Special needs newborn with bilateral clubfoot.

My referral is a special needs newborn with bilateral clubfoot. What is this condition and is it correctable?

Clubfoot is a very common birth defect. It appears more commonly than any other birth defect. Approximately one baby in 300 is born with a clubfoot and there seems to be a greater number of boys to girls who are affected with this. In a newborn with clubfoot, one or both feet are in a twisted position and they cannot be turned back to normal. The exact cause of this condition is not understood but it is believed that it may be due to a temporary halt in the foots development during the first 8 weeks of the pregnancy. To describe what clubfoot actually looks like, imagine a child walking on his ankles and the side of his feet. Fortunately, with the advances of modern medicine, clubfoot is a treatable condition .

The treatment of clubfoot is both surgical and non-surgical. Treatment is generally started immediately after birth. The non-surgical therapy begins under the care of an Orthopedist who has experience with Pediatrics. The newborn is initially treated with casts because the infant’s tendons, ligaments and bones are still very flexible and can easily be manipulated and re-positioned. The foot is stretched into a more normal position and the cast is then placed in order to retain this new position. Therapy for this condition usually lasts for about three to four months with weekly cast removal and further foot stretching in order to maintain a better final position. The success rate for this type of procedure is about 50%. If the cast fail to produce an adequate realignment, surgery needs to be considered. Surgery is also warranted if the clubfoot recurs or if there is an association with a neuro muscular disorder.

Surgery for this condition entails the lengthening if the heel tendon and may require follow-up operations that will release or transfer tendon of the foot to other positions.

As with any type of surgery the risks are as follows:

  1. reactions to the anesthesia
  2. breathing problems
  3. bleeding
  4. infections

If surgery is performed in a timely manner by an experienced Orthopedic surgeon, the club foot usually become quite functional. After the surgery is performed, the feet will be placed in a cast for about three months. There will be an on going need for constant physical therapy in order to keep the foot in an acceptable position and to improve function and flexibility.

Modern treatment for this old condition can help to provide a relatively normal standard of living for these children.

Written by George Rogu MD CPE of Adoptiondoctors.com