Monday, 01 August 2016

Clubfoot in Newborns

Clubfoot is a congenital disorder that occurs in 1 out of 1,000 births per year. A clubfoot looks as though it was rotated wrongly at the ankle. Several different factors cause clubfoot. Normally, clubfoot occurs due to genetics; however, some environment factors are a possibility as well. Breech presentation and the position of the baby in a womb can cause clubfoot as well. Connective tissue disorders, for example, have been linked to clubfoot. This abnormality is commonly noticed during an ultrasound of the pregnancy at the 20th week.

A common treatment of clubfoot is reshaping. This is suggested to be done soon after a child is born. The foot or feet are put into place, and then casted on the legs for stability. Required check-ups occur once a week to stretch and recast the feet. This process is done for about 5-10 weeks. Following, one more cast is placed on for 3 weeks.

Once positioned correctly, a child needs to wear a brace day and night for 3 months. For the next 3 years, while sleeping, the brace must be worn. These steps are taken to prevent the feet from reverting back to its misshapen position.

This non-surgical approach over the past 15 years has been very successful. However, severe cases require surgery. The surgery is usually performed after nine months of age. If surgery is performed, corrective shoes or a brace must be worn for up to a year as a preventive measure. Secondary or repeat surgeries may be needed to correct scar tissue damage as the child grows. Another surgical procedure may be needed as an adult.

Botox, instead of surgery, is another method that has been used. It is injected into the calf, weakening the Achilles tendon, and allowing the ankle to grow into a normal position. Usually only one injection is needed, but repeat injections can be done. Weakness typically lasts several months from the injection.

Children who go through these treatments have not shown any issues with their feet. A clubfoot sometimes may be slightly smaller than feet without the condition. In other instances, calf muscles may be smaller too. Children born with a clubfoot should grow up and be able to walk, run, play sports, and wear normal shoes. Olympic Gold Medal figure skater Kristi Yamaguchi, soccer star Mia Hamm, and Hall of Fame football player Troy Aikman have all overcome clubfeet.

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