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Pediatric Clubfoot Treatment

Symptoms, Causes and Treatment of Children's Clubfoot

What Is Clubfoot?

The medical name for clubfoot is congenital talipes equinovarus (CTEV). It is a congenital deformity that may affect both feet or only one foot. The affected foot appears to rotate internally at the ankle. If a child is not treated for this disorder, they will walk on the sides of their feet or on their ankles. This may lead to further medical issues, arthritis, or require surgery.

Thanks to advances in medical science, there are a number of treatments for patients who suffer from CTEV. And, with proper treatment, a significant majority of clubfoot patients enjoy 100 percent recovery. Successful treatment enables them to walk normally and even participate in athletics.

Please note that, although the condition looks painful, the baby experiences no pain or discomfort due to clubfoot. However, that pain-free experience ends once the child begins walking.

Diagnosis, Symptoms, and Causes of Clubfoot

Clubfoot is a musculoskeletal birth defect that affects nearly 200,000 infants every year. The condition is likely as old as humanity; you see depictions of it in Egyptian hieroglyphs and writings by Hippocrates that date back to 400 BCE.

Scientists do not yet know what causes CTEV. Although popular supposition describes the condition as occurring due to the position of the fetus inside the uterus, most experts disagree with this theory. Although a definitive cause has not yet been determined, there are numerous hypotheses, each related to a different part of the musculoskeletal system.

Common Symptoms of Clubfoot

The most common symptoms of CTEV are:

  • The top of the foot twists inward and outward
  • The heel is highly pronounced and turns inward
  • In extreme cases, the foot may appear to be completely upside down
  • Calf muscles are not fully developed
  • When only one foot is affected, it is typically shorter than the other foot
  • The sufferer feels no pain or discomfort until he or she tries to walk
  • Healthcare professionals detect the condition either at or before birth

Diagnosing Clubfoot

As this disorder is easily visible, it is detected immediately upon birth. With ultrasound technology, healthcare professionals are often able to detect CTEV before birth, particularly when it affects both feet. However, treatment may not begin until after birth.

One benefit of early detection is that doctors can conduct further tests to determine whether the child has other musculoskeletal issues, such as muscular dystrophy or spina bifida.

In certain cases, the doctor uses x-rays to study the condition in detail.

Clubfoot Treatment Options

If your child receives a clubfoot diagnosis, there are numerous treatment options available. The earlier treatment begins, the better. This is because an infant’s joints and bones are highly flexible, which allows your pediatric podiatrist to manipulate the bones more easily.

Thanks to the numerous advances made in medical science, clubfoot is highly treatable. One of the most effective treatments is the Ponseti method, which involves a series of manipulations followed by casting. Kristi Yamaguchi, the American gymnast who won a gold medal at the 1992 Olympics, was born with CTEV and treated using the Ponseti method. If your child is born with the disorder, treatment may begin within a week of his or her birth.

Ponseti Method Casting Treatment

The Ponseti method utilizes a combination of gentle foot manipulation and casting. Each week, your pediatric podiatrist gently manipulates your child’s foot toward normal bone alignment. Another cast is applied, with the procedure repeating weekly for six to eight weeks.

When started early and performed by a trained podiatrist, the Ponseti method boasts a 90 percent success rate. For severe conditions, surgery may be required. Considered the gold standard of most podiatrists, Pediatric Foot & Ankle employs the Ponseti method whenever possible to treat CTEV.

This method is found to be most successful when it has been applied by a trained professional podiatrist. The Ponseti Method is considered the gold standard when it comes to clubfoot disorder.

The Importance of Early Detection and Treatment of Clubfoot

Detecting CTEV early is not difficult, as the doctor need only look at the baby’s feet to determine whether he or she has clubfoot. The doctor may order x-rays to help determine the severity of the disorder. If both feet are affected, the condition is usually detectable via ultrasound during pregnancy. When discovered this early, parents may explore treatment options before the birth. The earlier clubfoot is treated, the greater the odds that treatment will be successful.

Disadvantages of Not Treating Clubfoot Early

When not treated at birth, clubfoot may result in a functional disability and require surgery at a later stage. Conversely, early treatment typically leads to a completely normal foot, allowing the child to walk without any type of pain.

Delayed treatment may also result in the foot not being perfect even after treatment. For example, it may be smaller or less mobile than the other foot (or both). The child may also have smaller calf muscles.

Pediatric Clubfoot FAQ's

What causes clubfoot in children?

Clubfoot is caused by a combination of genetic and environmental factors affecting bone, muscle, and connective tissue development in utero. Exact causes are unknown but family history can increase risk.

How is clubfoot diagnosed?

Clubfoot is visually diagnosed at birth. The infant’s foot appears twisted inward and downward. An exam confirms limited mobility. Imaging like x-rays helps evaluate severity.

How is clubfoot treated in infants?

Nonsurgical treatment involves gently manipulating the foot into proper position followed by applying casts weekly to gradually correct position. This is done over a period of 2-3 months.

When is clubfoot surgery needed?

If non-surgical treatment fails to fully correct clubfoot, surgery may be required. This usually involves lengthening or releasing tendons and ligaments to improve alignment.

What is the outlook for children born with clubfoot?

With early diagnosis and proper treatment, the vast majority of children born with clubfoot are able to have normal functioning, pain-free feet. Regular monitoring until full bone maturity is reached is important.

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