Clubfoot

December 8, 2011

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Clubfoot   - A condition which is characterized by deformation of the foot. When this stop is rejected inward from the longitudinal axis of the tibia. To distinguish clubfoot congenital   and purchased . This pathology is quite common: for example, all of congenital clubfoot deformation is about 12%. At the same time the boys this disease is found twice as often than girls, and about half of the cases there is a bilateral clubfoot.

Causes of Clubfoot

Provided the baby is born with clubfoot in healthy parents and the probability of the birth of a second child with such defects is increased by a few percent (2-5%). However, in most cases of clubfoot in children is sporadic , Which confirms its origin as a congenital .  Experts say that the fetus is disturbed muscle development about 8-12 week of fetal development .  Researchers call and other causes of this defect .  Thus, the cause of limb deformities may be teratogenic number of substances - drugs (Ecstasy), chemicals .  Also, there is a probability congenital clubfoot, if a pregnant woman has too low amount of amniotic fluid (ie oligohydramnios) .  There is also the theory of neuromuscular origin of congenital clubfoot .  This theory proves one of the explanations for the origin of soft tissue fibrosis, which manifests itself as a result of violation of the innervation of the primary deficit of nerve fibers .  Despite the presence of several theories, described above, to date there is no clear and the only correct explanation of the origin of this disease .

Types of clubfoot

To distinguish some types of clubfoot according to certain criteria. So, in terms of the etiology of the disease are distinguished: idiopathic   ( primary ) And clubfoot secondary   clubfoot. In turn, the secondary clubfoot can be divided into neurogenic   clubfoot, arthrogryposis   and amniotic band constriction .

In terms of the severity of the disease distinguish mild clubfoot (a relatively slight deformation of foot, easily amenable to correction); Disease moderate and severe clubfoot (strongly pronounced deformation of the foot, while there is a large rigidity)

Diagnosis Clubfoot

Diagnosis "clubfoot" specialist, as a rule, can put in the hospital, guided tour of the child and discovered in the process of deformation characteristic. In some cases there may be external torsion   (ie twisting) leg bones, and inflection   (bend) of the sole, so that because of the bend formed transverse groove Adams. Moreover, quite often a child diagnosed hypoplasia   (ie hypoplasia) of the foot and lower leg reduced volume of tissue, ie it malnutrition .

The preliminary diagnosis is carried out, guided by the results of ultrasound, which is carried to the fetus prenatally during the second trimester pregnancy   (after 16 weeks).

In setting up such a diagnosis the doctor considers that clubfoot is very often associated with certain pathologies. So, very often in parallel with clubfoot in children develops dysplasia   hip and spina bifida   no clinical myelodysplasia .

Treatment of clubfoot

In the treatment of this disease it is very important to respect certain principles on which directly followed the envy of the effectiveness of therapy. So, it is very important to treat clubfoot start as early as possible, preferably in the first days after the baby is born with a pathology. Secondly, during the treatment, the doctor must choose a method to provide full correction of any and all components of the deformation. Equally important in the treatment of clubfoot is considered to be constant monitoring and correction of foot deformities. Such measures must be taken regularly, as long as the period of growth is over the foot (aged 12-14)

The main conservative treatment of clubfoot is today considered plastering . For greater effect, the treatment also performed corrective massage for two weeks. Sections were then applied the same method of gypsum, which in some cases is combined with applications paraffin. Gypsum is used for the treatment of this disease in young children. Plaster cast on a limb can have 3-7 days of age. First achieved the maximum possible correction of the foot, then it is applied plaster cast. Such bandage child should be changed after about one week later it was changed every two weeks. Gypsum is not removed until such time until you reach the full or maximum possible correction of the foot.

Deformed foot correction is performed in a certain order. Please corrected varus and enforcement, then held supination of the foot, Equinus . The next stage will be the imposition of gypsum in the period from three to five months.

However, to date only the effectiveness of therapy using conventional gypsum is only 58%.

In addition to the traditional method of gypsum today also used method of applying plaster on Pontseti, which was named by the name of American podiatrist. This method is considered to be standard in some European countries, as well as in the United States. Its efficiency reaches 89%.

In the clubfoot patients assigned not only gypsum but wearing splints . This special orthopedic devices, which fix the foot in position. To make a similar device, used a plaster cast of the child's legs. The device is attached to the foot by straps with Velcro. To wear splints on your child's feet mostly during sleep. Also on the recommendation of a doctor wearing a used tire that secure the foot in position. Good effect as regular wear special orthopedic shoes.

If massage and gypsum give good results, then the doctor prescribes a repetition of these procedures. In case of failure of such methods of the child aged 1-2 years, surgery is performed. Surgery must be approximately 10-30% of cases of clubfoot. This operation involves the transplantation of tibialis anterior muscle tendons on the lateral cuboid bone. This helps prevent further inversion of the foot.

Complications clubfoot

With the right approach to the treatment of clubfoot in children appear very high chance of getting rid of the disease. But if the disease can not be timely treatment, there is a risk of subluxation of the bones of the foot. When this skin pathology strongly coarsens stop shin muscles not involved in walking and accordingly atrophy. After some time, they disrupt the normal function of the knee, resulting in noticeable manifest violation of motor function the patient's legs.