Clubfoot
What is clubfoot?
Clubfoot occurs when the foot or feet appear to turn inwards beginning at the ankle.
Clubfoot is characterized by the painful-looking way it causes a person to walk or stand. Those who suffer from clubfoot look like they are walking on their ankles or the sides of their feet, with the heels of the foot pointed downwards and the front half of the foot turned inwards.
Clubfoot deformity is not an uncommon birth defect and occurs in 1 out of 1000 babies, and 50% of the clubfoot birth defects occur in both feet.
The exact causes of clubfoot are not fully determined, but with treatments, Clubfoot can be resolved.
When does Clubfoot treatment begin?
Generally, babies with
clubfoot can be discovered in the uterus with an ultrasound. If there is a diagnosis of clubfoot made, then we recommend checking in with an orthopedic surgeon in order to prepare a plan to fix the clubfoot. After the baby is born there may be an x-ray or CT scan conduction so the doctor can examine exactly how the tendons, ligaments, and bones are affected.
We recommend treatment right after birth. The reason for this is because that is when the ligaments and tendons are still soft and palatable. With the Ponseti Method (casting of the foot), we can adjust the
clubfoot into the regular position in degrees.
The Ponseti method is endorsed and supported by World Health Organization, National Institutes of Health, American Academy of Orthopedic Surgeons, Pediatric Orthopedic Society of North America, and European Pediatric Orthopedic Society, and is widely considered to be the best option for treating clubfoot.
There are two phases to resolving clubfoot: the treatment phase and maintenance phase.
Treatment phase should begin within 7-10 days of birth. The procedure involves the doctor gently moving the baby's feet closer to the correct position, then placing them in small plaster casts. This is done in stages, similar to dental braces. The baby's foot is moved a small amount at a time to help it develop properly. The cast is worn five to seven days before it is removed, the foot is moved closer to the correct position, and a new cast is placed.
The process takes about two months and approximately five to six casts to completely correct the
clubfoot problem. In most cases, a small surgical procedure will be required in order to lengthen the Achilles tendon. This minor surgery is done under local anesthesia, does not require stiches, and can be completed in only ten minutes.
The maintenance phase begins as soon as the treatment phase has completed. Maintenance is simple and simply requires the baby to wear a foot brace to keep the foot in the correct position. Once the treatment and maintenance are complete, the baby's clubfoot should be corrected and look and function like a normal foot.
Adult Clubfoot
Clubfoot is a condition that is present at birth where one foot or both feet are in a position that points inward and downward. The condition occurs in about 1 in every 1000 births and is more frequent in boys than girls.
While clubfoot can be treated in newborn babies with the Ponseti Method, clubfoot also exists in adults.
A residual deformity is an adult
clubfoot that happened in infancy that was treated improperly or not treated at all. There are also cases where a clubfoot-like deformity can happen after a trauma or stroke. The good news is there is technique for adults, which is very successful.
The Ilizarov Method was developed by Professor G.A Ilizarov at the Institute of Kurgan, Siberia in the 1950s and introduced in the United States in the late 1980s.
In the Ilizarov Method, a foot and ankle surgeon placed tension wires (connected to a frame) through the bony structures of the
clubfoot to realign the joint surfaces and foot anatomy.
The Ilizarov external fixator, also called the Ilizarov Aparatus, may also be used to stabilize fractures, re-grow lost bone or correct deformities.
The external fixator on the leg is adjusted gradually at home by the patient with instructions given by the surgeon. By doing this, the bone – in the clubfoot - moves into a better and more corrected position, making it easier to walk.
The external fixator stays on the feet and legs for about 5-6 months. After the external fixator comes off, then a surgeon, who specializes in
Ilizarov surgery, applies a below-knee walking cast for about 2-3 months.
The Ilizarov Method has been advocated as a way of avoiding some drawbacks of other types of surgery, such as the risks of neurovascular injury and soft tissue injury.
Our office sees clubfoot patients of all ages from infants to adults. Our foot and ankle surgeons are experts using the Ilizarov Method and external fixation to fix adult clubfeet.
If you or someone you love is interested in adult clubfoot treatment, a surgeon, who specializes in Ilizarov surgery, can examine your feet and give you the best course of action.
The Limb Lengthening Institute of Los Angeles is a premiere medical group and their experienced surgeons are the only doctors who do adult clubfoot treatment in the Los Angeles area.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your adult clubfoot treatment and/or other cosmetic foot needs.
