Foot Problems – Club Foot
(Disability Specially in Children)
Club foot is a complex deformity of the foot. It is inborn (congenital) and can only be compensated by a so-called Redressionsbehandlung or surgery. A club foot can occur in one or both feet and be less pronounced. In addition, the calf muscles is often underdeveloped.
Club foot is a preventable, because this is a congenital deformity. Therefore it is important to have a clubfoot earliest possible treatment to improve the associated constraints. Only with appropriate therapy can be a clubfoot subsequent pain when standing and walking prevented.
For congenital clubfoot the exact causes are mostly unknown. A clubfoot may occur alone or in combination with other malformations. Here comes the so-called neuromuscular clubfoot in disorders such as spina bifida on. Here usually are based on a muscle imbalance, the muscles may be partially paralyzed or otherwise ill.
As the deformity arises is exactly, but so far not fully understood. It is believed that not during development muscles and connective tissue form in the right proportion. As a result of the high proportion of connective tissue (fibrosis) results in a muscle imbalance . Thereby also the bone growth is changed. There will be failures and thus to clubfoot.
It is also possible that the Fußentwicklung in an embryonic stage of development stops when the muscle development is not yet complete. Sun is similar in form to the Clubfoot early embryonic foot.
In some cases, a nerve disorder causes clubfoot.
Club foot Symptoms
A child with a congenital clubfoot shows clear symptoms. The malformation can occur one or both sides and usually has four components.
1) Equinus : luffing ankle, elevation of the heel bone with shortened Achilles tendon
2) inwardly inclined hindfoot : extreme O-position of the lower ankle joint, the heel pointing inwards
3) Adductus : The metatarsal and toes turned inwards
4) Cavus : The longitudinal arch of the foot is raised
Sufferers can go without proper treatment only on the Fußaußenrand, in severe cases, even only on the dorsum. In this extreme stage of the clubfoot, the foot is facing upward.
Clubfoot is not just about a deformity of the joints, but a heavy, complex malformation of the entire foot. Particularly affected are the bony Fußwurzeln, the ligaments and tendons, as well as individual muscles.
In contrast to a similar shape, but harmless habit posture of the foot in infants, which shows as a further symptom clubfoot a substantial stiffness.
Club foot Diagnosis
The doctor can in congenital clubfoot diagnosis immediately after birth by the unique clinical features provide. An additional note is a very thin, shortened calf (Klumpfußwade).
In many cases, the doctor examined the bony deformities with an X-ray examination . The x-ray is a clubfoot diagnosis usually not mandatory, however, helps to assess disease progression in clubfoot.
Club foot Therapy
Crucial to the successful treatment of a clubfoot is the timely and consistent therapy . This should immediately after birth begin during controlled and possibly to be continued until the growth is complete.
The principle of treatment is to correct the foot deformity for a long time, similar to braces on crooked teeth acts. First, a physical therapist brings the feet of hand gradually into the right position. Later help plaster casts – called redressing thigh casts. You will first day, later changed at weekly intervals and the foot position by continuously corrected (leg cast treatment). Physiotherapy exercises to stretch and strengthen the muscles and complement the clubfoot treatment.
After completion of the gypsum treatment it is important to obtain the corrected position of the feet with apparatus, night splints, and inserts a long time. Regular checks during the first years of life, in part by the end of the growth phase, are necessary to detect as early as possible setbacks and treat.
If consist of clubfoot remains despite previous therapy or later occurs (so-called relapse), various operations may be useful:
i) Equinus : surgical Achilles tendon at the age of about six months
ii) “Rebellious” club foot (barely speaks to therapy and often occurs after successful treatment again): capsule removal
iii) Recurrence in growing children: tendon extensions and operations where the doctors position the bone correct