Acquired and Congenital clubfoot in children: signs, treatment, photo pathology
Clubfoot in children and adults: typical signs and treatment
Clubfoot – a deformity of the foot. Pathology is not uncommon, approximately 12% of the total number of anomalies.
The disease is characterized by eversion of the foot inward or outward, in most cases the diagnosis is established after the baby is born.
The defect is more common in boys and affects 1 child out of thousands. In 50% of cases, experts observe a bilateral lesion.
Classification of the disease
There are congenital and acquired clubfoot.
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A disease in which the deformation of the lower extremities of the foot is considered the most common malformation of musculoskeletal system.
In advanced cases, can lead to early disability.
External signs of congenital clubfoot is:
The deviations typical clubfoot is characterized by:
- equinus— the heel is turned upwards and the foot remains in plantar fasciitis condition;
- varus — heel turning inside;
- valgus – heel is deployed to the outside;
- supination – medial edge turned outward;
- adducci stop given to the midline of the body.
The atypical form is more severe symptoms: plump and short foot, has a deep transverse crease on the foot, bones visibly bent the shank in the plantar section.
The disease occurs due to serious violations of the musculoskeletal device.
There are two types of clubfoot according to severity:
- light – curable without surgery;
- the middle movement is limited, difficult treated;
- heavy – conservative treatment is powerless, the pathology can be corrected by repeated operations.
The causes klassificeret:
- primary (idiopathic) – occurs as an independent disease;
- secondary – develops as a result of other diseases or defects of the foot.
Occurs after injuries in distal tibial epiphysis.
Adult ananomaly may develop tuberculosis of the bones of the foot, and an ankle fracture the talus and or wrong Assembly of fragments.
Who is at risk?
Despite the serious studies in this field, the exact causes of the disease are still not identified. However, experts have put forward several reasons for the occurrence of kosolaposti in newborns :
- mechanical – the disease is caused due to malposition of the fetus inside the uterus, under strong pressure on the feet of a baby;
- genetic — influence of bad heredity;
- the neuro muscular and abnormal development of the fetus, the ligaments and muscles that form the foot already on 8-12 week of pregnancy;
- toxic – admission in the expectant mothers of drugs, narcotic drugs, Smoking;
- dry pregnancy;
- bad ecology;
- infectious diseases, transferred to the third trimester of pregnancy.
Acquired clubfoot occurs in adolescents and in adults. Pathology has its reasons of development:
- diseases of the nervous system;
- incorrect merging of bones after fractures;
- acute inflammatory processes;
- fractures of the foot.
If the disease is not treated, over time, adults acquire a «figure of Winnie the Pooh»; rounding of the back, misalignment of the thoracic, alignment, bending in the lumbar. When walking people are transferred from one foot to the other.
The disease often develops in young children in the period when they be on the legs and begin to walk. The baby is growing, gaining weight, the skeleton is pulled quickly, and the muscles and tendons do not have time for his growth.
At this time there is strong pressure on the feet, resulting in deformity.
As still not revealed the exact cause of the disease, so risk factors are not clear.
Modern orthopedics and traumatology suggests that the most prone to disease:
- people with hereditary predisposition.
The clinical picture
The symptoms of clubfoot are visible immediately after the birth of the child: the foot may be turned inward, outward, or deployed in an unnatural position.
Anomalies reveal the doctors at the hospital or at the first examination by a podiatrist.
Specialist makes a diagnosis when the following symptoms:
- the toes bent under the foot (inside);
- the front part of the foot raised;
- torsion of the bone in the area of the lower leg with the bend of the sole;
- restriction of movement in the ankle;
- sole on the outer edge is omitted, and the inner edge is raised;
- handled gait.
Features of the disease
Therapy of patients with congenital anomaly is accompanied by dissatisfaction with the end result of treatment or complications.
It is associated with anatomical changes in the skeleton of the foot and joints. In addition, often there is a shift and a chronic muscle strain that 96% leads to their degeneration.
What to do parents
Self-diagnose, and even more to start treatment if clubfoot is not worth it.
If the diagnosis was put by doctors in the hospital, after discharge, it is necessary to go on reception to the orthopedist.
It is important to start treatment as early as possible – with age, the plasticity of the muscles gets worse and harder to coordinate.
Conservative therapy begin to hold already in weeks of age. In older age it is important to do special exercises. You must remember that exercise will have positive dynamics in the case if they are done barefoot.
The complex LK picks up the podiatrist with regard to the shape of the disease.
An important place in the treatment of diseases is given to swimming, which promotes the development of muscles.
The task of parents: to strictly follow the advice of experts, interest of the child to execute physical therapy, to walk barefoot on the sand, the pebbles – this will create an additional burden on the muscles of the foot.
The formation of the correct arch formed only 4-5 years, so the implementation of a physician will help over time to cope with the problem.
During the ultrasound examination in II and III trimester of pregnancy it is already possible to detect clubfoot.
When the specialist puts such a diagnosis, it must be remembered that this disease may be a manifestation of other diseases, such as spina bifida or hip dysplasia.
For accurate diagnosis it is recommended to conduct screening. However, this method is not suitable for children under 3 months as at this age the bones still consist of cartilage. Therefore, when the diagnosis ultrasound is used.
After three months of doing the x-ray in two mappings: lateral and anteroposterior, in this case should be the maximum of the back and the plantar flexion of the foot.
- electromyography of the lower extremities;
- neurological examination;
- CT 3D reconstruction.
So what to do?
Treatment of deformation of the stop is always complex and lengthy. The choice of treatment depends on the age, type and severity of the disease.
Treatment of clubfoot may be:
- conservative – held up to 2 years;
To get rid of the classic methods of clubfoot treatment is necessary:
- remedial massage – performed mild;
- overlay soft bandage;
- paraffin baths combined with massage treatments;
- gypsuming for correction;
- superimposition of the plaster bandage method Ponseti;
- the use of orthoses, splints, braces;
- wearing special orthopedic shoes;
- vitamins of group b and of the drug «Neostigmine».
With the ineffectiveness of conservative methods of therapy, surgical intervention or by the method of Zatsepin G. A. Ilizarov (over 4 years). Children operations are conducted upon reaching 8 months of age.
A video every parent can learn how to do massage for clubfoot in children:
Serious complications — a common occurrence
In the later stages of the disease appear serious complications, stop changes its configuration appear corns, bones of lower limbs are often subjected to sprains and strains. In addition, the observed changes of the entire skeleton.
In adults, complications lead to the pathology of other organs:
- thrombosis of the veins;
- difficulty of venous outflow;
- osteoarthritis of the feet;
- ulcers of the leg;
- prolapse of internal organs.
In the preventive purposes during pregnancy, hereditary predisposition, are prescribed medicinal drugs for proper bone development of the baby.
At the first sign of the disease is necessary to pass a comprehensive examination and conduct all procedures, corrective pathology.
Clubfoot is a serious condition that progresses and can lead to complete disability. It is therefore important not to delay treatment, and the time to consult a podiatrist.
Modern medicine has sufficient means to correct the defect and achieve the right shape of feet.