Club Foot

Clubfoot refers to a variety of foot abnormalities where your baby's foot is twisted out of shape or position and is typically present at birth (congenital). Tendons, the tissues that connect muscles to bones, are shorter than normal in people with clubfoot. Clubfoot is a reasonably typical birth abnormality that typically affects only one newborn who is otherwise healthy.

You can have mild or severe clubfoot. Children who have clubfoot typically have it in both of their feet. Clubfoot will make it more difficult for your child to walk normally, therefore doctors typically advise treating it as soon as possible after birth.

Clubfoot is typically effectively treated medically without surgery, though occasionally youngsters require a second operation down the road.

A musculoskeletal birth defect that is most prevalent

Generally 1:1,000, although in some groups 1:250

The highest incidence among Maoris and Hawaiians

The male to female ratio is about 2:1.

Anatomic location

The majority of instances are bilateral.

Clubfoot is an isolated malformation in 80% of people.

Genetics

• the genetic component is strongly suggested

• unaffected parents with the affected children have a 2.5% - 6.5% chance of having another child with a clubfoot

• familial occurrence in 25%

• recent link to PITX1, a transcription factor critical for limb development

• the common genetic pathway may exist with congenital vertical talus

In utero ultrasound can sometimes detect clubfoot

trimester one

When a kid is diagnosed with clubfoot in the first trimester, related anomalies, including non-musculoskeletal ones, are highly common.

second trimester

These are usually genuine clubfeet, however related oddities are less frequent.

Trimester three

Due to a larger likelihood of intrauterine crowding, the false positive rate is higher if clubfoot is initially diagnosed in the third trimester.

Radiographs

often skipped

AP AND dorsiflexion lateral (Turco view) are the recommended views to take.

Ponseti method of serial casting and modification

In much of the world, the Ponseti method is the gold standard.

indications

The recommended treatment for untreated clubfeet is this.

outcomes

Ponseti technique avoids complete surgical release with a > 90% success rate.

In the absence of additional comorbidities, children can be anticipated to walk, run, and be completely active.

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French method of daily physical therapy, manipulation and splinting

indications

hardly ever employed in the US

outcomes

decent results in experienced hands