Clubfoot, a common congenital condition, requires appropriate treatment to address the deformity and ensure proper development and functionality in children.
Fig – Our patient 7 days old with club foot
Fig2 – Same child at 4 years age – fully active, normal feet
Some studies suggest that specific genetic mutations play a role. At the same time, other factors, such as abnormal positioning in the womb or restricted fetal movement, may contribute to the development of clubfoot.
The treatment of clubfoot in children typically involves a combination of non-surgical and surgical interventions. Non-surgical methods like the Ponseti method involve gentle manipulation and casting to correct the foot position gradually. It is usually followed by braces or orthotic devices to maintain the corrected alignment.
In some cases, surgical procedures may be necessary to release tight ligaments or tendons and achieve optimal foot alignment. Early intervention and consistent follow-up care are crucial for successful clubfoot treatment in children, promoting normal foot function and preventing long-term complications.
The Dennis Browne Splint (DBS) is a boot on both feet connected by a bar. (See Pic). The angle on the boot is preset and depends upon the type of clubfoot. In normal feet and in Atypical Club foot, the angle is set to 50 degrees. In normal clubfoot, the angle is set to 70 degrees. This device is essential for maintaining the correction of your child’s foot.
The Dennis Browne splint is worn day and night for the first 3 months. It is removed for exercises 6 times a day. It is also removed for bathing. After 3 months, it is worn only while sleeping (Both day and night).
The DBS is applied daily as part of the treatment, and by extending and realigning the damaged foot, it progressively helps to repair the deformity. For a number of months to years, the youngster wears the splint while receiving follow-up care to track their progress. Physical therapy activities are frequently advised in addition to the splint to improve flexibility in the muscles and joints. The goal of treatment is to return the foot to its natural alignment and function so that the kid may walk and engage in daily activities with ease.
Club foot can be corrected at any age. The correction is best when the child comes to us at 7 days of age. With increasing age, the correction becomes more difficult,
When a child presents to us in the first month of life, the treatment is completed within 30 to 45 days.
This is called a relapse. Relapse is seen in approximately 10% cases. The cause often is abandoning the use of a Dennis Browne Splint. Sometimes the club foot is very severe and may come back in-spite of the best possible efforts. However, relapses can be treated very successfully by cast applications, and surgery. The highest chance of relapse is in the first 4 years of life.
The club foot does not affect the length of the limb of the height of a person. In severe CTEV, the affected foot is smaller than the opposite side, and remains so. However, the smaller foot does not cause any physical limitation to the child.
CTEV or Club foot is a common birth defect. It is present in 1 in every 1000 children. The defect is more common in boys. The cause is multifactorial.
Genetic defect that develops spontaneously may produce a club foot deformity.
A genetic anomaly causing club foot deformity when present in a parent or a sibling may cause a CTEV to develop.
No. Club foot is a rarely seen in Down’s syndrome.
Club foot may be associated with other genetic defects such as Trisomy 18. It may be associated with intraspinal pathology such as a meningo-myelocoele. It may be associated with arthrogryposis, or amniotic band syndrome.
In most cases, the cause is not known.