What is Clubfoot (Pes Equinovarus)? How is it treated?

Clubfoot, also known as Pes Equinovarus, is a congenital deformity of the foot that affects approximately 1 in 1,000 newborns. It is a condition where the foot is twisted inward and downward, making it difficult or impossible to walk normally. The affected foot may also be smaller than the other foot and the calf muscles may be underdeveloped.

The exact cause of clubfoot is not known, but it is believed to be a combination of genetic and environmental factors. It is more common in boys than girls and can occur in one or both feet.

There are two types of clubfoot: idiopathic and syndromic. Idiopathic clubfoot is the most common type and occurs without any other associated medical conditions. Syndromic clubfoot is associated with other medical conditions such as spina bifida, arthrogryposis, or cerebral palsy.

Diagnosis of clubfoot is usually made at birth or during a prenatal ultrasound. The foot is examined for its position and range of motion. X-rays may also be taken to evaluate the bones and joints of the foot.

Treatment for clubfoot usually begins soon after birth and involves a series of non-surgical and surgical interventions. The goal of treatment is to correct the deformity and allow the child to walk normally.

Non-surgical treatment involves a process called serial casting. This involves applying a series of casts to the affected foot to gradually stretch and reposition the foot into a more normal position. The casts are changed every one to two weeks and the process can take several months.

After the casting process is complete, the child may need to wear a brace or special shoes to maintain the corrected position of the foot. This is called a foot abduction brace and is worn for several months to prevent the foot from returning to its original position.

In some cases, non-surgical treatment may not be successful and surgery may be necessary. Surgery for clubfoot usually involves releasing the tight tendons and ligaments that are causing the foot to be in an abnormal position. This is called a tenotomy or tendon transfer. In severe cases, bone may need to be cut and repositioned to correct the deformity.

After surgery, the child will need to wear a cast or brace for several weeks to allow the foot to heal. Physical therapy may also be necessary to help the child regain strength and range of motion in the affected foot.

Long-term follow-up is necessary to monitor the child’s progress and ensure that the foot remains in a corrected position. The child may need to wear a brace or special shoes for several years to prevent the foot from returning to its original position.

In conclusion, clubfoot is a congenital deformity of the foot that affects approximately 1 in 1,000 newborns. It is a condition where the foot is twisted inward and downward, making it difficult or impossible to walk normally. Treatment for clubfoot usually involves a series of non-surgical and surgical interventions. The goal of treatment is to correct the deformity and allow the child to walk normally. With early diagnosis and appropriate treatment, most children with clubfoot can lead normal, active lives.