How to correct clubfoot in children: treatment methods. Clubfoot in children - treatment and correction of all types of pathology depending on the cause Treatment of clubfoot in children

– an anomaly in the development of the musculoskeletal system, characterized by inward deviation of the fingers, bending of the inner edge of the sole upward and inward. It manifests itself as external deformation, changes in gait, and limitation of foot movements. Possible pain. Diagnosis of clubfoot in children under 3 months. carried out using ultrasound, in older children - using x-ray examination. Treatment is carried out by an orthopedist and includes wearing orthopedic shoes, massage, gymnastics, physiotherapy, and possibly the use of plaster casts and special splints.

ICD-10

Q66.8 Other congenital foot deformities

General information

(foot equinovarus deformity) is one of the most common developmental anomalies of the musculoskeletal system (33-38%). As a rule, it occurs on both sides. Clubfoot is diagnosed twice as often in boys as in girls.

Causes of clubfoot

The reasons for the development of pathology are not completely clear. It is believed that risk factors for clubfoot may include fetal position abnormalities, lack of amniotic fluid, smoking, alcohol and drug use. Due to the adverse effects on the fetus, the development of the bones of the foot, muscles and nerves of the lower leg is disrupted. Secondary clubfoot is possible, resulting from pathology of other parts of the musculoskeletal system.

Classification

Subsequently, children with clubfoot are prescribed physical therapy, massage, therapeutic exercises, and wearing orthopedic shoes. At night, special polyethylene splints are placed on the legs. If conservative correction of clubfoot is ineffective, surgery is performed. Surgical treatment is carried out when the child reaches the age of 1-2 years and includes plastic surgery of tendons, ligaments and aponeuroses of the foot. In the postoperative period, plaster casts are prescribed for up to six months.

Incorrect foot placement while walking is a serious problem for humans. The roots of this pathology go back to early childhood and, possibly, during fetal development. On the path of life, each of us has probably met people who placed their feet incorrectly when walking and wore special shoes.

Medical experts say that orthopedic problems in childhood are quite common. For example, doctors often have to diagnose club feet in young children.

This pathological condition deserves separate consideration. After reading this article, you will learn what childhood clubfoot is, what stages of the disease exist, is it possible to cure it, what symptoms indicate developing clubfoot?

The topic of diagnosing the pathology in question and methods of correction (treatment) existing in modern medicine will also be touched upon.

Clubfoot is a pathological condition of the human musculoskeletal system, which develops due to improper placement of the foot on the heel. Clubfoot usually develops in infancy. A young child develops foot deformities (on one or both legs) and, as a result, is unable to place his heels flat.

Children's clubfoot can be acquired or congenital. Congenital clubfoot is diagnosed by a doctor during an ultrasound examination already in the 2nd trimester of fetal development. After a baby with signs of pathology is born, he is examined by a neonatologist. If a specialist sees signs of foot deformation, he gives the little patient an accurate diagnosis. Congenital clubfoot can affect only one child’s foot, or two at once.

There are many cases where clubfoot is not diagnosed immediately after birth, but 2-3 years after the baby is born. The child begins to place his legs incorrectly, his gait changes, and his knees point inward.

There are several factors that indicate that a newborn baby suffers from clubfoot.

• when lowering the foot, the heel still remains raised;
• the outer edge of the foot drops greatly;
• the inner edge of the foot becomes too elevated;
• the big toes point inward.

If a neonatologist suspects a clubfoot in a newborn child, he sends him and his parents for examination to an orthopedist. Mild forms of foot deformity are the easiest to correct. Work on eliminating moderate clubfoot is more difficult, but severe pathologies cannot be completely eliminated.

Stages of the disease

The problem of clubfoot can be corrected, but in order for the doctor to be able to correctly develop a treatment program, he needs to know the severity of the pathology. Now in medicine there are several types of classification of childhood clubfoot. Basically, specialists focus on the possibility of correcting foot defects caused by deformities using passive methods. In this case, there are 4 forms of clubfoot.

1. Easy. Correction of deformed areas occurs without problems, unnecessary effort and pain.
2. Average. The child suffers from limited movement in the ankle joint. When the doctor begins to work on eliminating the defect, springy resistance of the muscle tissue is observed.
3. Heavy. Movement in the foot is severely limited (as well as in the ankle joint). It is no longer possible to manually correct such a defect - a small patient requires surgery.
4. Extremely heavy. It will not be possible to completely eliminate the pathology.

There are several other variants of the classification of childhood clubfoot, developed by qualified medical specialists, orthopedists who have the status of professors and doctors of medical sciences. The following table presents the most famous of these options.

Full name of the scientist	Aspects of classification
T. S. Zatsepin	Professor and Doctor of Medical Sciences T. Zatsepin back in 1947 proposed classifying congenital clubfoot into 2 groups. The 1st includes typical pathologies, namely: Ligamentous clubfoot, in which the subcutaneous layer of fat is clearly visible and there is high skin mobility; Bone form of clubfoot, characterized by minimal skin mobility (it is the most difficult to cure); Internal deformations of the bones of the lower extremities, their displacement to the side relative to the center line of the body. Category 2 includes atypical forms of congenital clubfoot, resulting from defects in bone development, arthrogryposis, or amniotic processes. The classification of congenital foot anomalies, formed by Zatsepin, is still used in the work of many orthopedic doctors.
G. S. Bohm	Professor and Doctor of Medical Sciences G. Bohm in 1935 developed his own version of the classification of forms of clubfoot in children. Late clubfoot, when the child has a clearly visible transverse groove on the sole of the feet, the heel is well developed, and the signs of pathology are weakly expressed. This type of clubfoot is easily corrected. Neurogenic clubfoot. Similar to polio-type pathology, characterized by frequent relapses and treatment difficulties. Clubfoot of the amniotic type, which is a congenital pathology of the foot. Too tight, underdeveloped heel, dense muscles on the back of the lower leg. Anomalies of this type are difficult to correct. Arthrogrypotic clubfoot, which develops as a result of damage to the spinal cord by arthrogryposis. Varus deformities of the feet. This pathological condition creates a cosmetic defect and difficulties in choosing shoes. A fold appears on the sole. This pathology does not cause functional disorders or deformations of the secondary type. At the genetic level, the growth of bone tissue is impaired, and against this background clubfoot develops. Treated clubfoot that is difficult to correct. Congenital skeletal defects cause the development of defective clubfoot.
I. Ponseti	An orthopedist from America named I. Ponseti in 1950 proposed his classification of foot deformities in clubfoot. An untreated pathology that is congenital or diagnosed in children under 8 years of age. Corrected clubfoot treated using Ponseti techniques. Resistant is a type of deformity that occurs against the background of various syndromes (for example, arthrogryposis). Recurrent. Supination (curvature) of the foot continues after initial corrective techniques are applied. Atypical. The child is diagnosed with shortening of the big toe, the presence of a fold on the plantar part of short and thick feet, and a similar fold behind the ankle joint. Many clinics in Russia that correct pathological foot deformities in children use the classification created by Ponseti in their work.

Congenital clubfoot

Congenital clubfoot is easily diagnosed even at the stage of intrauterine development of the fetus, starting from the 16th week of pregnancy. An experienced neonatologist can immediately determine the presence of foot deformities in a newborn baby.

Acquired clubfoot in young children is easily diagnosed at 2-3 years of age. Its development occurs due to the fact that a large load is created on the baby’s legs. The child grows, quickly gains weight, his bones change their shape, but tendons and muscles develop more slowly.

Because of this, the tone of certain muscle groups is increased, while others are completely relaxed. This difference between muscle groups leads to foot deformities.

An example photo of a clubfoot can be seen below:

This is what congenital clubfoot looks like

Why can a child develop clubfoot?

There are several reasons that cause clubfoot in young children.

If the baby’s pathology is congenital, then the prerequisites for its development may be:

improper behavior of a woman during pregnancy;

• oligohydramnios;
• severe toxicosis;
• viral infections;
• a woman’s use of alcohol, potent drugs, smoking;
• vitamin deficiency during pregnancy;
• amniotic processes caused by pressure on the fetus from the muscles of the uterus;
• in the later stages of intrauterine development, the fetus is positioned incorrectly;
• multiple pregnancy.

The development of acquired clubfoot does not occur very often. This type of pathology manifests itself in infancy, but sometimes clubfoot is diagnosed in children aged 14-15 years.

The causes of foot deformities are:

• genetic predisposition;
• polio, rickets, bone dysplasia;
• abnormal development of ligaments and muscles;
• lack of mineral components and vitamins;
• inflammatory diseases;
• tumors;
• neurological disorders;
• loads on the child’s musculoskeletal system that are incommensurate with the norm for his age;
• severe tension on the lumbar muscles, problems with the spine;
• incorrectly chosen children's shoes;
• serious bruises, injuries to the lower extremities, burns, fractures, sprained ligaments or muscles.

Early diagnosis of childhood clubfoot will allow timely correction of the pathology.

Symptoms and signs of clubfoot in children

The symptoms of clubfoot are determined depending on the form of the pathology.

Congenital clubfoot is determined by the following characteristics:

• feet arched outward or inward;
• twisted shin bones;
• the soles of the feet are strongly bent;
• the foot is unnaturally turned.

In a newborn baby, the legs in the foot area have external signs of underdevelopment due to the fact that the volume of the lower leg is reduced. The situation worsens when the child begins to walk, getting to his feet. If a baby is diagnosed with congenital clubfoot, he learns to walk late. If the pathological deformities are one-sided, then the child limps when walking. If the congenital deformation of the feet is bilateral, then the baby’s gait is a waddle, similar to the movements of a baby penguin or duckling.

The baby stands on the outer part of the feet, because his peroneal muscles atrophy, and the skin on the foot itself is damaged, calluses and mucous bags appear under the skin.

At an older age (7-9 years), such pathologies lead to rapid fatigue of the child when walking.

As for the symptoms of acquired clubfoot, the main ones are:

• change in gait, which is caused by incorrect placement of the feet when walking;
• during games or walking, the toes of both legs (or only one of them) are turned inward;
• the child places his feet incorrectly on the floor, and parents can see this fact by his footprints in wet sand or snow (when the imprint of the foot with a foot defect is turned towards the other limb);
• the baby's knees turn inward;
• the ankle joint is inactive;
• deformations of the feet are especially noticeable at the moment when the baby is sleeping and the muscles of his body are completely relaxed;
• inward deviation of the big toe (with the formation of bumps on the inner edge of the foot).

Features of clubfoot diagnosis

Diagnosis of clubfoot in children can occur both at the stage of their intrauterine development and after birth.

If a doctor monitoring the course of a woman’s pregnancy suspects the baby has clubfoot, he may prescribe the expectant mother to undergo additional ultrasound diagnostics, as well as computed tomography.

When diagnosing deformities of a child's foot, the X-ray method does not always provide a complete picture. This happens because all the baby’s bones have not yet formed and contain a lot of cartilaginous tissue. It is often difficult to see them on X-ray images.

It is also not difficult to recognize acquired clubfoot. Attentive parents will probably be able to see that the baby has some kind of pathology of the legs, and immediately contact a pediatrician or surgeon. A specialist, taking into account the characteristic complaints from adults, will be able to draw up a clinical picture of the disease, as well as by conducting an external examination of the lower extremities of a small patient (feeling the fingers and the foot itself, checking the level of their functioning and determining how serious the pathology is).

A complete diagnosis of clubfoot in a child involves an ultrasound scan of the deformed foot, and, if necessary, a computed tomography scan.

When diagnosing clubfoot, several important measures are taken:

• obtaining advice from a neurologist (this specialist will help eliminate the impact of neurological factors on the processes of foot deformation);
• X-ray (a photo of clubfoot helps determine how serious the level of pathological processes (which develop in the child’s foot), deformities of joints and bone tissue);
• A general analysis of urine and blood allows the doctor to find out about the health status of a small child;
• Using ultrasound and computed tomography, a hospital specialist determines the extent of soft tissue damage, as well as the condition of ligaments and muscles.

How to treat

Treatment of clubfoot in children involves the use of several methods and techniques.

After a thorough diagnosis, the doctor creates an individual plan for comprehensive treatment and the maximum possible correction of foot deformity.

Massage for children's clubfoot

Based on the diagnostic results, the orthopedic doctor determines how many sessions of therapeutic massage the baby must undergo in order for the correction of foot deformities to be successful. If recovery is slow, the specialist increases the number of massages. It is worth noting that therapeutic massage has certain differences from classical, restorative massage. And therefore it is better to do it with the help of an experienced massage therapist.

Before starting the session, it is necessary to warm up and relax the lower leg muscles well. To achieve this effect, a good massage therapist performs a set of measures:

• uses special compounds and oils for massage;
• performs vibrating movements;
• stroking;
• muscle shaking.

Gradually, the massage therapist increases the intensity of his movements, he kneads and rubs the muscles in the area of ​​​​the feet and legs.

Good exercises and exercise therapy to correct pathology

Correction of clubfoot is carried out not only with the help of massage. Modern medicine also uses exercise therapy (physical therapy), which helps if you start doing exercises with the child as early as possible (3-4 weeks after birth). It is during this period that the baby’s muscles and ligaments remain pliable.

The following exercises help with clubfoot:

• flexion and extension of the legs (at first – alternately, then – simultaneously);
• flexion of the feet;
• lower limb raises;
• performing circular movements with the feet;
• walking with support.

Immediately after performing therapeutic exercises for clubfoot, it is recommended to apply a soft fixing bandage using the Finnk-Etingen method.

Leg casting

Questions related to how to treat clubfoot can be resolved using the Ponseti technique. It involves casting a small child’s legs up to the knee, and also has a second name – “boots” (for its similarity to this type of shoe). The basis of the proposed method is to alternately cover the legs with a plaster solution with bandages.

1. Immediately before applying plaster and applying bandages, a pediatric orthopedist performs his manipulations to relax the muscles of the legs and feet.
2. A plaster bandage is applied to the little patient’s leg, which looks like a boot.
3. The doctor recommends wearing such a bandage for 1 week.
4. Then the plaster is removed, and the small leg is fixed in the direction of the correct position.
5. The plaster is reapplied.
6. The orthopedic specialist continues the above procedure until the required correction result is achieved.

In order for casting for clubfoot to give a positive result, it is often supplemented with other effective procedures. For example, a child is recommended to wear special orthopedic devices with fixing properties, take pine baths or paraffin applications.

Kinesiotherapy, as well as other physiotherapeutic techniques, help well with such foot pathologies. After the casting procedure is successfully completed, the baby is sent for exercise therapy and massage sessions, and is also prescribed to wear special orthopedic shoes. All this helps to consolidate the achieved results.

What shoes should a child wear with club feet?

Orthopedic shoes for clubfoot in children are one of the most important conditions for the correct correction of the pathology. You can purchase it in a specialized store, focusing on the following criteria:

• the presence of hard backs;
• pads that will well fix the ankle part of the lower extremities;
• equipping shoes with instep supports.

Sometimes the treatment of childhood clubfoot requires wearing orthopedic shoes with a complex design, called braces. It consists of boots that are fixed on a metal or plastic bar at a certain angle of inclination. Such shoes are often used to consolidate the results of surgical treatment of clubfoot or leg casting.

It is recommended to wear the braces around the clock, removing them only before swimming. Duration of wearing is 2-3 months (depending on the complexity of the problem). There is another recommendation, according to which braces should be worn before daytime or nighttime sleep until the age of 3.

What complications can occur with clubfoot?

Clubfoot is a pathology that, if left untreated, leads to certain complications. The main one is lameness. The English poet Byron suffered from congenital clubfoot, which resulted in lameness. The Olympic champion in figure skating, winner of the 1992 gold medal for winning the Olympic Games held in Albertville, Kristi Yamaguchi, had the same diagnosis. The girl’s treatment program included regular skating.

Statistics show that acquired clubfoot in a child often develops as a result of the dishonesty of his parents. They prefer not to notice that the baby has an incorrect gait. If you do not pay attention to the signs of clubfoot and do not take any therapeutic measures, then the following complications develop:

• on the outer part of the feet the skin becomes rough, cracked and injured;
• the functions of the knee joints are impaired;
• leg muscles atrophy;
• the spine is bent;
• subluxation of the bones of the foot occurs.

If clubfoot is neglected too much, the child risks remaining disabled and will only be able to move around with the help of crutches for the rest of his life. To prevent this, it is necessary to begin treatment for clubfoot in a timely manner, as well as adhere to certain preventive measures.

Prevention of pathology

photo of clubfoot

Preventing clubfoot in a young child is not difficult. The main thing is to promptly cure all diseases during pregnancy (and ideally, prevent their development at all), and control the gait of your baby. Prevention of clubfoot should be comprehensive and include the following procedures:

• massage;
• water baths;
• walking on a massage mat or fractional natural materials (sand, pebbles), as well as on grass;
• taking foot baths;
• playing sports (cycling and swimming are good for clubfoot);
• electrophoresis.

A child suffering from clubfoot should eat foods rich in calcium. Gymnastics should also be performed for clubfoot, which will strengthen the muscles. It is better not to use walkers as an aid for clubfoot, as they will not help you master walking skills. It is better to select shoes for children with club feet so that they are 12 mm longer than the foot.

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Clubfoot occurs less frequently in adults than in children, but it causes great inconvenience to a person. Incorrect foot position causes poor posture, back pain, and displacement of internal organs. Treatment of adult clubfoot is much more difficult than that of children.

Causes

In the vast majority of cases, clubfoot in adults is the result of an untreated foot problem in childhood. Primary clubfoot in adults is quite rare and is usually associated with serious injuries to the arch of the foot.

Sometimes clubfoot is congenital and occurs as a result of a violation of the formation of the skeleton in the prenatal period. But more often, curvature of the foot is associated with the following reasons:

• Rickets;
• Hormonal pathologies;
• Myasthenia;
• Injuries of the musculo-ligamentous apparatus of the foot;
• Wearing uncomfortable shoes;
• Overweight;
• Curvature of the legs.

Clubfoot that started in childhood is very difficult to cure in an adult.

How it develops

Under the influence of one or more of these reasons, a restructuring of the bone apparatus of the foot occurs. The bones that make it up begin to change their shape, taking on a non-physiological position. Ligaments and muscles gradually adapt to the changed shape of the foot skeleton. This is how clubfoot develops.

What does it look like

Signs of clubfoot in adults differ slightly from those in childhood. The most characteristic symptom of clubfoot is the inability to place the entire sole of the foot on the floor. The foot turns out to the right or left, part of the heel is raised up. Most often, the foot turns inward, and the person rests on its outer side.

An adult with club feet has a characteristic “Winnie the Pooh” figure. Incorrect foot position leads to flattening of the lumbar spine and arching of the thoracic spine. As a result, the back is rounded and the buttocks are raised. The waddling gait typical of clubfoot develops.

There are 4 stages of clubfoot development:

• Easy. Pathological changes are minimal and can be corrected by wearing orthopedic shoes, massage, and gymnastics;
• Average. The changes are more pronounced, pain appears, and the position of the ankle joint changes. Treatment is more complex and lengthy;
• Heavy. The curvature of the feet and ankle joint is very pronounced. Correction is only possible surgically;
• Extremely heavy. Pronounced deformity of the limb. There is a curvature of the spine, a change in the position of the internal organs. This stage cannot be treated.

Upon examination, you can see the following signs of pathology:

• Raising the front of the foot;
• Uneven location of the outer and inner edges of the foot;
• Limitation of movements of the ankle joint;
• High arch of the foot;
• Curling your fingers inward.

Interesting!

With the development of severe or extremely severe clubfoot, a person becomes disabled.

Diagnostics

The diagnosis of clubfoot is made based on characteristic symptoms. To determine the degree of clubfoot, an x-ray examination is required. The x-ray shows the displacement of the bones of the foot relative to each other. The more pronounced the displacement, the more severe the degree of clubfoot.

Severe clubfoot in an adult is accompanied not only by displacement of the bones, but also by the development of their deformation.

Treatment methods

How to stop clubfoot - an adult cannot cope with this disease on his own. Treatment for clubfoot should be prescribed by an orthopedic surgeon. A combination of different conservative methods is used, and if they are ineffective, surgical ones.

Shoes

Explaining how to get rid of clubfoot in adults, doctors point out the importance of wearing orthopedic shoes. In it, the foot acquires a physiological position, its further displacement does not occur. High heels for adults with club feet are strictly prohibited. The maximum heel height should not exceed two centimeters.

Correct therapeutic shoes for clubfoot have instep supports on the inside of the sole, a hard heel, and a tight toe. This ensures maximum support for the foot. A person with club feet needs to wear orthopedic shoes at all times.

Massage

It is impossible to completely eliminate the problem with massage. But massage is a mandatory step in the treatment of clubfoot. It helps strengthen muscles and ligaments, relieves pain, and eliminates spasms. Massage is carried out daily, before bedtime. For massaging, you can use various oils or pain-relieving gels.

Drug treatment

Taking medications is indicated if the cause of clubfoot is a pathology of the nervous system. To restore neuromuscular transmission, the drug Prozerin is used. It is used in the form of intramuscular injections. The drug is prescribed according to strict indications, as it has significant side effects.

Prozerin can only be prescribed by a doctor; treatment is carried out under medical supervision. It is easy to overdose on the medicine, resulting in serious cardiac dysfunction.

Symptomatic drug treatment of clubfoot involves taking painkillers, drugs to improve blood circulation, vitamin-mineral complexes, and chondroprotectors.

Gymnastics

An important stage in the treatment of clubfoot in adults is therapeutic exercises. With its help, the muscular-ligamentous apparatus is strengthened, the bones of the foot are returned to the correct position. The greatest effect from gymnastics is obtained if it is performed constantly, regularly.

The necessary exercises for clubfoot are selected individually for each person by an orthopedic doctor or exercise therapy specialist. For gymnastics, special equipment is used - gymnastic sticks, expanders, mats.

Operation

How to correct severe clubfoot in an adult - in this case, only surgery can help. The operation consists of eliminating bone deformities, giving the bones the correct position, and suturing the muscular-ligamentous apparatus.

But surgical intervention is not always effective in eliminating clubfoot. Severe bone deformities cannot be completely corrected. In such cases, partial restoration of the arch of the foot is performed.

Forecast

The most common complication of adult clubfoot is varicose veins of the lower extremities. This is due to the fact that incorrect foot placement leads to disruption of the venous outflow in the legs.

Often an adult with clubfoot suffers from dislocations of the knee or hip joint. With severe disease, scoliosis develops.

Treatment will be effective only at the initial stage of the disease. In all other cases, irreversible changes develop in the limb, spine, and internal organs.

Treatment of clubfoot in adults is a complex process. This is due to the fact that after 18-20 years, bone growth stops, they become strong and are less amenable to correction. The elasticity of the ligamentous apparatus decreases. However, correcting clubfoot is possible if you do it at an early stage of the disease.

“Clubfooted bear” - this phrase evokes a variety of associations in adults and children: a cute character from a fairy tale, a brand of delicious candy from childhood, various songs and rhymes for kids. But when doctors diagnose a child with clubfoot, parents cease to understand what it is and where it came from. In this article, we will consider the phenomenon of clubfoot in children, we will talk about its symptoms and the treatment prescribed by doctors.

Clubfoot is a fairly common defect of the musculoskeletal system, which consists of incorrect position of the foot; At the same time, babies cannot fully place their feet on the floor.

Classification of clubfoot

Clubfoot can be unilateral or bilateral, congenital or acquired.

The anomaly can be unilateral or bilateral, congenital or acquired, and also typical and atypical.

Typical form Clubfoot occurs due to a defect in the development of muscles, ligaments and tendons. This pathology usually does not extend beyond the foot and is divided into three types:

• varus contractures (grade I), which are characterized by a mild course and respond well to treatment with manual correction;
• soft tissue form (II degree), a less common type of clubfoot, in which significant soft tissue resistance is observed when attempting manual correction to eliminate the defect;
• bone form (III degree), a very rare defect, which consists of persistent deformation due to severe changes in the soft tissues and bones of the foot, while the work of the joint is very limited; not amenable to conservative treatment.

Atypical form Clubfoot occurs as a consequence of serious disorders of the musculoskeletal system:

• the formation of arthrogryposis, a disease of the musculoskeletal system, which is characterized by multiple joint damage, muscle atrophy and deformation of the limbs, as a result of which the patient’s movements are very limited;
• dysostosis, or hereditary skeletal diseases, the main symptom of which is the formation of bone tissue in uncharacteristic places, for example, instead of cartilage;
• osteochondrodysplasia, a group of congenital hereditary diseases that are characterized by disturbances in the embryonic development of the osteochondral system in the fetus and manifest themselves in skeletal defects due to improper maturation of cartilage tissue;
• longitudinal ectromelia: birth defect or absence of bone;
• amniotic bands (fusions, Simonard's bands): soft threads that connect the two walls of the uterus; most often they do not affect the course of pregnancy and childbirth, but can cause congenital clubfoot;
• congenital defects of the lower leg bones, for example, underdevelopment of the tibia.

The disease is distinguished by the degree of clubfoot:

• mild, that is, movements in the ankle joint are preserved, this degree is well treated;
• moderate, that is, movements are limited, the disease is difficult to correct;
• severe degree, in which only surgery is indicated; Conservative treatment methods are powerless in this case.

Congenital clubfoot (newborn clubfoot)

A birth defect is not so difficult to see already at 16 weeks of fetal development, when an ultrasound is performed. When the baby is born, the neonatologist may notice signs of clubfoot. Four main symptoms are enough to make a diagnosis:

• equinus: the outer edge of the foot is lowered, and the inner one, accordingly, is raised, while the back side looks towards the other foot;
• varus: a deformity of the foot in which the emphasis is on the outer part of the foot;
• torsion (twisting) of the leg bones outward;
• adduction (adduction): full rotation of the foot, in which the sole of the foot points upward (relates to a severe degree).

There are a few additional signs:

• the heel is raised up, while the toe of the foot is down and looking down;
• the foot is smaller in size than it should be;
• inflection: transverse bending of the sole, which forms Adams' groove;
• mobility in the ankle joint is limited;
• The heel axis is shifted inward compared to the shin axis.

There can be many causes of congenital clubfoot.

Mechanical reasons, which arise due to strong pressure from the walls of the uterus on the feet of the fetus. Most often this occurs with oligohydramnios and abnormal position of the fetus in the uterus (postural clubfoot).

Genetic causes, for example, Edwards syndrome, a hereditary disease that occurs due to the tripling of the 18th pair of chromosomes and is characterized by multiple malformations. When diagnosing clubfoot, in no case can a hereditary factor be excluded when there have already been cases of this disease in the older generation in the family.

Neuromuscular causes(pathologies in fetal development):

• primary nerve fiber deficiency;
• disorders of the development of muscles and ligaments that occur as early as 8-12 weeks of fetal life;
• pathological course of pregnancy, vitamin deficiency;
• drugs the mother used during pregnancy.

Acquired clubfoot

Impaired foot placement in healthy children begins to appear at 2-3 years of age, with the following signs gradually developing:

• change in gait (“bearish” gait - when walking, the child seems to “rakes” with one leg);
• the baby places his feet incorrectly; this can be seen in its tracks in the snow or wet sand, when the track from one leg is steadily turned towards the other;
• knees often point inward;
• poor mobility of the ankle joint;
• the disorder can be noticed when the child is sleeping and his muscles are relaxed;
• the big toe deviates inwards: hallux valgus, with the formation of lumps on the inner edge of the foot.

Acquired clubfoot, like congenital clubfoot, has many causes:

• underdeveloped bones of the baby, their dysplasia (impaired development and growth of tissues and organs);
• disorders of the nervous system, for example, with pyramidal insufficiency, flaccid and spastic paralysis appears;
• acute inflammatory processes of various etiologies;
• improper fusion of the bones of the foot or leg after a fracture;
• rickets;
• foot burns and leg injuries;
• incorrectly selected shoes.

Clubfoot develops due to increasing stress on the child's legs. He gains weight, bones grow quickly and change shape, while muscles and tendons develop more slowly and cannot keep up. Therefore, some muscle groups are in increased tone, while others, on the contrary, are completely relaxed. This manifests itself in the form of foot deformation.

Complications

You should not let the disease take its course, hoping that everything will go away with age. Clubfoot is not only accompanied by other diseases of the musculoskeletal system (flat feet), advanced disease can lead to disability and a number of complications:

• atrophy of entire muscle groups;
• subluxation of the bones of the feet;
• roughening of the skin on the outside of the feet;
• dysfunction of the knee joints.

Diagnostics

Congenital clubfoot can be diagnosed during pregnancy with an ultrasound scan or in the first month of the baby’s life when examined at a doctor’s appointment. Attentive parents themselves can notice that the child’s legs are not all right and contact a pediatrician or pediatric surgeon.

Acquired clubfoot can also be easily diagnosed based on the characteristic complaints of parents. After which the doctor will carefully feel the foot and toes, checking their functioning and determining the severity of the pathology.

The most reliable examination methods that will confirm the diagnosis are ultrasound of the foot and computed tomography.

It should be noted that an x-ray is not always informative, since it may not reflect the whole picture completely. And all because the child’s small bones are not yet formed and consist of cartilaginous tissue, which is never clearly visible in the picture.

Conservative treatment of clubfoot

Basic principles for successful treatment of any type of clubfoot:

• timely early start of treatment;
• constant observation by an orthopedic surgeon;
• patience and perseverance of parents.

All conservative treatment methods are aimed not only at correcting the defect, but also at consolidating the results of therapy.

Treatment of congenital clubfoot

Acquired clubfoot in children is treated using special orthopedic shoes.

The diagnosis of congenital clubfoot is made in the maternity hospital. About a week after birth, treatment can begin. It is performed on an outpatient basis under the supervision of an orthopedist. But sometimes inpatient or sanatorium treatment is required.

The baby's foot is fixed with a plaster cast, which is changed every week until the result is achieved - the maximum possible correction of the foot for the type of deformity that was diagnosed. This is the best and simplest treatment option, since the bones at this time are still soft and easy to adjust. After the cast is removed, and to avoid relapses, a splint is specially made for children, which is worn only at night.

Many doctors adhere to the technique proposed by Vilensky. It is effective for treating not only infants, but also older children. With such complex therapy, the result is achieved 2-3 times faster than with treatment with stage-by-stage plaster casts alone. In addition, the technique often helps in cases where orthopedists are already ready to prescribe surgery. It is for her excellent results that many surgeons and orthopedists love her so much.

The main directions of therapy according to Vilensky:

• step-by-step plaster casting (“boots”);
• splints, or special orthopedic devices for fixation (complete immobilization) of joints;
• physiotherapy: paraffin baths;
• kinesiotherapy: a separate direction in physical therapy, which consists of treatment with movements and special loads;
• therapeutic exercises: a set of special exercises shown by an orthopedist;
• relaxing massage of the muscle group responsible for clubfoot, prescribed by a neurologist;
• warm baths, especially with the use of pine extract, which helps reduce hypertension and overall strengthen the body.

The most common treatment method in our country is staged plaster casting. First, the orthopedic surgeon lightly kneads the baby's leg (without forceful techniques). As soon as it begins to give in a little, the surgeon applies a plaster cast in the form of a boot. She's been carrying her baby for about a week.

At the next appointment with the doctor, the plaster is removed, the orthopedist again stretches the leg, gradually correcting its position, which is again fixed with another plaster “boot”. And so on several times until the doctor achieves the desired result in correcting the foot. This treatment is carried out for a year along with paraffin applications, after which children are recommended to wear orthopedic shoes to consolidate the result.

There are many other methods for treating clubfoot. In addition to plaster casts, soft bandaging, splinting and splinting are used to immobilize the joint. As well as drug treatment with Botox.

Botox is a drug containing botulinum toxin type A, which affects the nerves. So, for clubfoot, Botox is injected into the calf muscle, which causes muscle relaxation. Over the course of about a week, the Achilles tendon weakens. This allows the foot to take the correct position for 1-1.5 months.

The effect of the injection lasts about 3-6 months. Despite the fact that, unlike surgery, Botox does not have such a long-lasting effect, it allows you to correct minor foot defects without scars and long-term painful procedures. If necessary, the injection can be repeated.

But it should be remembered that the method of treatment always depends on the severity of the disease, the causes of its occurrence, the age of the child and the individual characteristics of his body. It is selected only by a doctor after an adequate assessment of the baby’s condition.

Treatment of acquired clubfoot

First of all, you need to determine and eliminate the cause of the disease.

Next, as in the treatment of congenital clubfoot, fixation is carried out, massage and a set of exercises are prescribed. Older children benefit from special orthopedic shoes with a hard back and a block that secures the ankle joint.

Usually the course of treatment takes 2-4 months. It is necessary to carry out 3-4 courses per year until the clubfoot problem is eliminated.

If conservative treatment does not help, the child has an advanced form or a severe course of the disease, surgery is performed.

Surgical treatment of clubfoot

Surgical treatment is resorted to in cases where the foot refuses to assume a normal position, despite all the measures taken, or the child has a severe pathology that cannot be treated conservatively. In such cases, surgery is necessary to correct the ligaments, tendons, joints of the foot and ankle.

It is advisable to correct congenital clubfoot when the child is 8-9 months old. This is due to the fact that treatment must be completed before the baby begins to walk independently.

For the surgical treatment of children under one year of age, several proprietary methods have been created that have proven good results: the operation proposed by N.N. Makov and co-authors, as well as O.A. Batalov and I.V. Musikhina.

Ponsetti method is an original technique developed by an American doctor. Therapy can be started at the age of 1-2 weeks. First, a step-by-step casting of the leg is performed from the toes to the upper third of the thigh. Its distinctive feature from the domestic method is that the position of the foot is corrected in several planes at once. Therefore, for such treatment the doctor must be specially trained. At the first stage of treatment, the plaster cast is changed approximately 6-7 times, while the position of the foot gradually changes and the ligaments are stretched. When there is very little left before the defect is completely corrected - a few degrees - the doctor performs a small operation on an outpatient basis under local anesthesia. The technique is simple: a small incision is made in the Achilles tendon to give the foot even more freedom.

As soon as the leg is in the correct position and the wound has healed, the child begins to wear braces (complex orthopedic shoes) to prevent recurrent clubfoot. At first they need to be worn 23 hours a day. Gradually this time decreases. By the age of two, braces can only be worn at night.

Relapses after treatment using the Ponsetti method are rare. In such cases, repeated staged casting is carried out (usually shorter) and wearing braces is again recommended.

This method is described in the attached video:

The advantages of the method are obvious. This is not only a low relapse rate. This operation is less traumatic, and the wound practically does not hurt after it. With this method of treatment, the muscles of the feet are more flexible and strong than with the traditional one, when in any case muscle stiffness and frequent pain in the leg occur.

Children aged 2-7 years undergo a different operation - tendon plastic surgery according to Zatsepin- another method of surgical treatment of clubfoot, which is used by almost all surgeons.

In case of congenital deformity of shortened or deformed bones of the lower leg, the first step is a corrective osteotomy followed by the use of an Ilizarov apparatus: a medical device that is designed for long-term fixation of bones. It is used to perform distraction (stretching) or compression (squeezing) of bone tissue.

Acquired clubfoot should be treated by removing the defects that caused it: scars, injured muscles, nerves, tendons and ligaments.

Paralytic clubfoot, which occurs due to damage to the peroneal nerve and muscles, or as a result of polio, is eliminated by repairing the tendons or damaged nerve. In this case, the tibialis anterior or posterior tendon is sometimes transplanted to the outside of the foot.

Another type of surgical intervention is arthrodesis. This is an operation whose essence is to fix the bones in the joint. At the same time, its complete immobilization is achieved and the ability to support increases. The best results are achieved by calcaneocuboid and subtalar arthrodeses.

In case of severe deformation of the foot due to rough scars resulting from severe burns and injuries, the scars are excised and the tendons are restored. Then skin autoplasty is performed (transplantation of the patient’s own tissues).

Deformities that arise as a result of injury or osteomyelitis are eliminated by corrective osteotomies with osteoplastic surgeries. Often, an Ilizarov compression-distraction apparatus is used.

Subsequently, for another year after surgical treatment, the child needs to wear special orthopedic shoes or braces used for walking.

After surgery, despite the obvious effect, the foot muscles still become more rigid (hard, elastic), the operated leg often hurts, is significantly weaker than the healthy foot and is 1-1.5 sizes smaller.

Prevention of clubfoot

Walking barefoot on pebbles is very good for your feet.

Everyone knows that it is better to prevent any disease than to treat it later. The same applies to clubfoot. By following simple rules, you don’t have to worry that this disease will disturb your child.

To prevent congenital clubfoot, you need to avoid causes that can trigger the disease:

• lead a healthy lifestyle during pregnancy;
• get proper nutrition, follow a daily routine.

After the birth of the child, new rules are added:

1. Always look closely at the footprints a child leaves in wet sand or snow. They should be parallel, and the toes should be slightly apart.
2. It is also necessary to monitor the baby’s gait, especially if the parents are already alerted to his tracks. It is best to do this in the morning, when the child is sleepy, or during play, when he is interested in the process. At such moments, he does not monitor his gait, and deviations can be noticed. If, when walking, the baby turns his socks inward or walks, raking with his foot, then you should visit an orthopedist.
3. Physical exercises are useful for the child: slow running, jumping from a squatting position, walking on bent legs. Cycling, snowboarding or skateboarding help a lot. Only the child must watch himself so as not to cramp his legs.
4. You should not overtire your baby with long walks, especially when he is just starting to walk. It is better to take a bicycle or stroller with you.
5. Particular attention should be paid to children with excess weight, which is an additional load on the baby’s spine and feet; as a result of disorders, not only clubfoot can develop, but also flat feet with various curvatures of the spine.
6. Swimming is the best preventive measure for many diseases of the musculoskeletal system, including clubfoot and flat feet.
7. A child’s nutritious diet must include fish, milk, cottage cheese and other fermented milk products, which. It should be varied and nutritious, containing all the vitamins, micro- and macroelements necessary for a growing body.
8. The child should wear only high-quality shoes with good arch support and a hard heel. If parents notice an emerging clubfoot, under no circumstances should they swap boots or shoes. This will not improve the situation, but will only make it worse.
9. Walking barefoot on sand, pebbles, and grass is useful not only for adults, but also for children.
10. When performing morning exercises, you need to evenly pay attention to different muscle groups. Walking up and down stairs is also helpful.

Summary for parents

Parents should remember that clubfoot often accompanies other disorders of the musculoskeletal system: scoliosis, flat feet, so in no case should the disease be left to chance, hoping that it will go away over time.

It is imperative to seek help from an orthopedist, otherwise the disease will inevitably progress. Subsequently, one leg may grow shorter than the other; the child will limp, will not be able to fully move and play with peers; There will be problems with choosing shoes. As a result, the child may become disabled.

As for how to treat clubfoot, it directly depends on what type of disease it is. Mild clubfoot can be treated even at home. For this purpose, special gymnastics and massage are used.

With moderate and severe clubfoot in children, there is already a limitation in ankle movements. If you try to normalize the position of your leg, you will feel serious resistance. Depending on the severity of flat feet, a stronger or weaker support will be observed. In severe forms of flat feet in children, limited movement is already noted. Sometimes it is not even possible to bring the position of the feet back to normal with your hands. These are already advanced cases - it is unlikely that orthopedic shoes or massage treatments will help completely correct the situation.

The classification of clubfoot in children can be different. This disease can be congenital or acquired. In addition, there is recurrent clubfoot, in which the problem returns again after a certain period of time.

The components of clubfoot can also be different:

• heel turned inward or facing upward with a significant increase in the foot;
• the edge of the foot is curved in the wrong direction.

There can be many variations of clubfoot in children. Depending on how exactly the leg is curved, treatment will be prescribed. There is no point in trying to cope with the problem on your own, since only an experienced orthopedist can prescribe truly effective treatment.

Diagnosis of the disease

To make a correct diagnosis, doctors use various methods. Clubfoot in children is most often well expressed and noticeable even to the naked eye. However, sometimes it is necessary to use additional diagnostic procedures to clarify the type of disease.

Specialists can prescribe not only ultrasound and computed tomography, but also blood tests. This is important, since clubfoot in children is often a consequence of a disease that deforms bones and joints.

To determine the cause of the disease, you need to consult a therapist or orthopedist. Sometimes it is necessary to involve other specialists, for example, a neurologist.

Congenital disease

Acquired disease

This type of disease develops for various reasons:

• improper development of tendons;
• abnormal growth of muscle tissue;

And yet, most often clubfoot occurs in children due to wearing poor-quality shoes. But not all parents pay attention to this point, and then the children suffer. Options cannot be excluded when the disease occurs due to genetic predisposition, trauma, burns, inflammatory processes and ailments associated with the nervous system. At risk are those children who have been diagnosed with scoliosis or flat feet.

Most often, acquired clubfoot becomes noticeable in children already at the age of 2-3 years. However, given that the formation of the foot ends only by the age of 14, before this time it is still possible to acquire clubfoot and other orthopedic complications.

Parents should definitely pay close attention to how their child walks.

IMPORTANT: Clubfoot in children can be congenital or acquired

As a rule, in babies under one year of age, congenital clubfoot is diagnosed by a neonatologist. Next, the diagnosis is confirmed by an orthopedist.

Parents themselves may suspect this problem in their child if:

• there is a deep transverse fold on the foot
• the foot is short and plump
• the foot is curved in the plantar direction (equinus)
• the heel looks inward (varus)
• the foot is turned inward, its upper edge looks up (supination)
• there are restrictions in the movements of his sole (adduction)
• his toes (one foot) are curled inward
• the child's shins are twisted (torsion)
• his calf muscles are weak
• The baby's legs generally look underdeveloped

IMPORTANT: Clubfoot becomes very noticeable when the child begins to walk. His gait is called the "Winnie the Pooh gait"

Causes of clubfoot in children. Congenital clubfoot in children

The causes of clubfoot in children are different, and they depend on whether the pathology is acquired or congenital.
If clubfoot is congenital, this means that the child’s musculoskeletal system initially, in utero, began to form incorrectly. The following were subjected to deformation:

• bones
• joints
• muscles
• vessels
• nerves

Most often, from birth, children have clubbed legs in both legs.

IMPORTANT: Interestingly, congenital foot deformities are more often observed in male newborns

The causes of such pathology of foot development cannot always be determined. Doctors call the following pathogenic factors the most likely:

1. Restrictions on fetal movements in the uterus. They can be caused by hypertonicity of the uterus, the presence of a septum or neoplasms in it, or abnormal position of the fetus in late pregnancy.
2. Genetic disorders. There is a high probability that a baby with club feet will be born in a family where the parents or their close relatives also had this problem. A number of intrauterine growth disorder syndromes include clubfoot
3. Pathologies of the formation of nervous and muscle tissues of the fetus. They arise not because of a malfunction in genes, but because during pregnancy the woman smoked, drank alcohol, took drugs, was often nervous, worked in hazardous work, took medications prohibited during pregnancy, or suffered from an infectious disease. other

Acquired clubfoot means deformation of the foot(s) already during the child's life. It occurs much less frequently than congenital, usually in adulthood, and occurs for the following reasons:

• muscle injury
• ankle ligament injuries
• improperly healed fracture of the bones of the leg, ankle joint, foot
• a burn that damages muscles and ligaments
• diseases of the nervous system
• muscle paralysis
• hip dysplasia
• spinal diseases
• foot tissue tumors

Clubfoot in children under one year of age

If clubfoot in an infant is severe, parents sound the alarm and take a full range of measures to correct it.

If the pathology was discovered not in the maternity hospital, but during a regular examination by an orthopedist, and the parents did not even understand that it existed, you can often hear the opinion that the child will outgrow the problem. They say that a baby’s body is plastic. But!

IMPORTANT: Even a slight curvature of the feet leads to incorrect, asymmetrical development of the child’s muscles

Overstrain of some muscles and insufficient tone of others in a child with clubfoot is fraught with:

• x-shaped curvature of the legs
• curvature of the spine, in particular scoliosis
• headaches
• sleep disturbance
• retardation in physical and mental development
• formation of the habit of placing the foot incorrectly

IMPORTANT: It is necessary to treat congenital clubfoot precisely when the baby has not yet learned to walk, otherwise you will have to not only solve the anatomical problem, but also overcome the habit ingrained in the child

How to correct clubfoot in a child, how to treat it?

Tactics for treating clubfoot in children:

• congenital pathology or acquired
• what age is the child
• what is the degree of clubfoot

There are three such degrees:

1. Mild – the child’s feet are slightly deformed, the ankle joints are mobile
2. Moderate – foot deformity and limited mobility in the ankle are pronounced
3. Severe – the child’s foot is significantly deformed, the ankle joint is immobilized

An orthopedist classifies clubfoot and selects treatment methods. It also determines the approximate duration of therapy, but the actual period may differ significantly from the preliminary one. Sometimes it takes months or years to correct the pathology.

Typically, mild to moderate clubfoot is treated conservatively. Applicable:

• soft bandages
• orthoses (removable orthopedic devices)
• orthopedic shoes
• physiotherapy

Severe clubfoot in children must be treated with surgical methods.
Children under 6 years old undergo surgery to lengthen the tendons by cutting the ligaments (Zatsepin method). Sometimes it is also necessary to operate on the skeleton of the foot. In this case, the patient must be older than 4 years old.

VIDEO: Treatment of clubfoot. Ponseti method

Massage for club feet in children

An orthopedist determines how many courses of therapeutic massage a child with a clubfoot problem needs to undergo. Sometimes they have to be done more if recovery is slow.

Since therapeutic massage differs from restorative massage, it is recommended that at least the first course be entrusted to a specialist.
The session begins with relaxation and warming up of the lower leg muscles (internal and posterior). This effect is achieved using:

• using special products, such as massage oil
• stroking
• vibrating movements
• shaking muscles

VIDEO: Clubfoot

Exercises for club feet. Exercise therapy for clubfoot in children

Exercises for clubfoot are most effective if you start doing them with a child 3-4 weeks old. At this time, the baby’s ligaments and muscles are still very pliable.
The following exercise therapy exercises are performed:

• alternate and simultaneous flexion and extension of the legs
• leg raises
• bending the legs at the feet
• circles with feet
• walking with support

After gymnastics, a soft bandage is applied - bandaging according to the Fink-Ettingen method.

Exercise therapy for clubfoot.

Plastering for clubfoot

To quickly and effectively correct clubfoot in children of different ages, orthopedists use the Vilensky method - “boots”.
The method consists of alternating plastering:

1. After the orthopedist’s manipulations achieve relaxation of the muscles of the foot and legs, a plaster cast resembling a boot is applied to the child’s leg. The child needs to wear it for one week
2. After removing the plaster, the doctor fixes the leg in a more correct position and reapplies the plaster
3. The procedure continues until the result is achieved

Plastering is complemented by the following procedures: wearing special fixing orthopedic devices, paraffin applications, pine baths, kinesiotherapy, and other physiotherapeutic methods
After plastering, to consolidate the result, the baby is advised to wear orthopedic shoes, exercise therapy and massage courses.

Shoes for club feet

Orthopedic shoes for correcting clubfoot are purchased in a special store. She must have:

• hard backs
• arch supports
• pads that provide good ankle support

Also, complex orthopedic shoes – braces – are used to treat clubfoot in children. These are boots attached at a certain angle to a plastic or metal bar.

Most often it is used to consolidate the results of surgical treatment of clubfoot or casting.
The braces are worn this way:

• 24 hours a day, taking off only for swimming – 2-3 months
• for night and day sleep (12-14 hours a day) – up to 3 years

Braces are provided to disabled children free of charge.

Clubfoot in children Komarovsky

Famous children's doctor E.O. Komarovsky shares the opinion of experts that the problem of clubfoot in children cannot be ignored; it will not go away on its own.

Advanced pathology is fraught with disturbances in the development and functioning of bones, ligaments, muscles, blood vessels, nerves, and major problems for the entire body.

All parents worry about the health of their children. Sometimes their worries are unfounded, and in some cases there are serious reasons for this. If you suddenly discover that a child turns his feet inward while walking, then it is better to consult a doctor, because these are the first signs of childhood clubfoot.

What is clubfoot

Clubfoot or clubfoot is a deformation of the arch of the foot, as a result of which it changes its location and thereby causes a lot of inconvenience to a person, both in terms of painful sensations when walking and in aesthetic terms. Most parents are interested in the reasons why clubfoot develops in childhood.

Experts say that treatment of clubfoot should be carried out immediately at the stage of identifying the disease. It can be congenital or acquired.

When a child has a clubfoot, his heel is not fully placed on the floor, it moves. Mostly, clubfoot affects two legs, but in rare cases, left-sided and right-sided ones occur. According to statistics, boys are more susceptible to this anomaly, but no one can yet explain this.

Causes of clubfoot development in children

There are different causes of the disease, they are influenced by the degree of pathology: congenital or acquired.

In the congenital form, it turns out that the child’s musculoskeletal system began to form incorrectly even inside the mother’s body. This pathology is quite rare and can occur in one child out of a thousand. Joints, bones, nerves, muscles, and blood vessels are subject to such deformations. If a child has club feet from birth, then, as a rule, both legs are damaged. It is not always possible to establish the causes of this pathology.

Certain factors are considered the most common:

• The fetus in the womb is limited in its movements. This is facilitated by hypertonicity of the uterus if there are septa or new formations in it.

  In addition, restrictions on the mobility of the fetus in the uterus may be due to its large size. Unfortunately, among most pregnant women there is an opinion that “no amount of food can ruin your pregnant figure.” That's why expectant mothers load up on portions. However, at the same time, firstly, they gain excess weight, even if it is not too noticeable with a growing tummy, which negatively affects the course of the pregnancy itself, and secondly, they “fed” the unborn baby to such a size that later, nothing clubfoot, childbirth, and even then become problematic.

• Genetic disorders. If parents or relatives suffer from clubfoot, then the child may also experience this at birth. Clubfoot contains certain signs of developmental disorders inside the womb, including those that arise at the genetic level.
• Deviations in the formation of muscle and nerve tissue in the fetus. This is not due to the fact that there are malfunctions in the genes, but due to the use of drugs prohibited during pregnancy, alcohol, drugs, smoking, the presence of stressful situations, harmful work activities, and the transmission of some infectious diseases.

Today, medicine diagnoses many diseases even when a woman is pregnant. Therefore, it is possible to influence certain anomalies, while all causes of the defect can be completely eliminated. Any doctor can immediately detect the presence of clubfoot in a child, so there are no problems in timely treatment of the disease. It is recommended to treat the congenital degree during the period when the child is not yet walking. Otherwise, it will be necessary to solve the anatomical problem, as well as get rid of the rooted one.

Fun fact: Twins are often born with club feet.

Acquired clubfoot is presented in the form of foot deformation throughout the life of children. When compared with the congenital form, this type of pathology is observed even less frequently. This type of disease does not occur often, mainly in adults.

Causes of acquired clubfoot:

• Muscle injuries as a child grows up.
• Injury to ankle ligaments.
• Clubfoot develops when bones do not heal properly after a fracture of the feet, lower leg, or ankle.
• Damage to ligaments and muscles.
• Diseases of the nervous system.
• Incorrectly selected shoes for a child, especially during his first steps.
• Muscle paralysis.
• Spinal diseases.
• Presence of a tumor on the foot.
• Improper development of the hip joints.
• Slow development of muscles and bones.
• Heavy loads on children's legs. Long hikes if parents put the baby on his feet early.

  Many young parents try to rush the time: to sit the child down earlier, put him on his feet earlier and lead him by the arms, but at the same time so that the baby walks with his own legs. Such haste often has a negative impact on the baby’s health. Early plantings are fraught with the development of scoliosis, kyphosis, lordosis and other types of spinal curvatures; early standing of the baby threatens club feet, deformation of the feet, and impaired formation of the muscles and bones of the legs. Pediatricians say that if a child does not try to stand on his feet until he is one year old, but is active, this is only a plus. In this way, he strengthens the muscles of his legs and back and thus prepares himself for upright walking.

Doctors say that it is dangerous to acquire clubfoot from three to twelve years of age. During this period of time, the skeleton and muscles develop. Clubfoot is not difficult to detect, and it needs to be identified. People who have once encountered this pathology will say that if the disease is detected late, then treatment will be difficult. Thus, for timely diagnosis of the defect, it is recommended to take a closer look at how the child walks, especially in the morning. If the foot is healthy, then on the footprint they are parallel. If there is an anomaly, the feet point toes at each other. If one leg is clubbed, then that means one leg is bent.

Degrees of clubfoot in children

The treatment of the disease is influenced by the degree of clubfoot. Only then will specialists select the optimal treatment method. The treatment is carried out by a doctor, and parents must strictly follow all recommendations. There are cases when treatment will take several years.

There are three degrees of severity in the development of clubfoot in children.

• Mild degree – the feet are slightly deformed. The ankle joints are movable.
• Medium degree – there is deformation of the feet, as well as limited movement of the ankle.
• Severe degree – severe deformation of the feet, complete immobility in the ankle.

When a clubfoot is detected in an infant, parents immediately contact an orthopedist and begin treatment. But it happens that the anomaly is discovered a little later, adults do not really understand how serious it is, they believe that the pathology will outgrow. If clubfoot is not treated in babies under one year of age, then in the future everything will only become more complicated. After all, some muscles are overstrained, while others have little tone. This is fraught with consequences.

• Curvature of the legs in the shape of the letter X.
• Rachiocampsis.
• Sleep is disturbed.
• Presence of headaches.
• A habit is formed of placing the foot incorrectly.
• Physical and mental development lags behind.

How to treat clubfoot in children

In case of congenital pathology, the orthopedist immediately begins treatment. Parents take an active part here. Their task is to monitor how the baby walks, to prevent the child from clubfooting, to control the process of positioning the legs and feet, and to choose special orthopedic shoes for the child. If the form is mild, then massage and gymnastics are prescribed. In addition, diseases that contribute to clubfoot are corrected. We are talking about adduction (movement of the legs to the middle of the body), supination (movement of the foot to the outside), equinus (walking on the toes, like a ballerina, while the leg is fixed with soft bandages).

If no methods remove clubfoot, then the child has a severe degree. In this case, surgical intervention is recommended. Young children are operated on ligaments and tendons, and if the child is older, they work on joints and bones. Very severe degrees almost never occur. It is removed by combining all methods. In addition, you are prescribed to wear orthopedic shoes. It also applies to disease prevention. According to statistics, if children wear special shoes, they will avoid clubfoot, even if many factors are present.

Exercise therapy for clubfoot

The exercises are quite effective, but they should be performed with a baby who is only a few months old. During this period, the muscles and ligaments give in well. Therefore, exercises are performed to lift the legs, bend them in the area of ​​the feet, simultaneous and alternate bending of the legs, circular movements of the feet and walking with supports.

Soft dressings

If a small degree is observed, then it is effective to use soft bandages. First, the doctor performs corrective exercises, and then soft bandages over the entire limb. The bandage should be applied sequentially and in a special position.

Orthotics

This method is characterized by the use of removable devices that record and correct movements. Such devices are made of elastic materials with hinges to fix the joints and compensate for areas of the foot that are overloaded. Some devices are produced individually. With the help of orthopedic shoes, the foot is corrected and brought into the correct position.

Exercises to correct clubfoot in children

To correct and prevent clubfoot in children, special physical activity is recommended for children. Performing exercises under the supervision of a specialist helps reduce the manifestation of foot deformities, and sometimes even get rid of the disease.

The set of exercises includes the following:

• Running in one place.
• Walking like Charlie Chaplin, jumping from a half-squat position.
• Stretching the foot and rotating in all directions.
• Spinal stretch.
• Skateboard recommended.
• Climb under a bench, chair, do not lift your stomach and pelvis from the floor.
• Horseback riding (for older children).

The set of exercises is initially performed under the supervision of an instructor, and later, when the child learns, classes can be carried out at home.

Preventive measures for clubfoot in children

To prevent clubfoot, experts recommend doing exercises such as walking on toes and heels, walking on orthopedic mats, climbing ladders and squatting without shoes on your feet. When a child is studying, you need to make sure that the toes do not point inward. Also, all movements and activities should be done in a good mood and without pain.

An important aspect in correcting and preventing the defect is wearing special orthopedic shoes or. Insoles are made to order and can be inserted into a child’s regular shoes, which significantly reduces the cost of purchasing expensive shoes.

In the summer, walking barefoot on small pebbles, sand and other rough surfaces is encouraged. Place a glass bottle on the floor and let your child roll it with the bottom of his foot. Such exercises also develop the muscles of the feet well and are a good preventive measure against the development of clubfoot and flat feet.

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