Clubfoot

Clubfoot is a complex combination foot deformity wrong with installing it. Almost 80% of cases clubfoot common congenital equinovarus deformation (internal horse toed foot), to which practically apply the term "club foot". Other kinds of deformations (with deviation feet outwards - valgus stop, turn - varus stop, a sharp bend and relying only on the forefoot and fingers - horse stop or straighten based only on the heel - heel foot, education excessively high arch - hollow-foot) are more often acquired accompany some neurological disorders with sluggish and spastic paralysis, diseases and damages of the bone-muscular system of the foot and lower leg.
Congenital clubfoot is one of the first places among orthopedic diseases and occurs in about 1% of babies, often in combination with other deformities. Clubfoot boys are almost twice as often as girls. Defeat mostly bilateral. Etiology of clubfoot is not entirely clear.

congenital clubfoot
Fig. 1. Bilateral congenital clubfoot.
correction of congenital clubfoot
Fig. 2. Manual steps to repair congenital clubfoot in young age.

Congenital clubfoot has a specific anatomical changes in the bones, ligaments, muscles of the foot and lower leg. The talus removed and thrown outwards and forward, stop several shortened muscles outer surface of tibia underdeveloped. The stop is in position curls, turned inward, the front part of her shows (Fig. 1). Support when walking is not plantar, and the front-the outer part of the foot. The degree of strain is different from the subtle and easy to eliminate significant, difficult correctable. When the child begins to walk, deformation increases, on the outer edge of the foot is formed amosulalol - netoptix - the mucous bag. The diagnosis of congenital clubfoot is not difficult and can be diagnosed during examination on the basis of external signs.
Treatment of clubfoot depends on the age of the patient and the type of deformation. To start the treatment it is necessary immediately after birth. In children under the age of 4 months deformation in most cases eliminated conservative. Treatment painstaking and must be done methodically. From the first days make frequent easy turning foot in the direction normal installation and start daily, for approximately 5 minutes, careful redresorului motion (Fig. 2). Redressal (straightening, correction of clubfoot) continue for a long time, until the stop will not be easy to keep in fixed condition. The position of the foot every time fix soft bandages that are changed daily. From 9 to 14-day stop keep circular plaster bandages that are changed every 7-10 days until then, until the foot is not positioned properly, then as needed. Before applying the plaster bandages skin legs treated with naphthalan ointment.
Plaster bandage for cotton bedding. Considering the tendency of the foot to the vicious installation, after elimination of clubfoot within 3-4 months. keep the foot fixation, combining it with massage and gymnastics. Treatment is considered complete when the deformity was corrected, and the child is actively produces extension lead and pronation of the foot. Treatment continued until then, until the child begins to walk.
If unsuccessful conservative treatment use of operational methods. The most widely operation Zatsepin on the tendons and ligaments of the foot, which is made mostly children older than 2 years. After the operation to consolidate the results of 6 months impose a plaster bandage. With significant and running foot deformities in children over the age of 8-10 years produce resection of the bone, and other operations.
In cases of acquired clubfoot treatment strategy depends on the cause and type of destruction: the transplantation of muscles or fusion (see) in the correct position when the paralytic of clubfoot, lengthening of the tendons in spastic forms, reconstructive operations on the bones of the foot of posttraumatic of clubfoot, etc.
Wearing orthopedic shoes (see) is shown in congenital and acquired a clubfoot.