One of the most common deformities in newborns are problems with the feet. Most of these foot deformities are treated with nonsurgical treatments, and in many cases can simply be observed. However, it’s important to understand the deformity to ensure appropriate treatment is being provided.
Metatarsus adductus is a common congenital foot condition that’s seen in about 1 to 2 percent of all newborns. It’s usually detected when your baby’s toes and forefoot are pointed inward, making it difficult to straighten them. The appearance of your baby’s sole likely resembles a bean shape.
Mild cases often resolve on their own, but more severe cases may need casts, splints, or corrective shoes. Surgery is rarely needed for metatarsus adductus.
CLUB FOOT –
Clubfoot actually describes an array of foot deformities that cause your newborn baby’s feet to be twisted, pointing down and inward. About half of babies with clubfoot have it in both feet and approximately 1 in 3 babies in 1,000 are born with this condition. Boys have clubfeet nearly twice as often as girls.
While clubfoot doesn’t cause your baby pain, it can cause long-term problems, affecting his or her ability to walk. However, if it’s properly treated with stretching exercises, casts, and/or surgery, the clubfoot deformity can often be corrected in early childhood.
The treatment for clubfoot typically begins soon after the child is born. Some orthopedic surgeons prefer immediate treatment when the child is still in the hospital. The advantage is that often parents are worried that any delay is potentially harmful, and the immediate treatment can put people at ease that something is being done.
The usual treatment of a clubfoot consists of the pediatric orthopedic surgeon manipulating the foot and casting in the corrected position. Over the span of several months, the manipulation is gradually increased to restore the normal position of the foot. This manipulation technique is called “The Ponseti Method,” named after the doctor who has popularized this treatment.
The position and timing of the casts are deliberate and intended to stretch and rotate the foot into a proper position. Approximately once a week, the casts are replaced in a process called serial casting. The casts slowly correct the position of the clubfoot.
In about one-half of cases, this manipulation is sufficient to correct the clubfoot deformity. In some cases, a surgical procedure may be necessary. During surgery, the surgeon will release, or loosen, the tight Achilles tendon to allow the foot to assume its normal position. Once the casts are removed, the child will usually wear nighttime braces until about age two.
Next Steps in Treatment
In some cases, additional surgery is needed to correct the position of the clubfoot. Most often this is needed in cases where the child has other developmental problems (such as arthrogryposis) or if the child begins treatment more than a few months after birth.
If the clubfoot deformity is not corrected, the child will develop an abnormal gait and may have serious skin problems. Because the child will be walking on the outside of the foot, a part of the foot not designed to walk upon, the skin can break down and the child may develop serious infections. Furthermore, the abnormal gait may lead to joint wear and chronic arthritic symptoms.