By Dr Amar Singh Chundawat
A stressful and fast-moving lifestyle is the reason for many medical abnormalities that are found nowadays. One such is the clubfoot condition, which is a congenital orthopedic anomaly that can witness a relapse regardless of the treatment, i.e., conservative or operative. It is a birth defect where the feet are either rotated inwards or downwards. As a result, children suffering from these disease are unable to walk and cannot even go to bathroom by themselves. Normally, this condition is detected within a week of birth. The treatment begins soon after it is diagnosed, with treatments ranging from pre-surgical to post-surgical as well.
Causes for clubfoot
Researchers are unsure of the causes of clubfoot, though they strongly believe that it is related to the deficiency of amniotic fluid in the womb, which may increase the chances of this condition. The amniotic fluid helps in development of lungs, overall muscles and digestive system. However, another reason could be smoking during pregnancy, which increases the chance of a child developing this condition. Lastly, children who have family history of the same are at high risk of developing this condition.
Doctors usually easily diagnose clubfoot by its appearance. In some cases, they take the help of the ultrasound to diagnose and check its severity. It is the symptoms that decide further course of treatment that will be given to the patient.
Usually, it is the baby’s calf muscle that remains underdeveloped; sometimes the feet are rotated inwards or downwards. Though clubfoot does not cause any pain, it is in the best interest of patients that they receive treatment as soon as possible and not let disease progress to a point of no return.
It is not possible to avoid this birth defect, though its early treatment decides further prognosis of the condition. Although there is no definitive cure for this condition, the treatment of this disease is mainly divided into two phases, conservative and surgical. With conservative treatment, under the Ponseti method, 5-8 weeks of muscle manipulations takes place, followed by casting of feet. In most cases, castings are removed within 5-7 days and repeated as necessary. The patient’s feet are placed in a foot abduction brace, a simple bar and shoe device. It keeps the feet in a proper place, preventing further deterioration.
Under surgical treatments of clubfoot, there are many surgeries that one may opt for. It all depends upon the severity of the condition. An orthopedic surgeon may opt to lengthen tendons to better position the feet. Postoperative care includes casting for two to three months after which one has to wear a brace for some time to prevent recurrence of this condition.
It is required that the child get treatment after birth. Also, parents should contact doctors for the condition without raising wrong concerns on the condition. It is seen in most cases that children who are treated early grow up to wear normal shoes and lead to normal and active lives afterwards.
(The writer is Chief Surgeon, Narayan Seva Sansthan, Udaipur.)