly and timely. The child may find it difficult to wear shoes and participate in physical activities. Sometimes foot size of affected side appears smaller than normal side.
Clubfoot can be diagnosed even before baby born (antenatal) by Ultrasound. Orthopaedic surgeon detects the deformity after birth by observing the appearance and movement of the baby’s feet and legs.
Clubfoot can be treated Non-surgically by serial casting followed by percutaneously done tenotommy with success rate over 90%. Tenotomy is a day care procedure done on OPD basis. After tenotomy child always put on braces for sometimes. In some cases surgery require like relapse, neglected, neuropathic and muscular cause of clubfoot.
The nonsurgical treatment methods require the child to wear special shoes and braces fulltime till the clubfoot is cured. Also, the child has to perform a variety of stretching exercises on a daily basis.
Q: – Is it correctable deformity??
A: – Success rate of treatment is more than 90% without surgery by casting + Tenotomy technique.
Q: – How many cast will be needed??
A: – Usually 4-5 cast (depend upon severity of foot) followed by tenotomy.
Q: – What is tenotomy??
A: – Tenotomy is a day care procedure done under LA/GA. In this we release tight posterior structure.
Q: – Any side effect of tenotomy??
A: – No, released structure regenerate spontaneously without any side effect.
Q: – What is braces and for how long need to bear??
A: – Braces are used to prevent the recurrence of deformity. Initially put for 23 hours in a day for three months and then at nap time till four years of age.
Dr. Nargesh Agrawal
Child Ortho Care
Child Orthopedic Surgeon & Consultant, Delhi