What Causes Clubfoot And How Can It Be Treated?

Published: 17th May 2011
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Clubfoot is a type of birth defect that causes the leg to look short in appearance, the heel to point downward, and the forefoot, or front half of the foot, to turn inward. Thus taking on the shape similar to a golf club. In adults, children, and infants with Clubfoot, muscles in the calf are generally smaller in the lower leg compared to normal, the heel can appear narrow, and the Achilles tendon in the foot is generally tight.



The causes of Clubfoot are believed to be both genetic and environmental. Genetically speaking, Clubfoot occurs twice as often in males as it does in females, and occurs more frequently in families with a history of Clubfoot. It is environmental in the sense that the fetus is not actually born with a clubfoot, but rather will develop the clubfoot while in the mother's womb.



Although this deformity occurs in nearly 1 out of every 1000 births, the exact cause of Clubfoot has not yet been determined. It may have something to do with the position of the baby in the uterus. Sometimes babies with clubfoot will have serious neuromuscular disorders such as cerebral palsy and spina bifida. Another sign of a clubfoot deformity is the decreased amount of amniotic fluid surrounding the fetus in the uterus during pregnancy.



The good news is that many babies with clubfoot can be diagnosed before birth with a simple painless ultrasound. Studies show that 10% of clubfoot cases can be discovered as early as 13 weeks. At 24 weeks into a pregnancy, about 80% of clubfoot cases can be found; this number steadily grows until the baby's birth.



It is important to note that ultrasounds have a false diagnosis rate of approximately twenty percent (20%). Still, if a diagnosis of clubfoot is made before birth, then it's a good idea to talk to an orthopedic surgeon on how to fix your baby's clubfoot after it is born. After birth, an x-ray or a CT scan might also be necessary to make an accurate diagnosis.



Treatment for clubfoot should begin very soon after the baby is born. This is because the baby's tendons, bones and muscles are still developing and can be moved around, including their feet, into the correct position. That's why it is very important to see a doctor and start a treatment of clubfoot soon after birth; there is no time to waste.



The most frequent and effective treatment for clubfoot is the Ponseti method. This treatment for clubfoot is when a doctor gently places the babies foot (or feet) into tiny casts, slowly moving the clubfoot (or feet) into the correct position. This is done gradually and the baby feels no pain. Every week, for about eight weeks, the foot is moved closer to the correct position and placed in a new tiny cast.



Minor surgery to the Achilles tendon is sometimes necessary. After the initial casting phase is complete, the babies foot, or feet, is placed in a special splint, or type of shoe, and is put into a physical therapy program to help normalize their abilities in their foot/feet.



The Ponseti method is the most frequently used treatment of clubfoot. Clubfoot in the majority of babies born with the deformity can be treated within 2 to 3 months. The success rate is very high for this treatment for clubfoot and parents should discuss it with a doctor before birth, if possible.





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Dr. Alireza Khosroabadi is a Fellowship trained foot & ankle surgeon. He did his Surgical training in NY and his fellowship at the Rubin institute for Advanced Orthopedics/International Center for Limb Lengthening at Sinai Hospital in Baltimore with world renowned Orthopedic Surgeons. He is practicing in LA, CA . More information @ http://footanklealliance.com/blog/

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