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Congenital clubfoot, also known as echinovaro clubfoot or, popularly, as "clubfoot inward", is a congenital malformation in which the baby is born with one foot turned inward, and the change can be seen in just one feet or both.
Congenital clubfoot is curable as long as the treatment is done in accordance with the guidance of the pediatrician and orthopedist, and the Ponseti method, which consists of using plaster and orthopedic boots, or performing surgery to correct the position, may be indicated. of the feet, however surgery is only indicated when the other treatment methods have no effect.
How to identify
The identification of clubfoot can also be done during pregnancy through ultrasound, and the position of the feet can be visualized by this exam. However, confirmation of clubfoot is only possible after birth by performing a physical examination, and it is not necessary to perform any other imaging exam.
Possible causes
The causes of clubfoot are still unknown and widely discussed, however some researchers believe that this condition is essentially genetic and that throughout the development of the baby there was activation of genes responsible for this deformity.
Another theory also accepted and discussed is that cells with the capacity to contract and stimulate growth may be present in the inner part of the leg and foot and that, when contracting, they direct the growth and development of the feet inward.
Although there are several theories about clubfoot, it is important that treatment is started early to ensure the child's quality of life.
Congenital clubfoot treatment
It is possible to correct clubfoot as long as treatment is started quickly. The ideal age to start treatment is controversial, with some orthopedists recommending that treatment be started soon after birth, and for others that it is started only when the baby is 9 months old or when he is about 80 cm tall.
Treatment can be done through manipulations or surgery, which is only indicated when the first method is not effective. The main method of manipulations for the treatment of clubfoot is known as the Ponseti method, which involves the manipulation of the child's legs by the orthopedist and the placement of plaster each week for about 5 months for correct alignment of the bones of the foot and tendons .
After this period, the child should wear orthopedic boots 23 hours a day, for 3 months, and at night until they are 3 or 4 years old, to prevent the foot from bending again. When the Ponseti method is performed correctly, the child can walk and develop normally.
However, in cases where the Ponseti method is not effective, surgery may be indicated, which must be done before the child is 1 year old. In this surgery, the feet are placed in the correct position and the Achilles tendon is stretched, called a tenotomy. Although it is also effective and improves the appearance of the child's foot, it is possible that over time the child will lose strength in the muscles of the legs and feet, which over time can cause pain and become stiff.
In addition, clubfoot physiotherapy can help by improving the correct position of the feet and strengthening the child's leg and foot muscles.