Introduction To Clubfoot For Newbie Parents: Signs, Causes, Treatment

Clubfoot, also known as Congenital Talipes Equinovarus (CTEV), is a medical condition in which the foot or feet are pointed inwards. In simple terms, the sole of the feet faces each other. And it is a very common condition. 

According to the National Institutes of Health (NIH), approximately 1 to 4 babies in every 1000 are affected by this condition. Moreover, boys are more likely to have this condition than girls. In 50% of the reported cases, both feet are affected by clubfoot. 

If your baby is affected by this condition, it’ll get hard for them to walk normally. Fortunately, with immediate action, this condition can be easily treated. 

But before you learn about its treatment, you must understand its signs. So, let’s begin! 

Symptoms

In this condition, the tendons (tissue connecting the muscles to bones) are shorter than usual. The Achilles tendon is tightened, and the bones are of unusual shape. If not treated on time, the person might have to walk using the side of their feet or ankles. 

The common symptoms of this condition are: 

  • The top of the foot is twisted inwards and downwards. 
  • The arch is more noticeable, and the heel is turned inwards. 
  • In a few cases, the foot might also look upside down. 
  • The affected leg is usually shorter than the other, particularly heels. 
  • The calf muscles are usually underdeveloped. 

The person affected does not particularly feel any discomfort or pain. Just the shape of the feet and legs is affected. 

Nevertheless, this condition can be diagnosed at birth and in few cases even before the birth during the ultrasound. So, the doctor suggests treating Congenital Talipes Equinovarus before the case gets any severe. 

Causes

The cause of clubfoot is idiopathic, which means the cause is still unknown. It is estimated that the reason for disformity might be genetics or due to the environment. 

Leading Risk Factors:

  • Family history: If any of the parents had clubfoot, the infant is likely to get affected by it.
  • Congenital conditions: In a few scenarios, this condition is associated with other abnormalities (congenital) that are present from birth. For instance, spina bifida (a condition where the spine and spinal cord don’t develop properly). 
  • Not enough amniotic fluid during pregnancy: The risk of clubfoot might increase if too little amniotic fluid surrounds the womb. 
  • Environment: Smoking is another significant risk factor that can increase the risk. Besides this, the diabetic condition can also lead to CTEV. 

Treatment 

This condition can not be improved without proper treatment. Instead, the complications might get worse as the baby starts to grow. Luckily, there are different surgical as well as non-surgical procedures to treat your baby. 

  • The Ponseti Method

It is the primary method of treating the foot. Here the specialists manipulate the foot with their hands. It is done to correct the bend. After that, a plaster cast is applied to hold the foot in a set position. The manipulation and casting are done very gently to ensure that the baby doesn’t feel any kind of pain.

Usually, there is one session every week. And in each session, plaster is changed, and the foot is manipulated a little more. The whole process generally takes around 4 to 10 sessions, depending upon the severity of the condition. 

Sometimes minor surgery is also performed to help release the Achilles tendon. Once the foot is in the right shape, the baby or patient has to wear special boots. It is to prevent relapse and ensure that the foot stays in its best position. 

Nonetheless, to get the best results, parents have to ensure that the boots are worn correctly and as per the doctor’s instructions. 

Despite all the efforts, sometimes the skin starts to change its color or temperature. It is nothing to be worried about. It only indicates that the cast is too light. So you need to readjust it from time to time. 

  • The French Method

This method is quite different from the ponseti method. It mainly consists of daily exercise, stretching, massage, and immobilization of the foot using a nonelastic tape. The aim here is also the same as ponseti, i.e., move the foot slowly to the correct position. 

This therapy session is generally performed by a physical therapist for the first 3 months. You’ll be able to observe a significant improvement in this time. The therapist may also give parents some training to continue the treatment at home. 

The tapping and splinting of feet continue till the baby gets 2 years old. As clubfoot is the disformity found in infants only, regular therapy ensures that the appearance and functioning of the foot significantly improves. 

Note: This method is still not actively used in many parts of the United States. Therefore, you must ask your doctor if they offer this treatment or not. Also, make sure the physical therapist has experience in treating infants. 

  • Surgery

Surgery is usually recommended if the above-written methods don’t seem to be working. Apart from this, it also depends on the severity of the condition. 

The surgery is performed to adjust the ligaments, tendons, and joints in the foot and ankle. For instance, by releasing the tensed Achilles tendon or by moving the tendon from the front of the ankle to the inside of the foot. It also releases soft tissue structures in the foot. After the surgery is complete, the surgeon uses casts and pins to help stabilize the foot. 

However, the surgery might lead to stiffness, pain, and overcorrection. In a few cases, it also leads to arthritis. Therefore, you must ask the doctor about every risk or complication involved in the surgery. 

Preventions

Although the primary cause of Congenital Talipes Equinovarus is unknown, the doctors provide a few preventive measures to mitigate the risk. The preventive measures need to be taken while you are pregnant and includes: 

  • Not drinking alcohol
  • Stop smoking (or stay away from a smoky environment to avoid passive smoking)
  • Don’t take any medications without your doctor’s approval. 

Key takeaways, 

The condition of clubfoot is very common and treatable. Still, it is better to take preventive measures. Plus, if you have any questions about this or any other lower limb condition, you must ask your doctor. It will help you provide a good life for your baby.