Clubfoot deformation which means congenital talipes equinovarus in Latin is excessively turned in the foot of children. This deformity seen in boys mostly is caused by genetic factors. Clubfoot can be seen in one or both feet.
With congenital talipes equinovarus, the front part of the foot turns in as well as the heel and middle part of the foot. If the deformation is present in one foot, this foot is smaller than the other and the calf is weaker. Although definitive reason is not known, it is generally known to be caused by genetic and environmental factors.
Diagnosis of Clubfoot
Talipes equinovarus can be diagnosed before birth with ultrasonic imaging of the womb. Clinic diagnosis is possible after birth. Babies having congenital talipes equinovarus should be examined for developmental dysplasia of the hip.
Treatment of Talipes Equinovarus
Talipes Equinovarus seen in 1 person out of 1000 is used to be treated as soon as the baby is born, and it is was stated that success rate reduces if the treatment is started late. This used to cause stress for the parents and prevent the connection between the mother and the baby. Today, the mother and newborn are provided 10 days.
In the treatment of talipes equinovarus, first of all, plaster treatment is applied. The foot is stretched with a special technique and plaster is applied till the groin. The foot is observed to be fixed relatively after about 1 week. The plaster is applied again. The plaster procedure is repeated for 4-6 months. In this technique known as ponseti method, the plaster is applied with different angles. At the end of the process, the foot is stretched and controlled. If the stretching is more than 20 degrees and the heel bone is in the place, the treatment terminates. If not, a small surgery is performed to elongate Achilles tendon. After tendon surgery, plaster is applied to the foot for 3 weeks. At the end of the procedure, the tendon recovers completely. After the plaster is removed, special shoes with rods called orthesis should be worn to preserve the shape of the foot. We recommend the patients to wear those shoes for 23 hours a day for 3 months. After 3 months, it is sufficient to be worn just while sleeping.
Treatment of congenital talipes equinovarus requires patience. Although this process reduces and gets more comfortable with time, it lasts until the age of 4. It is very essential for the family to be relaxed and adopt their children to have an easy treatment process.
Surgery of Talipes Equinovarus
The surgery of talipes equinovarus was used to be performed very often 20 years ago. However, thanks to non-surgical methods developed afterward, it is not the first option anymore. Today, surgery is performed when deformity is in advanced stage, recovery is not complete or deformity is accompanied by other deformities.
For the surgery, the baby should be at least 6-7-month-old. Above mentioned treatment methods such as orthesis should be used for 1-4 years after the surgery.