- Clubfoot reasons
- Clubfoot symptoms
- Treatment of a clubfoot
The clubfoot is a state at which one or both legs are in not physiological situation, since the birth moment.
Some scientists assume that the clubfoot begins to form at the beginning of pregnancy probably on the 10-12th week of a gestation.
Several ecological reasons which influence leads to a clubfoot are also offered. Many obstetricians-gynecologists consider that the risk of emergence of a clubfoot is influenced first of all pre-natal by the provision of a fruit. This theory is descendental, pointing to much higher level of a clubfoot among twins in comparison with monocarpic pregnancy. Pre-natal influence of drug мизопростол is also connected with a clubfoot. Mizoprostol is usually used for abortion in Brazil and other countries of South and Central America. If these attempts are unsuccessful, in many cases the child is born with this pathology. Researchers in Norway reported that men whose work is connected with printing house have higher risk to conceive the child who will be born with a clubfoot, than men of other professions. For the unknown reasons, amniocentesis is also connected with a clubfoot. Children of mothers who smoke during pregnancy have more chances to be born with a clubfoot, than posterity of women who do not smoke.
The true clubfoot is characterized by disturbance of a bone skeleton of the lower extremity. There are four options of a clubfoot: varus, valgus, a clubfoot on the "horse foot" type (ekvinovarusny) and a clubfoot of a calcaneus. The varus clubfoot is the most common form of a clubfoot, at the same time foot usually turns inside so that shins and feet look similar to a letter J. The valgus clubfoot is stated at turn of legs in the form of a letter L. The clubfoot as "horse foot" is observed at turn of foot down that makes it similar to the dancer's leg. At a clubfoot of a calcaneus of stop it is turned by a sock up, a heel down.
The clubfoot can be observed in one or both legs. Sometimes the lower extremities of the baby are deformed at the birth because of the pre-natal provision of a fruit till the birth. If there are no anatomic anomalies of bones, there is a false clubfoot, and the problem can be corrected by the use of a special bracket or devices capable to straighten the lower extremity.
The true clubfoot is, as a rule, obvious at a rozhdenii:stop has a typical appearance with turn inside and down. As the clubfoot begins in the first trimester of pregnancy, by the time of the birth this defect is already created. For the adult with a clubfoot walking becomes difficult or at all impossible.
The ratio of men and women with a clubfoot makes 2,5: 1. In the United States incidence makes about 1:1000 newborns. Genetic predisposition to a clubfoot comes to light at ¼ children. These data confirm a potential role of one or several genes responsible for a clubfoot.
Manifestations of a clubfoot can vary. Nevertheless, at the birth the affected leg usually falls into a state inside and down. This defect should gives in to manual influence. The gastrocnemius muscle on the party of defeat is less developed, than usually. One or both legs can be involved in pathological process.
Treatment of a clubfoot:
The clubfoot can be corrected by fixing in physiological situation or surgical intervention. To achieve the greatest result, treatment should be begun as soon as possible. The method of Ponseti which was offered still in the forties last century is quite popular. A method применителен at children since 1 week of life. Ponseti's technique consists in assignment of the struck foot in the provision of supination with the accompanying counter-pressure on an astragalus head that allows to prevent its turn and dislocation in an ankle joint. This physiological situation needs to be recorded a bracket which is not removed for the period of a dream. To be successful, the method demands active participation of parents.
If Ponseti's method did not bring positive effect, the surgical treatment consisting in "reorganization" of sinews, sheaves and joints of foot and an ankle joint is recommended to the child. Such procedure is usually carried out at the age of 9-12 months. After operation the leg in the necessary situation is held by fixers.
At timely diagnosis and treatment the forecast is favorable. Nevertheless, without treatment, the clubfoot can result in functional disability.
Now there is no way to prevent a clubfoot. Pregnant women can reduce risk of a clubfoot by refusal of smoking.