DEAR CLINIC MAYO: I am 24 weeks pregnant and had an ultrasound which found my child to have club foot. I am concerned for the life and function of my child with this diagnosis. What is the disease and are there new therapeutic advances that my baby can benefit from?
ANSWER: First of all, congratulations on having a baby. It is certainly an exciting time, but naturally it can be stressful when you hear that your child has something that could make them different.
Clubfoot is a common diagnosis that occurs in 1 in 1,000 births, making it one of the most common birth defects. The greatest fear of parents is that the quality of life of their child born with clubfoot will be limited. They worry about whether their child will be able to run, jump and play like their peers.
With the right treatment, your child could have a normal quality of life. Doctors at the Mayo Clinic, for example, are able to regularly treat children with clubfoot without surgery.
Children born with clubfoot may have other family members who were also born with clubfoot. Most of the time, these children only have club feet and no other bone, joint or muscle problems. However, there are a few genetic syndromes that clubfoot is also associated with, such as arthrogryposis and spina bifida.
At the Mayo Clinic, these other diagnoses are explored with the help of medical geneticists to offer a comprehensive genetic evaluation and determine if any additional challenges may arise in your child’s future.
Although clubfoot can affect both feet, it’s more common on one side of the body. Clubfoot can make your child’s foot slightly less flexible and a different shoe size than the unaffected foot, but over time your child should be able to walk normally with proper care. Surgical and non-surgical options are available for treating children. As your child grows, a gait analysis may be done to assess future surgical needs to maximize function.
Left untreated, clubfoot causes more serious problems, including arthritis and other orthopedic problems associated with awkward gait.
The main method used to correct club feet in children is known as the Ponseti method. This is a series of long legged casts that are changed weekly. It is important to seek an orthopedic specialist with knowledge of this condition, as well as a qualified plaster technician to place and remove casts weekly, to achieve the required correction.
After the cast is finished, many children have to have minor heel surgery to release tension in the Achilles tendon. Sometimes this procedure is performed in the area of the plaster itself. Other times it is done in the operating room.
Any surgery can be scary, but a recent innovation from the Mayo Clinic makes surgery painless. In partnership with the team of pediatric anesthesia experts, no anesthesia is used, only blockage of the nerves in the legs.
This technique is beneficial for two reasons: The child is not exposed to anesthesia and the surgery can be as long as necessary to be as precise as possible. Following the operation, the child can go home without hospitalization.
After the cast and small Achilles tendon surgery is completed, a plantar splint is worn full time for three months, followed by part time wearing until the child turns 3 years old. . Close collaboration with prosthetics and orthotics experts guarantees the comfort of orthotics.
Unfortunately, even with strict grip of the splint, clubfoot sometimes returns. At the Mayo Clinic, the gait analysis lab assesses a child for the possibility of a return of the disease. In the lab, the pressure under your child’s foot is measured, which creates an imprint that can give an early warning of a clubfoot return. This will allow the Mayo Clinic to perform fewer surgeries than if a corrective procedure was delayed. This small surgery is successful in allowing children with clubfoot to keep up with their peers.
In the future, your child should be able to have a normal quality of life and range of motion. It will be important to find a provider and expert with whom you are comfortable providing a careful cast and pain-free surgery. Plus, being committed to treatment and being diligent with follow-up should mean that your child with clubfoot will be able to run, jump, and play like their peers.
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Quote: Mayo Clinic Q and A: Childhood clubfoot (2021, December 28) retrieved December 28, 2021 from https://medicalxpress.com/news/2021-12-mayo-clinic-childhood-clubfoot.html
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