
In
the UK, the medical term for clubfoot is Congenital
Talipes Equinovarus. 'Congenital' means a
deformity that is present at birth, and 'Talipes'
means simply the foot and ankle. 'Equinovarus'
refers to the position of the foot, which
points downwards and inwards. Talipes can
involve both feet or just one, and is present
at birth.
There
are other forms of the condition, where the
front of the foot turns upwards, or the foot
turns outwards, but the above form of talipes
occurs most frequently.
It
is a condition that has been known about for
many years, and occurs worldwide, but very
little is known about the cause. There is
considerable evidence that the condition can
be hereditary, and it is more common in boys
than girls.
Where
the foot responds well to simple treatment,
it is likely to have been caused by the position
of the foot in the womb. Links have been suggested
with 'oligohydramnios' which is where there
is a reduction in the amount of amniotic fluid.
The condition can be detected pre-natally
by ultrasound scan, but is often not discovered
until birth.
Treatment should be commenced soon after birth,
and the aim is to achieve functional, pain
free feet. Initial treatment in Britain tends
to be conservative, with physio and strapping
being the most common options. Sometimes casting
is used instead of strapping - this will depend
on individual hospitals and consultants.
If
this is unsuccessful, an operation will be
required. The most common is a 'soft tissue
release' which involves lengthening the affected
tendons and ligaments. A plaster cast will
be needed afterwards.
Sometimes
there can be a relapse as the child grows
older, and further treatment may be required,
Because of this, the child is normally reviewed
regularly as he/she grows.