There are several different methods, both surgical and nonsurgical, that doctors use to treat clubfoot. The most common is serial casting and stretching of the tendons and ligaments in the foot and ankle region, more famously known as the Ponseti method.
Using the Ponseti method, doctors will stretch the foot of the patient and cast it in that position for a time span of one to two weeks. At that time, the cast will be removed and the foot will be stretched further, then recasted. The doctor will perform this same process several times until the feet have reached the proper position. After the patient has completed the serial casting, many of them will need to have an Achilles tenotomy performed. During this procedure, the doctor cuts a portion of the Achilles tendon in order to lengthen the ligament and change the position of the foot. After the patient has been through serial casting and the tenotomy procedure, the doctor will provide them with braces to hold their feet in the proper position. These must be worn for several hours each day in order to prevent the feet from moving back to their natural inward position. Children who are not made to wear their braces often experience a relapse and then are forced to go through more rounds of serial castings, and possibly another Achilles tenotomy.
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Clubfoot is a congenital (meaning present at birth) defect that affects the placement of the afflicted person's feet. It can present itself in a range of severity, from feet that simply point inward, to feet that have the bottom pointing upward. It can present itself in one or both feet; up to 50% of infants who have been diagnosed have bilateral clubfoot, meaning both feet are affected. Clubfoot itself is painless to infants who are born with it, but it is important for them to receive treatment right away to avoid future problems. The majority of people who have their condition treated as infants will have no adverse affects later in life.
Occasionally, clubfoot can be caused by the way a baby is positioned in its mother's womb. For example, if there is not enough amniotic fluid, the baby will need to squeeze into a smaller space than normal. However, the majority of children who have clubfoot get it as a result of a genetic anomaly. If one child in a family is born with clubfoot, the other children are more likely to also have the condition. Additionally, some people develop clubfoot in tandem with other medical conditions such as spina bifida or other nerve, muscle, or brain abnormalities. For this reason, children with clubfoot will need to undergo a medical evaluation as soon as the condition is discovered. In the United States, approximately 1 in 1,000 children are born with clubfoot. Globally, 150,000 to 200,000 babies are born each year with the condition. Approximately 80% of these cases occur in low to middle income areas of the world, meaning that treatment is difficult for these families to attain. If the condition is not treated, the affected person will not develop the ability to walk and is likely to experience a life of pain and disability. This is why I believe it is extremely important for all people to have access to afforable, quality medical care. If the condition is treated while the patient is young, many medical complications can be avoided. Babies and young children are also far more resilient than adults, which makes the condition easier and more painless to treat them. |
AuthorMy name is Bri Kappers. I chose to blog about this topic since my daughter has bilateral clubfoot, and I am curious about how people around the world address this issue. Archives
September 2017
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