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Congenital Clubfoot

25 February 2018 by Ortopediatri Yazarı

Pes Equinovarus

Seen in one case per 1000 births, pes Equinovarus is seen more frequently in boys, compared to girls. Rate of recovery in this disease that worries families is very high if treatment begins early.
Pes Equinovarus is the foot base being turned towards the leg. Baby is defined as congenital clubfoot. Although the reasons are not completely known, familial factors and position of the baby in mother’s womb have an effect. Although rarely seen accompanied by other congenital anomalies, it is generally observed alone. Baby’s feet being turned inwards and foot base looking up, cause parents to worry. However, feet can be corrected with simple practices.

When accompanied by other congenital anomalies, treatment process differs. When seen exclusively, early diagnosis and treatment is vital in congenital clubfoot disease. Delay in treatment may cause permanent disabilities or long surgery processes

Can be detected in Pregnancy

First diagnosis can be made during pregnancy by obstetrician and gynaecologist. When not detected in pregnancy, it is easy to diagnose as the disease is visible.

While it can be corrected with only massage, cast or cast and minor intervention of specialists, there may be cases that require serious operations.

Golden Standard in Treatment: Ponseti Method

Starting weekly casts after birth is essential in treatment of the disease. This cast treatment is called Ponseti Method. Dr. Ponseti developed with method and saved children from long operation processes.

In this casting method the paediatric orthopaedist practicing the treatment applies casts to the child’s feet that changes each week. By changing cast position each week, gradual improvement is obtained. This continues until the foot of the child is completely corrected. Generally 4 weeks of cast application is enough to completely correct the foot. However, correction is obtained in 8 week application at most. After the casting treatment is complete the child wears a device that looks like a shoe but slightly bigger, named orthosis that the child will use 23 hours a day for the next 3 months. Afterwards, the device shall be continued until age 4, albeit only at nights.

Pes equinovarus can relapse!

One of the most important complications of congenital clubfoot is that it can relapse. Families can have problems during the use of the device after successfully completing casting treatment. Disease may relapse during this process. If the disease relapse before age 2, casting is repeated with Ponseti Method. If it relapses after that age, solutions required may lead to surgery. Difficulty of surgery increases with age. At this point, cooperation of families is essential.

It is highly beneficial for children with pes equinovarus to be regularly monitored by paediatric orthopaedist until their bone development is completed. After recovery, these children can continue their lives normally and engage in sports. There are national athletes who have suffered and recovered from this disease during their childhood.

 

Contents of the page are for information purposes only, you must consult your doctor for diagnosis and treatment.

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