CLUB FOOT
CTEV – Congenital Talipes Equino Varus
Treatment at the best Club Foot Correction Center in India
PONSETI TREATMENT FOR CLUB FOOT (CTEV) IN OUR CLINIC
Has your baby been diagnosed with a club foot or CTEV (Congenital Talipes Equino Varus)?
Club foot is a birth defect that causes a malformation of the bones, joints, and muscles, resulting in the foot being twisted inwards and downwards. This condition affects approximately 1-4 out of every 1,000 newborns and is treated shortly after birth using the Ponseti method of club foot treatment.
At The Children’s Orthopedic & Spine Care Clinic (COSCC), we have been pioneers in the use of the Ponseti technique in India. Since 2001, Dr. Sarup has successfully treated over 1,500 children with this condition. All children treated for club foot at our clinic have achieved full recovery. They experience no restrictions, can participate in sports, play games, and even take part in activities like dancing. In short, they lead happy and normal lives.
Early identification and treatment are crucial to ensure optimal correction and recovery. With expert care, children with club foot can achieve excellent outcomes and enjoy a life free of limitations.
What happens when I get my infant with club foot treated at the clinic?
We are specialists in the PONSETI method for correcting clubfeet.
We advise all parents to bring the infant with clubfoot for cast correction treatment in the first week of life. At this stage, the bones of the foot are soft and the correction is faster and easier. After one month of age, the foot is stiffer. The correction takes a longer time and more plasters have to be applied. In some cases, untreated club foot may affect growth and mobility. Advanced solutions like grow tall surgery in India can help address these challenges and improve overall quality of life.
In order to commence casting, we need the following items to be bought by the parents:
- An age-appropriate soother from a good company (Go to a good chemist or children’s store).
- 1 bottle of White vinegar (Available with your grocer)
- Diapers of the correct size
- Rash free cream (Available at the local chemist)
The plasters are applied as frequently as once in 4 or 5 days. Most infants with clubfoot (Congenital Talipes equino varus) at this age are corrected in 1 month, and usually require 5 to 6 cast changes.
We teach parents how to remove plasters at home in a quick and safe manner.
- It is very important to keep the plasters dry. Do not let the cast be soaked with urine. A plaster that gets wet accidentally must be dried by blowing COLD air by a hair drier onto the wet area. (DO NOT BLOW HOT AIR AS THAT CAN DAMAGE THE SKIN OF THE BABY). A wet cast causes a rash. Sometimes the rash can become so severe that casting has to be abandoned.
- Keep an eye on the toes of the baby. The toes should always be pink in color. Persistent Blue or white discoloration, or marked swelling of the toes, indicates that there is internal swelling of the leg, or that the cast is too tight. Usually, this is accompanied by excessive crying. If this happens, you will need to inform our staff and then remove the plaster at home. You can always bring the baby in next day for a new cast.
- Sometimes, the baby cries excessively at home after the cast has been applied. This can be because the cast can cause an area of excessive pressure on the skin. In this case, the baby will become uncomfortable and may be in pain. If the crying persists for more than 2 hours, let us know and you may need to remove the cast at home. You can always bring the baby in next day for a new cast. This will occasionally happen in the process of infant’s clubfoot treatment.
How do I remove the cast at home?
Take a medium sized basin and fill up to halfway with warm water. The water should be at the same temperature as used for bathing a baby).
Add 2 cups of white vinegar to the water.
Hold the baby in your lap with legs sticking out over the basin. Keep pouring the basin water over the casts for 10 minutes. The cast will get soft. Pluck off the cast end and unwrap like a bandage, pouring more water over drier inside portions as they get exposed.
Wash the legs with soap and water and dry.
Does my child need surgery as a part of CTEV treatment?
At the end of the casting period, most infants undergoing club foot correction are advised to have a tendon release surgery. This procedure is performed at the hospital, where the baby is admitted for 4 hours as part of day care. A local or short general anesthesia is administered, with utmost precautions taken by our experienced anesthesia team.
The surgery is carried out by our club foot specialist with precision through a small 4mm incision. The baby experiences no pain during or after the surgery. Following the procedure, a cast is applied, which is maintained for one month. This marks the completion of the infant’s club foot treatment.
Postoperative Care
In the postoperative period, it is normal to notice a bloodstain on the cast around the heel area, which may increase slightly during the first day. This is a common occurrence and not a cause for concern.
For families seeking CTEV correction in Gurgaon and Delhi, India, our center offers expert care focused on safe and effective outcomes, ensuring your child achieves the best possible recovery.
The baby experiences no pain from the surgery.
In the postoperative period, sometimes a bloodstain will appear on the cast around the heel area. At times, this will increase over the first day. This is normal and is not a cause for concern.
What happens after surgery?
At the end of the one-month casting period, parents can remove the cast at home. A small adhesive dressing at the back of the heel must be gently removed. The leg is then washed with soap and water, dried by patting with a clean towel, and liberally moisturized.
Following this, the child is taken for measurements to fit a Dennis Browne Splint. Once the splint is ready, an appointment is scheduled with the doctor at the clinic. During this visit, parents are taught exercises for the child, which form an integral part of the treatment process.
Physical Therapy for Club Foot
Our specialized team trains parents in club foot physical therapy, which is carried out at home. These exercises are continued until the child is 7 years old to ensure the best outcomes. With consistent care, children achieve optimal correction and can lead fully functional lives.
What is the Dennis Browne Splint (DBS)?
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 clubfoot physical therapy exercises 6 times a day. It is also removed for bathing. After 3 months, it is worn only while sleeping (Both day and night).
What are the precautions with Dennis Browne Splint (DBS)?
The Dennis Browne Splint is essential for maintaining correction of your child’s foot. Our Clubfoot specialists advise that Club foot relapses in all cases whose parents abandon the use of this splint. We know that it is restricting for children to wear this splint as they get older. Therefore, it is essential to train the child in such a manner that they accept the splint as a part of their normal routine. The DBS is worn for the first 4 years of life.
When wearing a DBS, the feet need frequent careful inspection at the time of physical therapy for clubfoot. Make sure that the skin is healthy and has no areas of breakdown or pressure. If this happens, please get in touch with us at the clinic.
How frequently should I visit the doctor after correction?
You will generally have your newborn with Congenital talipes Equino Varus (CTEV) visit our clinic once in 3 months for the 1st two years, and then once in 4 months in the 3rd year, and then once in 6 months till the child is 12 years of age.
Follow-up is important as it allows us to monitor the feet for any early recurrence.
What happens if there is a relapse?
With regular exercises, and the use of a Dennis Browne Splint – the relapse rate is very low (around 10% in our clinic). This is amongst the lowest relapse results for all CTEV corrections in India.
When we detect an early relapse, we usually review the exercises, or correct a faulty habit (such as noncompliance with wearing a DBS). We may then choose to apply serial casts again. In some children, repeat surgery is required (a tenotomy, or a tendon transfer or both).
Get Answer To Your Most Asked Questions
What is CTEV and how is it treated?
CTEV stands for Congenital Talipes Equinovarus, commonly known as club foot. It is a condition where a newborn’s foot is twisted out of shape or position. Treatment typically includes plaster casts, CTEV boots, and in some cases, surgery to correct the foot position and improve mobility.
What is the CTEV surgery procedure?
CTEV surgery is performed to correct severe cases of club foot that do not respond to casting or bracing. The surgery involves making small incisions to lengthen tendons and ligaments, allowing the foot to move into the correct position.
How long does club foot treatment take?
Club foot treatment varies depending on the severity of the condition. The Ponseti method, which includes casting, bracing, and sometimes surgery, typically requires several months for full correction. Post-treatment, the child may need to wear a foot abduction brace to maintain the corrected position.
Where can I find a club foot specialist near me?
If you are looking for a club foot specialist, many orthopedic centers, including Child Ortho Spine Care, offer expert care for CTEV treatment. It’s essential to consult a pediatric orthopedic surgeon with experience in club foot management for the best outcomes.
What causes clubbed foot? / What causes clubfoot in pregnancy?
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.
Is Clubfoot a sign of Down syndrome?
No. Club foot is a rarely seen in Down’s syndrome.
What is club foot associated with?
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.