Club Foot

Clubfoot(CTEV) is a condition characterised by deformity of foot in which the foot is curved inwards. It is seen in 2-3 per 1000 live births. Though this condition can be diagnosed on ultrasound before birth, it’s treatment starts only after birth. The treatment of choice is Ponseti method of correction in which plasters are applied within one week of birth and foot is corrected gradually with 4-5 serial plasters. After full correction the child is braced for 2 years. The results of this method are very good and time tested and the child is left with minimal residual deformity.

Possible causes of ClubFoot

  • In Idiopathic clubfoot the cause is unknown and best results are obtained by serial correction using casts.
  • Non idiopathic conditions include neurogenic (arthrogyrposis, spinal dysraphism, etc), connective tissue disorders and other genetic syndromes. The feet in these conditions are more difficult to treat and show a high recurrence rate. Recurrent cases require surgical correction.

 

Frequently Asked Questions

Is it because of some sort of curse?

No. it is not because of any curse or because of your sins. It is a fairly common condition and you should not feel guilty about it. Your child will have no physical disability and will lead a normal life if treated in time.

·  Is this condition completely curable?

Yes! This condition is completely curable and you need not worry about it.

·  How do I take care of the plaster?

The plaster should not get wet otherwise the underlying skin will get damaged. Use diapers to protect the plaster or a plastic wrap around the plaster.

·  Can the child have a bath?

You can sponge the child with warm water. Take care that water does not enter through the sides of the plaster. On the day the plaster is to be changed you can remove the plaster at home and bathe the child and bring the child for the next plaster

·  What is the chance of recurrence?

There is a 5-10 % chance of recurrence especially in non idiopathic clubfoot. The recurrence can be treated with repeat plaster or a tendon transfer surgery.

·  How do I prevent recurrence?

Recurrence can be prevented by proper shoe wear and physiotherapy.Physiotherapy includes turning the foot upwards and outwards and stroking the outer border of foot.

·  Will open surgery be required?

If the treatment is started late or if the deformity is very severe then open surgery is required. Surgery is performed around 9-12 months. Older children also can be operated but the surgery is more complex in these cases.

·  What are the types of surgery?

Open surgery which leaves a scar on inner and back side of foot and is performed in younger children. Older children need correction with JESS Fixator or Ilizarov Fixator.

·  Is there a chance that one foot will look smaller?

Around 10-15% children will have their involved foot smaller by around 1 cm. They will however have no disability later in life and will be able to do normal sports activities.

·  Does the next child have increased risk of clubfoot?

The next child has 5-10% more chance of having a clubfoot. Children of parents with clubfoot also have 3-10% increased risk.