Clubfoot
The Clubfoot occurs when the foot and ankle are
twisted permanently. In clubfoot, the ligament and tendons which holds the
muscles to bones very tight. It is a congenital deformity.
Clubfoot is classified in two groups:
·
Isolated clubfoot: It is very common
form of deformity and occur to children who have no medical issues.
·
Non-isolated clubfoot: It occurs in
combination with various health condition.
The cause of clubfoot is not clear, it may be the
combination of genes and environment.
Symptoms
·
Affected leg may be shorter.
·
Calf muscles in affected leg is under
developed.
·
Top of foot is twisted downward and
inward.
Treatment
An orthopedic surgeon is recommended
for the surgical treatment to correct bone structure of foot. There are
non-surgical and surgical treatment for clubfoot.
Non-surgical Treatment-
Ponseti Method: It is a widely used technique throughout the
world. In this method a gentle stretching and casting is done to correct the
deformity.
The elements of ponseti method
includes:
1. Manipulation and casting- The
baby's foot is stretched and manipulated to correct position and held in place
with long legged cast. Every week the process of stretching, re-position, and
casting is repeated till the foot is improved. The improvement takes about 6 to
8 weeks.
2. Achilles tenotomy- After going through manipulation and casting,
90 percent of babies need minor procedure to release tightness. For this a
quick procedure is performed, doctor will take a thin instrument to cut tendon.
The cut is very small and will not require stitches. New cast will be applied
to protect the tendon during healing process. It takes about 3 weeks to heal.
By the time cast is removed, the achilles tendon regrow to proper length and
clubfoot is cured.
3. Bracing- After successful correction,
the clubfoot can recur. To ensure, foot is completely corrected, baby will have
to wear braces for few years. The brace will keep the foot at correct angle to
maintain correction.
4. Considering Ponseti Method- The
ponseti method is extremely effective for most of the children . It require
high commitment from family to apply the braces properly every day.
Surgical Treatment
The child's foot is partially
corrected with stretching and casting, then to fully correct the clubfoot,
following kind of surgery-
1. Less extensive surgery- It will
target those tendon and joints which are helping in deformity. This include releasing
of tendon at back to inside of mid foot.
2. Major reconstructive surgery- It
involve extensive release of multiple soft tissue structure of foot. Once the
correction is made, joints of foot are stabilized with pins and long-leg cast
while the soft tissue heals. After 4-6 weeks doctor will remove pins and cast.
A short leg cast is applied, which has to be worn by the child for 4 weeks.
When the cast is removed, there is still chance of club foot to return, s
special shoes are used for a year after surgery.
Risks
·
Genes.
·
If mother smokes during pregnancy.
·
If you have spina bifida or other spinal
injuries.
-SurgeryXchange is an online
platform for medical second opinions and advisory services for hospital admission.
No comments:
Post a Comment