club foot

Clubfoot: description

The clubfoot is a malposition of the foot, which results from a lack of muscle power. The foot is turned inwards (supination position). The soles of the feet then point inwards / upwards, and the lower leg muscles are deformed.

Mostly this disease is innate. If during pregnancy certain muscle groups in the child can not fully develop, creates a clubfoot. However, baby feet are still very flexible and flexible, which is why treating them immediately gives them a good chance of recovery.

In some cases, the clubfoot is also caused by a nerve defect (for example after an injury). The nervous innervation of the muscles was possibly severed and then missing. The longer the muscles are not used, the more they regress and clubfoot can be the result.

There are various deformities of the foot, which can occur in a clubfoot:

Deformations of the foot

talipes (Pes adductus or Anspreizfuß called): Read more in the article sickle foot.

equinus (Pes equinus): Read more in the article Spitzfuß.

Hohlfuß(Pes cavus): Read more in the article Hohlfuß.

Pes varus (a bend of the foot inside the ankle)

Clubfoot: symptoms

Both congenital and acquired clubfoot symptoms are clearly visible. The affected person runs on the outer edge of the foot or in very severe cases even on the back of the foot (as far as that is possible). One or both feet may be affected. Normally, the clubfoot is characterized by four different characteristics:

• Bony deformities (usually affect the heel bone)
• Deformities or dislocations in the joints (often the ankle is affected)
• Attenuated or shortened muscles (for example the calf muscles)
• Restrictions in the capsule-ligament apparatus (when tendons or ligaments are shortened or damaged)

Also typical is the so-called “clubfoot calf”, which is caused by a curvature of the calf muscles and a shortening of the Achilles tendon. Important for the success of therapy is that the symptoms are treated as quickly as possible.

Clubfoot: causes and risk factors

One distinguishes between a congenital and an acquired clubfoot. Meanwhile, there are some explanations for the acquired clubfoot. For the innate variant, however, there is still no universally valid explanation.

Congenital clubfoot: causes

• A clubfoot can occur when the unborn child in the uterus is so twisted that the legs are restricted in growth.
• An existing shortage of amniotic fluid is also a potential cause.
• Early childhood brain damage due to lack of oxygen can lead to deformities such as clubfoot.

Acquired clubfoot: causes

• Neurological disorders in which the muscle supply is impaired.
• Poliomyelitis often leads to a clubfoot in the 1950s, but is less common today due to the introduction of vaccination.
• A congenital “open back” (neural tube defect) can lead to a faulty supply of the lower leg muscles and thus lead to clubfoot.
• Injuries that cut through the nerve of the lower leg muscles cause an undersupply of the muscle. As a result, the muscles dwindle, and it comes to a clubfoot.
• A circulatory disorder of the calf muscle artery (posterior tibial artery) also leads to a lack of muscle supply and thus possibly to a clubfoot.

Clubfoot: examinations and diagnosis

A clubfoot can usually already be seen with the naked eye. To secure the gaze diagnosis, the doctor often stops X-ray photograph, On this, the extent of the malformation can be seen more accurately.

Lately finds the ultrasound more and more use in clubfoot diagnostics. It is a quick and convenient way to demonstrate the supply of a muscle region.

Another investigation method is the dynamic foot pressure measurement (Pedography) dar. Here, the pressure load of the foot is measured in a uniform state. This method is also used in the manufacture of orthopedic footwear.

In order to get to the root of the causes of a Klumpfuß disease, one should in any case carry out a comprehensive diagnosis, since the cause is also trend-setting for the treatment.

Clubfoot: treatment

Congenital clubfoot

For a congenital clubfoot, treatment should begin immediately after birth. The body tissue is still very flexible after birth, so that the best results can be achieved. However, before surgery on the clubfoot, there are many less invasive (conservative) treatment options.

Newborns benefit most from one plaster therapy or from taping. The children wear a cast for a longer period of time, which puts the feet in the right position. This may seem more frightening to parents than it ultimately is. The cartilage and bone tissue is still very elastic, and the child usually suffers no pain. The upholstered plaster should be changed every few days and recreated as this process is done in stages.

At the taping First, a daily mobilization of the joints by physiotherapy. Then the affected foot is fixed by means of special adhesive tapes. The corrections achieved with this must then be maintained. There are special rails, orthopedic shoes or insoles that need to be worn during the growth phase. In addition, regular checks are important.

Sometimes, this non-invasive clubfoot treatment does not bring about the desired success or clubfoot reoccurs over and over again. In these cases, surgical therapy should be considered to extend the Achilles tendon. However, there are now only ten to 15 percent of conservatively treated children who need surgery.

Acquired clubfoot

In acquired clubfoot, conservative therapy rarely leads to success. For nervous causes, specially made rails or shoes can still help. However, the stronger the clubfoot is pronounced, the more likely one has to be surgery be considered.

There are various surgical techniques that are used depending on severity and severity. In all procedures an accompanying physiotherapy is very useful to eliminate the clubfoot for good. It helps to stretch the muscles and to take a correct attitude.

Clubfoot: disease course and prognosis

If the clubfoot is not sufficiently treated, the malformations increase more and more with time. At some point, the affected foot stiffens, and a conservative cure is then only possible with difficulty. In addition, a pronounced, stiffened clubfoot causes pain during exercise. On the other hand, immediate and regular treatment usually gives good results.