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What is Club foot?

Club foot is a condition present at birth wherein there is an anomaly in the development of the foot, specifically the talus, which is the bone located between the heel bone and the bones of the lower leg. Club foot is also called Congenital Talipes Equinovarus (CTE) because it may affect one or both feet rendering them internally rotated towards the ankle with a tip-toed appearance. The calf and the foot may be slightly smaller than the other and there is an observable asymmetrical shape to the foot. Club foot is a birth defect that is more common in males than in females, though both genders can be affected. This condition is said to develop during the first three months of the pregnancy.  This is the period in the pregnancy when the growth of the muscles, bones and connective tissues begin.

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Classifications of Club Foot

Cases of club foot are classified into Postural and Structural.

  • Postural club foot is caused by external factors such as exposure to teratogenic agents during the first trimester of life in the womb. It can also occur in the third trimester where there can be possible cases of Oligohydramnios, a condition wherein the amniotic fluid is less than 400 ml; and breech presentation, in which the baby’s feet or buttocks comes first instead of the head thereby causing intrauterine compression which can result to club foot.
  • Structural club foot is related to the genetic make-up of the baby. The genes from the parent with club foot are passed on to the baby giving him or her higher chances of also developing the condition. This type may also arise from genetic defects such as Trisomy 18 or Edward’s syndrome which is characterized by an excess of the 18th chromosome.

Structural club foot can also result from compartment syndrome or compression of the blood vessels and nerves of the body causing a limited access to oxygenation that may lead to club foot.  Other congenital conditions may also bring about Congenital Talipes Equinovarus, these include Spina bifida, arthrogryposis, tethered cord syndrome and cerebral palsy.

Club foot treatment

There are three known management techniques for club foot, namely, the Ponseti Method, French Method and surgery.

  • Ponseti Method- In this system, the foot or feet are stretched and maneuvered into the preferred position before a cast is applied to maintain and hold the position. The cast is removed after a week and there would be another manipulation of the foot or feet to better reach the targeted position. The procedure is repeated until the foot or feet could hold the correct position. Splinting braces, specialized shoes and exercises would then be employed for 3 years to help maintain the position.
  • French Method – This method involves stretching the foot or feet everyday then adhesive tape is used to maintain the desired position. It is done until the baby reaches 6 months of age. If the correct position is achieved, splinting braces worn during at night and exercises are done to maintain the position.
  • Surgery – This is done when the Ponseti and French methods have failed or are not enough to correct the condition. For severe cases of club foot, this is also the preferred method of treatment. After the surgery, a pin and cast are used to put the foot or feet in place until the site has healed. When it has healed, the pin and cast will be removed by the physician.

 

If club foot is left untreated, the child would have arthritis, experience difficulty in walking or lose the ability to walk altogether.  He or she may also suffer from body image problems because of the abnormal appearance of his or her foot.

Club foot diagnosis

The child with club foot should be checked and diagnosed appropriately because club foot is a destabilizing condition. It is advisable for a pregnant woman to have regular prenatal checks up including an ultrasound to detect club foot. If the fetus is observed to have club foot, the expectant mother should not worry too much because this is not a painful condition and there is a great chance for the condition to resolve inside the womb. Even if the abnormality is not resolved when the baby comes out, there are still several treatment options that can help solve the problem. X-ray and computed tomography scans can diagnose club foot.

Pregnant women should be aware of the possibility that the fetus in the womb may be affected by club foot if there is no proper awareness and care given. If club foot is discovered after birth, it is better to manage it as soon as possible before the child learns to walk because the condition may affect his or her ability to walk properly later on in life.

Club Foot Images

 

 

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