Club foot: causes, symptoms, treatments, to prevention

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Definition

What is club foot?

Club foot is a term used to describe a leg deformity that is congenital. The clubfoot usually appears crooked as a sprained or irregularly shaped.

In this condition, the tissue that connects the muscles to the bones (thighs) is shorter than it should be. Clubfoot is a common disorder that babies experience and is usually a problem in itself for healthy newborns.

This condition can occur on one or both sides of the foot. Clubfoot makes it difficult for the child to walk, so doctors will immediately refer him for treatment after birth.

Clubfoot conditions can be mild or severe. Half of babies with clubfoot experience it on both their feet. If your child has clubfoot, it can be difficult for him to walk.

Doctors can usually treat this condition without surgery. The sooner it is treated, the clubfoot can recover fully, although sometimes it will require further surgery at a later date.

Types of club foot

There are two types of clubfoot compiled by the Mayo Clinic, namely:

• Isolated clubfoot

This condition is also known as idiopathic clubfoot. This is the most common type. Usually occurs in children who have no other health problems.

• Nonisolated clubfoot

This type of clubfoot occurs in conjunction with other health problems, such as arthrogryposis or spina bifida. Babies with arthrogryposis are born with joint problems that make it difficult to move their arms or legs.

In this condition, the joint may not move in the right direction or it may be fixed in one position. Spina bifida is the most common type of neural tube defect (NTD).

NTD is a birth defect of the brain, spine, and spinal cord. Spina bifida can affect the development of the brain, spine, spinal cord and meninges. The meninges is the tissue that covers and forms the brain and spine.

Signs and symptoms

What are the signs and symptoms of club foot?

The following are signs and symptoms in babies with clubfoot:

• The instep is bent downward
• The leg can be rotated so badly (palms facing up while the back is bent downward) that they appear upside down.
• Weakened calf muscles
• The leg with clubfoot is usually shorter than the other side

A person with clubfoot usually doesn't feel any discomfort or pain when walking. Health professionals usually have detected this condition in babies since in the womb.

However, children with this condition will usually feel pain over time.

When do I call the doctor?

Usually doctors have known the condition of clubfoot since your baby was born from its appearance. The doctor may suggest treatment or refer your baby to a specialist in bone and muscle problems.

Cause

What causes club foot?

Clubfoot condition usually occurs without a cause (idiopathic). Genetic factors are believed to have an important role in this condition. However, this also has not been clearly proven.

Clubfoot is also not caused by the position of the baby in the womb. Sometimes, this condition is related to another condition, such as spina bifida, or a known condition called hip growth hip dysplasia or developmental dysplasia of the hip (DHH).

In most cases, clubfoot occurs as a result of the baby's feet being misplaced while still developing in the womb. However, clubfoot is often caused by a combination of genetic and environmental exposure that can increase the risk of birth defects in the baby.

Clubfoot can also occur as a result of injury to the nerves, muscles, and bone systems, such as a stroke or brain trauma.

Risk factors

What increases my baby's risk of club foot?

There are many risk factors for clubfoot, such as:

• Your baby is male

Men are more at risk of developing club foot than women.

• Family history

If you have had a child with clubfoot, the risk increases in future pregnancies. It also means that you or your partner and family have a history of clubfoot.

• Your baby has a genetic problem, such as Trisomy 18 (also known as Edwards syndrome)

Babies with trisomy 18 have the possibility of developing birth defects and life-threatening health problems.

• Congenital birth

In some cases, clubfoot can accompany spina bifida, a serious birth defect that can be fatal.

• Getting infected, using drugs, and smoking during pregnancy

If you smoke while pregnant, your baby may have clubfoot at twice as much as babies born to nonsmoking women.

• Amniotic fluid is lacking which can damage the fetal tissue that is developing in the womb.

Complications

What complications might a child with club foot experience?

Club foot usually doesn't cause any problems until your baby can get up and walk. If clubfoot is well cared for, your baby will be able to walk normally. Chances are, your baby will experience the following difficulties:

• Movement: The clubfoot condition causes the feet to be less flexible.
• Leg length: Clubfoot also makes the foot shorter than the single one, but usually does not cause disturbances in movement.
• Shoe size: The foot affected by clubfoot is usually 1.5 times larger than the unaffected foot.
• Calf size: The calf muscles in the leg affected by clubfoot are usually smaller than the others.

If left untreated, clubfoot can cause serious problems, including:

• Arthritis
• Bad self image

The unusual appearance of the legs makes the body image of your child a concern.

• Cannot walk normally

The twisted ankle may prevent your child from walking on the sole of the foot. Your child may walk on the ball of the foot, the outside of the foot or even the top of the foot in severe cases.

• The adjustment problem is running

The walking adjustment may prevent the growth of the calf muscles, cause large sores or calluses on the feet and make gait awkward.

Diagnosis

How is club foot diagnosed?

Ultrasound during pregnancy can help doctors detect signs of birth defects in babies early. Even so, clubfoot is easier and more often diagnosed at birth by paying attention to the shape of the baby's feet.

Normal baby feet are flexible and can be moved normally. In babies who have clubfoot, the legs are stiff.

In some cases, the doctor may order an X-ray to find out how bad the clubfoot is in your child, but this procedure is usually not necessary.

Treatment of clubfoot in babies cannot be done before birth. However, knowing earlier about this condition can give you a lot of time to discuss the treatment to be carried out with doctors and other health professionals.

Treatment

How is club foot treated?

The baby's legs, joints and muscles are still very flexible, so treatment in the first week after birth will help improve the condition. Therapy is aimed at improving the shape and function of the feet so that children can run more smoothly later.

Therapy done as soon as possible immediately after birth can increase the child's chances of normal activities. The treatment consists of:

Stretches and casts (Ponseti method)

This is the most common treatment for clubfoot. The doctor will do:

• Move your baby's leg into a large position and place it in a cast for support.
• Repeat the above steps once a week for several months.
• Make a small splint to lengthen the Achilles tendon, the large tendon in the ankle, as a closing procedure in this method.

Once your baby's foot shape is repositioned, you should defend it with one or more of the following:

• Do stretching exercises with your baby.
• Give special shoes and brace .
• Make sure your baby is wearing special shoes and brace it's as long as it takes. Usually this process takes up to three months, and at night at bedtime up to three years.

For the success of this method, you will need to place the brace according to the doctor's instructions so that the baby's feet do not return to their original position. The main reason for the failure of this method is an error in installation brace .

French method

With this treatment, the physical therapist will stretch your baby's legs into the correct position and use a bandage and stretch them. Splinting can help by preserving bones and tissues.

This treatment is usually started immediately after birth and is done every day for two months and the intensity will decrease until your baby is three months old.

Your baby will be treated by a therapist three times per week. Your therapist will also teach you to perform similar treatments at home.

Operation

If your baby's clubfoot condition is so severe that it cannot be treated without surgery, surgery may be needed. The surgeon is able to lengthen or reposition the tendons and ligaments to make it easier for the foot to move into a better position.

After surgery, your baby may wear a cast for up to two months and a brace for a year to prevent clubfoot from returning.

Even after going through the surgical procedure, the club foot condition may not recover completely. But in most cases, babies who wear special shoes can lead an active life well.

Prevention

What can I do to prevent club foot in my baby?

Since the cause of clubfoot is unknown, there may not be a specific way to completely avoid it. However, the following things can be done to lower your baby's risk of getting clubfoot:

Before pregnancy

• Perform preconception checks

This is a pre-pregnancy health check to ensure that you are in good health while pregnant.

• Consult a genetic counselor

This is done to detect any club foot offspring. A genetic counselor is someone who specializes in genes, birth defects, and other health problems that occur in families.

• Get an infection check, like Zika

Early checkups and care can help you get through a healthy pregnancy and baby.

During pregnancy

• Get a pregnancy checkup

Pregnancy examination is a medical treatment during pregnancy. Getting early and regular prenatal checks can help you have a healthy pregnancy. Keep checking the uterus, even though you feel well.

• Protect yourself from Zika

Do not travel to places infected with Zika, unless you have to. In addition, you must avoid mosquito bites.

Do not have sexual relations with a Zika-infected partner or someone who has recently traveled to Zika-infected territory.

If you work in a hospital or clinic, laboratory, or medical equipment, follow safety rules to avoid transmission through body fluids or samples.

• Don't smoke or expose yourself to secondhand smoke, drink alcohol, and take over-the-counter drugs