CLUB FOOT DISABILITY AMONG CHILDREN

CLUB FOOT DISABILITY AMONG CHILDREN
(CTEV (CONGENITAL TALIPES EQUINO VARUS))

Lily like a soft newborn baby reaches into the arms of their mothers with cute hands and legs.  Unfortunately, some babies are born with clubfoot deformities (bending of the foot inward or outward or in other directions).  Worldwide, 200,000 babies are born with clubfoot (deformed foot) each year.  Clubfoot is one of the most dangerous birth defects in children and a condition that restricts children's movement.  In ancient times, when there was no research on this, it was considered as the wrath of God or the entry of evil spirits into the body. This foot disability of the children pushes the family into extreme trauma.  Although it is not noticed immediately after birth, the defect can be detected soon after.

 

CLUB FOOT (ADDUCTUS)

WHAT IS CLUB FOOT (CTEV)

     Clubfoot is a complex and dangerous disorder caused by abnormal development of the baby's bones, ligaments, and muscles while in the womb. At first glance, the clubfoot affected foot may appear to be curved/twisted inward or outward. The foot may appear thinner, wider, or sharper than usual, and the muscles in the ankle may be thinner. In addition, the clubfoot affects the baby's feet and ankles, causing the heels and calves to move inwards/outwards, etc. It is not possible to fix the disability on its own if it is severe. This condition is more common in children in low-middle-income countries. If left untreated, it can lead to a lifetime of disability. Its variants are Cavus (arch-like or cavernous curvature of the foot), Adductus (forefoot bent inwards), Varus (heel upside down or inward), Equinus (the foot pointed downwards; encourages a person to walk on the front toe). A person with such a disability may experience difficulty walking, leg pain, and exclusion from the mainstream of society.

CLUB FOOT (CAVUS)

CAUSES OF THE DISEASE

        Most of the defects from the reviews appear to be caused by isolated genetic variations or environmental changes. Maternal smoking, diabetes mellitus, and changes in the uterus during gestation are also a factor. Other risk factors include congenital malformations, damage to the spinal cord associated with the brain, genetic disorders such as Down Syndrome, infections, and maternal malnutrition, etc. The basic diagnosis is still being researched.

CLUB FOOT (VARUS)

DIAGNOSIS

    Physical examination is important in diagnosis and opinion. After the baby is born, a physical examination is usually performed from head to toe. Ultrasound can be used to diagnose the complaint before birth. The problem of clubfoot is usually not noticed when the baby is born under normal conditions and begins to stand and walk. However, the disease is confirmed by the fact that the feet are abnormally bent downwards or inwards. It can occur in both feet and just one foot. Clubfoot is more common in males than females. Apart from this, some children can be seen turning their toes inwards when they start walking. This is called in-towing. This is sometimes self-correcting with age. If the baby's feet and ankles look abnormal after birth, do not hesitate to seek the advice of an orthopedic surgeon as soon as possible.

CLUB FOOT (EQUINUS)

CURRENT TREATMENT METHODS

        Functional deformity of the Achilles tendon, the muscle that connects the shank to the foot, causes the foot to rotate inward or outward. Currently, the treatment goes through three stages. i.e. Casting, Surgery, Special shoes/Bracing. This is known as the extensively accepted  Poncetti Method. This is the system used by Dr. Ignacio Poncetti, an American surgeon, to treat clubfoot. It can start in early nonage. Continue treatment at different stages can vary from 4 to 5 years. Manipulation, casting, tenotomy, and bracing are used to correct the disorder in several stages.

Serial casting: This involves placing an artificial leg cast (plaster) extending from the baby's toes to the shanks. A week later it was replaced and the effectiveness was analyzed and the corrected cataplasm treatment continued. This process is repeated several times to straighten the ankles.

Achilles Tenotomy:   After the cataplasm treatment a minor surgery is performed to restore the ankle-to-ankle joint and to achieve a sustainable correction. This is called the Achilles tenotomy. Correction and casting continue again after this surgical treatment. Again the final casting process takes about three weeks.

Special Shoes or Bracing: Foot Abduction Brace (FAB) or Boot and Bar (BnB) treatment take place after the final casting period. Braces should be worn daily for at least 12 weeks after the correction phase of the treatment, daily for 23 hours. Then the child needs to wear this brace for 12/24 hours till the age of 4-5 years. Continuous wearing of the braces helps to maintain the correct position of the foot and prevent recurrence of the deformity.

 In addition, other treatments are also performing in simpler clubfoot variants. In some cases, a foot and ankle orthopedic surgeon, without surgery, gently massages the feet and ankle and achieves release action of the contracted tissues. Treatment progress is assessed by X-ray and repeated after each interval. In mild cases, it can be partially successful.

EFFECTS TO LOOK OUT FOR DURING TREATMENT

        The full involvement of the parents during the clubfoot treatment is very important. The child should be cared for in a timely manner and the doctor's instructions should be followed. The baby's skin condition and blood circulation should be monitored regularly during the bracing period. Wear comfortable, wrinkle-free, comfortable socks. It is also important to use brace shoes for incorrect fitting regularly. It is also important to ask the treating physician about any doubts you may have regarding the wearing of the brace. The final step in treatment is to continue with the suitable braces regularly and the period prescribed by the doctor to avoid the possibility of recurrence.  The success rate is depending upon the correct method and periodicity of treatment.

SOCIAL SUPPORT

    Children with club feet should be treated at par with the other children and trained to be able to move forward with the community. Parents should no way allow their social backwardness. You need to play with them and engage in mindfulness. In some cases, about 10-15% of children experience a difference in the size of the leg from other about one centimeter due to therapeutic reasons. This condition can be completely cured if proper treatment is started on time. In a few, it seems to recur with age. However, clubfoot is a disorder that can be treated and normalized.

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