Clubfoot Treatment in Gurgaon
Welcome to our Young Bones Clinic
Parents with babies having Clubfoot need to take extra care of their child.
At Young Bones Clinic, our dedicated orthopedist in Gurgaon is an expert in providing effective treatment for Clubfoot for people in and around Gurgaon.
In this article, we will explain to you everything about Clubfoot.
So Stay Tuned!
What is Clubfoot
Clubfoot is a congenital deformity in which an infant’s foot is twisted out of shape inward or upward. It is the most common deformity of the bones and joints in newborns. It can be mild or severe and occur in one or both feet.
Approximately one newborn in every 1,000 live births will have clubfoot. In clubfoot, the tendons that connect the leg muscles to the foot bones are short and tight, causing the foot to twist inward.
But what causes clubfoot?
The cause of clubfoot (Idiopathic type) is not exactly known, but it is most likely multifactorial and no single reason has been identified.
- Maternal and paternal smoking
- Lack of amniotic fluid (protective liquid) in the womb
- 1st pregnancy
How is clubfoot diagnosed?It can be easily detected in the womb after 20 weeks of pregnancy by ultrasound. Most are detected at birth on clinical examination. The specific components of the foot deformity make the diagnosis easy by the pediatrician or pediatric orthopedic surgeon.
Wait! Is clubfoot treatable?Yes. It is a completely treatable deformity. In most cases, the parents should not worry if their baby is detected with clubfeet at or before birth.
- With timely intervention at birth and with sequential plasters, the child ends up having normal feet without any functional limitations.
- The key is early treatment starting 5-7 days after birth.
- It is successful in 95% to 98% of the children and doesn’t require any extensive surgical correction.
Who treats babies with clubfoot?
A trained pediatric orthopedic surgeon is the best doctor to treat this condition. At Young Bones Clinic, we have a well-trained and qualified pediatric orthopedic surgeon in Gurgaon, Dr. Ratnav Ratan. He is one of the best surgeons for clubfoot treatment in Gurgaon with more than 13 years of experience. He pays complete attention to smaller details to avoid complications and get normal, painless feet until the child starts walking.
Treatments for Clubfoot treatment
At our clinic, most clubfoot cases are successfully treated with non-surgical methods that include a combination of initial stretching, weekly casting, and finally bracing.
Gentle and slow movements and stretches of the foot help to move the abnormal foot into the correct position.
A baby wears a plaster cast that gently moves the abnormal foot into the correct position.
It is a device that consists of two boots connected to a metal bar. It is fixed on the foot to keep it in the correct position.
Treatment usually begins after birth within 5 to 7 days, provided the baby is healthy and mature enough. In premature birth or extremely low birth-weight babies, only stretching is done until the casting is safe for the baby.
The Ponseti TechniquePonseti technique is the most widely used technique in the world. It uses gentle stretching and casting to gradually correct the deformity. It is an effective method for all types of clubfeet as the initial non-surgical treatment.
- In the technique, the baby’s foot is gently stretched and manipulated into a corrected position and held in place with a long-leg cast (toes to thigh).
- Each week, this process of stretching, re-positioning, and casting is repeated until the foot is mostly improved. For most infants, this improvement takes about 6 to 8 weeks.
- The next phase involves a minor procedure to release continued tightness in the Achilles tendon (heel cord) in 90% of the babies. During this procedure (called a tenotomy), we use a very thin instrument to cut the tendon. A tendon is a tissue that connects the muscle to the bone. The cut is very small and does not require stitches.
- A new cast will be applied to the leg to protect the tendon as it heals. This usually takes about 3 weeks.
- The Achilles tendon is regrown to a proper, longer length. Then, the cast is removed.
- Once the final cast is off, the baby will need to wear special boots connected with a metal bar for 3 months. After this, the baby has to wear special boots at night and during daytime naps for around 4 years. This is known as bracing.
This technique is highly successful for children with clubfoot and avoids any extensive surgeries.
The treatment goal is to obtain a functional, pain-free foot that enables standing and walking with the sole area of the foot on the ground. The younger the age at which the treatment is initiated, the sooner and better the cure.
Post-treatment care at homeParents will also need to continue doing stretching exercises with their babies. Babies might be fussy during the first few days of wearing a brace and will need time to adjust. Adhering to the prescribed usage guidelines for the special boots are extremely important. Not following the guidelines correctly is the commonest cause of failure of this treatment method.
Will surgery be required to treat clubfoot?
Surgery may rarely be required in cases where:
- The foot is stiff which is prone to relapse
- Secondary clubfoot in a syndromic child
- Neuromuscular disorders
- Untreated clubfoot
- Failure in responding to Ponseti treatment.
A tendon transfer is most frequently required if the child is showing signs of a hyperactive tendon, causing inward movement of the feet while walking.
Are there any risks associated with the technique?
The technique is safe, provided the critical steps are diligently followed.
- Sometimes plaster sores can happen in babies with sensitive skin or too much correction in the stiff foot. It is easily managed with antibiotics and by removing the cast for a week or so.
- Non-adherence to the critical steps in the Ponseti technique may lead to a rocker bottom foot (midfoot break) or an iatrogenic complex clubfoot.
- Sometimes bleeding happen after the heel-cord-cutting procedure and can be easily managed.
The overall outcome of clubfoot for a baby to have a normal life
- With appropriate treatment, the child should have a nearly normal foot, and he or she can run and play and wear normal shoes.
- The affected foot is usually 1 to 1 and a half size smaller and somewhat less mobile than the normal foot.
- The calf muscles in the child’s clubfoot leg will also stay smaller, so the child may complain of “sore legs” or getting tired sooner than peers.
- The affected leg may also be slightly shorter than the unaffected leg, but this is rarely a significant problem.