Clubfoot in children

Clubfoot in children

What is clubfoot?

Approximately one in 1,000 babies is born with a deviated foot. He can curl up sideways with his toes curled into a funny angle. Or it may be oddly shaped and point in the wrong direction, so it appears crooked or even almost upside down. Doctors call it clubfoot.

Most children born with clubfoot are otherwise healthy; about 1 in 3 of them have it on both legs.

Clubfoot does not cause pain, but if left untreated, it can be difficult for a child to walk without limping. In most cases, this is easily corrected, so most children do not experience long-term effects.

Can we prevent this?

Clubfoot occurs because the tendons (bands of tissue that connect muscles to bones) and muscles in and around the foot are shorter than they should be.

Doctors don't know what causes it, and there's no guarantee your baby won't be born with the condition. But some things make clubfoot more likely. They understand:

  • Gender. Two-thirds of children with clubfoot are boys.
  • History of the family. Babies whose parents or siblings have had clubfoot are twice as likely to have it.
  • Choice of lifestyle. If you smoke or use illegal drugs while pregnant, you increase the chances of your baby being born with it.
  • Other birth defects. In some cases, this is due to another condition the child was born with, such as spina bifida.
  • Too little amniotic fluid during pregnancy. It surrounds your baby in the womb. If it's not enough, your baby's chances of being born with a clubfoot are higher.

Symptoms

Clubfoot is easy to spot when a baby is born. Here are some signs:

  • The foot points downward, and the toes may be curled inward.
  • The foot appears to be sideways or sometimes even upside-down.
  • The foot may be smaller than a normal foot by up to a half-inch.
  • The calf muscles on the affected leg may not be fully developed.
  • The foot may have a limited range of motion.

Most doctors can detect clubfoot just by looking at a newborn. If you had an ultrasound late in your pregnancy, your doctor may notice this then.

Treatment

Your doctor will start correcting your baby's clubfoot shortly after birth. Babies don't use their legs until they learn to stand and walk, so the goal is to get them corrected as early as possible to avoid delays. Your doctor will put on a cast or perform surgery.

Casting. A child's tendons bend and stretch very easily, so doctors can rotate the clubfoot in the right direction to help correct the problem. They smoothly move the foot to a position closer to where it should be. A cast is then applied to hold it in place.

After about a week, the doctor removes the cast. He stretches the child's leg a little more, puts it in a new position and applies a new cast. He will continue this pattern for weeks or months. Your doctor may take x-rays to make sure the baby's bones are slowly moving into the correct position.

If a series of casts help correct your child's clubfoot, he will need to wear a splint or special shoes to keep him at the right angle until he can walk. This is because the clubfoot tends to return to its original position. Some children may only need to wear a corset or shoes for a short time. Others may need it for several years to make sure the foot stays at the correct angle.

Surgery. If the tendons and other tissues in your child's foot are too short, no amount of stretching or sculpting will help. If so, surgery may help.

Babies who need surgery for clubfoot often have it done between the ages of 6 months and a year. Unlike the progressive molding process, the doctor fixes everything in one procedure. He may lengthen the tendons or take other steps to rotate the foot into a more normal position.

After the operation, the child will need to wear a cast to keep the foot at the correct angle. Then he will need a splint or special shoes for about a year so that the foot does not return to its original position. 


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