CLUBFOOT: HOW TO AVOID DISABILITY
Clubfoot is a deformity of the foot, in which it assumes an unnatural position, deviating from the axis of the lower leg. Cases of clubfoot, according to various data, range from 33% to 38% of all musculoskeletal malformations and about 12% of congenital anomalies in general. Usually this pathology is congenital and affects both feet in half of the cases. In boys, clubfoot is detected about twice as often as in girls.
Without adequate treatment, clubfoot can lead to disability, but, fortunately, there are many methods of correcting this developmental defect.
CLASSIFICATION OF CLUBFOOT FORMS
There are several types of clubfoot, depending on the features of deformation and concomitant disorders.
Idiopathic clubfoot. With this type of clubfoot, a decrease in the talus bone and the pathological location of its neck are revealed. There is also a so-called “horse foot” (equinus): the heel is pulled up, the foot itself is curved, turned towards the sole. Pathology is accompanied by shortening of the calf muscle and impaired vascular development in the anterior region of the lower leg.
Positional (postural) clubfoot. In this case, the talus and calcaneal bones are not changed, and the articular surfaces are developed normally, but a state of subluxation is observed.
Clubfoot due to congenital myopathy and neuropathy. This type of clubfoot differs in that the deformity of the foot is a consequence of other disorders of the development of the musculoskeletal system (for example, congenital dislocation of the hip, multiple curvature of the limb bones, etc.).
Syndromological clubfoot. A type of clubfoot characterized by a combination of the previous form with another, extra-skeletal pathology (for example, abnormalities of kidney development).
Depending on the nature of the deformation, the following types of clubfoot are distinguished.
Equinovarus: the foot is turned downwards and inwards.
Varus: the heel is turned inwards.
Hallux valgus: the heel is turned outward.
Supination of the foot: the foot fully unfolds with the heel forward, and its front (in the normal position) part takes the form of a bob.
In addition, clubfoot is divided into primary (such is idiopathic) and secondary (which develops as a consequence of other pathologies). According to the severity of the deformation, it is divided into light, medium and heavy.
SYMPTOMS AND DIAGNOSIS OF CLUBFOOT
Severe forms of clubfoot can be diagnosed by visual signs, but not always the disease manifests itself so vividly. Therefore, even in the maternity hospital, the baby should be examined by a pediatric orthopedist. If you suspect clubfoot, you may need an ultrasound examination.
Children older than three months are prescribed radiography (at an earlier age it is ineffective, since bones still consist mostly of cartilage tissue and pathology is not visible on the pictures).
If it was not possible to establish a diagnosis in the first months of a child’s life, the deformity of the foot can be noticed by an unusual gait: the baby cannot rely on the entire foot (usually there is support on the outer edge), the muscles of the lower leg may be noticeably underdeveloped, and eventually atrophy altogether. Of course, parents may not always notice deviations in the gait of a child who is just learning to walk, but if you have the slightest suspicion, be sure to consult a pediatrician. Perhaps the child will be sent for examination to an orthopedist.
TREATMENT AND PROGNOSIS
The prognosis depends very much on the severity of clubfoot and the time when treatment was started. The bones of the child are very malleable, so with early diagnosis, even very serious defects can be eliminated. In severe cases, patients are shown complex treatment, including one or more surgical operations and a number of conservative measures. Non-surgical treatment is enough for more “simple” patients.
Conservative methods of treatment
If the form of clubfoot is light enough, the doctor may recommend foot massage, therapeutic gymnastics, plastering. In addition, even at the end of treatment, such children are shown wearing orthopedic shoes (preferably sewn individually) and strengthening exercises.
Surgical operation to correct the shape of the foot
Surgical intervention is required in severe cases or with very late treatment. In some cases, a number of operations are prescribed in combination with massage and exercises. The decision in each case is made individually, and its main goal is not only to return the patient to a beautiful gait, but also to help avoid disability.
