The problem of clubfoot is very relevant at present. A lot of children who put their feet wrong when walking. Why it happens? Is it convenient for them or is it a sign of more serious development problems? The article will discuss the clubfoot in children, signs and treatment methods prescribed by doctors. Parents will also be able to learn how to detect this ailment and what needs to be done so that it does not develop into more serious complications.
Types of clubfoot
Before talking about the methods of treating the disease, you should understand what we are dealing with. Clubfoot in a child is a pathology of the joints of the foot, in which the leg is not able to stand in the correct level position. When walking, the foot “goes” inside, the heel rises a little, and in the most difficult cases the sole rises so much that it looks up. In this case, the muscles of the sole and bones are grossly deformed, and the mobility of the ankle joint decreases, and eventually reduces to zero.
Clubfoot in children is divided into two types:
- acquired - occurs in a child by 2-3 years due to a violation of the development of bones or the nervous system, inflammatory processes, rickets, wrong shoes and so on;
- congenital develops in the uterine period, and there are many reasons for it, for example, mechanical, genetic, pathology of fetal development.
It should be noted that acquired clubfoot is more difficult to treat than congenital deformity, but it is necessary to treat both, since this pathology entails many consequences.
Signs of clubfoot in children
You can notice this deformation of the foot in the child yourself, you need to take a closer look at how the baby puts the leg. The main signs of clubfoot in children (a photo of the disease will be presented later), by which you can independently diagnose this disease, are:
- The heel is raised up, and the toe of the foot is very lowered and looks down.
- With a transverse bend of the sole, an obvious furrow is visible (in medicine, it is called the Adams furrow).
- The foot becomes smaller than it should be.
- The ankle joint is inactive or non-mobile at all.
- The axis of the heel is shifted inward with respect to the axis of the lower leg.
Causes of clubfoot
Congenital clubfoot in a child develops for the following reasons:
- Mechanical - as a result of the pressure of the walls of the uterus on the fetus, most often this occurs when the fetus is in the wrong position and lack of water.
- Genetic is a hereditary disease, especially those children who have had cases of the manifestation of this ailment in their families.
- Pathology of the development of the fetus - this may be a violation of the development of ligaments and muscles, a deficiency of nerve fibers, vitamin deficiency in a pregnant woman, or the use of drugs or alcohol during pregnancy.
In absolutely healthy children, a violation of the setting of the feet begins to appear from 2 years. Clubfoot in a child can be seen by such signs:
- A “bearish” gait appears, the baby, as it were, “rakes” one leg.
- He puts his feet wrong, this can easily be seen on the track in the snow or in the wet sand - one leg is as if turned towards the other.
- Weak mobility of the ankle joint.
- The knees are turned inwards.
The acquired clubfoot also has many reasons:
- Underdeveloped bones of the child.
- Violation of the nervous system.
- Improper bone fusion after fracture.
- Rickets.
- Acute inflammatory processes.
- Polio.
- Leg injuries, burns.
- Incorrect and outsized shoes.
Clubfoot in a child develops due to the load on the baby's legs. It grows and gains weight, its bones also grow and change shape, while tendons and muscles develop more slowly. For this reason, certain muscle groups are in good shape, while others are relaxed. Such a development process is manifested in the form of foot deformity.
Possible complications
Wrong setting of feet at your baby should not be left to chance, it will not pass with age. Other diseases, such as scoliosis, flat feet, are associated with clubfoot, in addition, the neglected form can lead to a number of complications, and in the worst case scenario, to disability. Possible consequences that can be caused by clubfoot:
- subluxation of the bones of the feet and sprain;
- atrophy of muscle groups;
- hard callus formation on the outside of the feet;
- impaired mobility of the knee joints.
Diagnostics
Congenital clubfoot in children can be detected by ultrasound during pregnancy or during examination by a pediatrician in the first month of life. In addition, parents themselves may notice that the child’s legs are not all right. Photos of clubfoot in children are horrifying, and in fact this pathology brings a lot of suffering and anguish to both the children themselves and their parents. Both those and others will need a lot of patience and fortitude to cope with this defect.
Acquired clubfoot can be diagnosed by the characteristic complaints of parents. The doctor will examine the baby and determine the degree of pathology.
But the most accurate examination method that confirms the diagnosis is ultrasound of the foot and computed tomography.
It should be borne in mind that making x-rays is absolutely useless, since the child’s still small bones are not completely formed and consist of cartilage tissue, which is not visible in the pictures.
Conservative treatment of pathology
The main principles of successful treatment of clubfoot in children are timely start, observation by an orthopedic surgeon, perseverance and patience of parents.
Non-surgical methods of treating this defect are aimed not only at correcting it, but also at consolidating the results achieved.
Congenital clubfoot is diagnosed in the hospital. After about two weeks, you can begin treatment, which is carried out on an outpatient basis under the supervision of an orthopedic surgeon. Inpatient treatment or a spa approach may be required.
The baby's foot is fixed with a plaster cast, which is changed every week until a positive result is achieved. This is the simplest and best treatment option, as the child’s bones are still very soft and easily amenable to medical adjustment. To avoid relapse after removing the cast, children only wear a specially made langeta for the night.
Many doctors love the Vilensky technique. It is very effective for treating clubfoot in children, both infants and older. This is a complex therapy, in which the result is achieved several times faster than with plaster dressings. This technique helps even in cases where doctors are ready to prescribe an operational way to solve the problem. The technique consists in a set of measures such as:
- Tupor (orthopedic special devices for rigid fixation of joints).
- Phased casting.
- Therapeutic exercise is a treatment with movements and physical activity.
- Therapeutic gymnastics with clubfoot in children is a complex of exercises that are prescribed by a doctor.
- Paraffin baths.
- Warm baths with the use of coniferous extract, which helps to reduce muscle hypertonicity.
- A relaxing massage with clubfoot in children is prescribed by a neurologist.
The most common method is phased casting. An orthopedic surgeon kneads the leg, then puts a plaster cast in the form of a boot. Her baby wears about a week. Then the doctor removes the gypsum, kneads the leg again and fixes it again with a plaster boot. And so it continues until the doctor achieves a positive result. Treatment takes about a year and is combined with paraffin baths. After the course of treatment, orthopedic shoes should be worn.
In addition to gypsum dressings, soft bandage with applying tires and a splint is used.
Recently, medical treatment with Botox has become very fashionable. This drug acts on the nerves, it is injected into the calf muscle, as a result of which it relaxes. After about a week, the tendon weakens and the foot is in the correct position. But this is a temporary effect that lasts about 6 months, after which the injections can be repeated.
The method of treatment depends on the severity of the defect, the causes of its occurrence, the age of the baby and the characteristics of the body.
Children are very well helped by special orthopedic shoes, which have a hard back and shoe.
In addition, massage and a set of physical exercises for clubfoot in children are quite effective. The course takes about 3-4 months.
Sports are highly recommended for older children: swimming, dancing, skateboarding and snowboarding.
And only if conservative treatment is ineffective, a surgical operation is performed.
Surgical treatment
This method of treatment is resorted to only if the baby’s foot does not take the correct position, despite all the measures taken, as well as if the child has a very severe form of deformity that is not subject to a conservative treatment method. In such cases, doctors decide on a surgical procedure to repair the tendons, ligaments, ankles and foot joints.
Congenital clubfoot is usually corrected when the baby is 8-10 months old, and treatment should be completed before the baby starts walking on its own.
During the year after surgery, the child needs to wear special shoes or staples that are used for walking.
It should be noted that after the operation, despite the positive and quick effect, the foot muscles still become elastic and rigid, the operated leg very often hurts, it is weaker than healthy and smaller by 1 size.
Clubfoot Exercise
In order to cope with this defect, you must constantly engage in physical exercise. For this, it is not necessary to visit the gym, you can do exercises at home, in the forest, on the street, in the country. It is necessary, together with the doctor, to develop a set of exercises and each time gradually increase the load.
How to fix clubfoot in a child? What exercises are recommended to do?
Here are some to deal with this ailment:
- You should start practicing with running. Let the baby run a few laps, it will stretch all his muscles. But from the very beginning it is necessary to teach him to run correctly, and constantly monitor his staging when doing this exercise. We do not need speed, we need to learn how to put the legs, and parents should carefully monitor this. You need not be afraid to punish the baby for mistakes, but do it in a playful way. For example, push-ups or squats for every wrong step.
- Once he learns to run, the task should be complicated. When running, he must raise his hands to his chest, clench his fists and rotate his wrists in front of him. This exercise is aimed at learning how to mechanically set the foot in the right position (before that, he would keep an eye on himself).
- Charlie Chaplin style walking.
- Squatting
- The rotation of the foot to the outside.
- Stretching exercises.
One of the most effective exercises is cycling (but there is a little secret, it’s worth tying a plastic bottle at the knee level to the frame, it will prevent the child from bringing his legs together. This is the easiest and most effective way to deal with clubfoot and flat feet.
After the first positive results, they must be fixed, the baby must be recorded in any sports section or at dances.
Prevention
Any disease is easier to prevent than to treat later. Observing certain rules, you can not worry that this defect will develop in a child.
To prevent congenital pathology, it is necessary:
- Lead a healthy lifestyle.
- Eat well.
- Have more rest.
To prevent acquired clubfoot, you must:
- Take a closer look at footprints in the sand or snow. If they are not parallel, you need to consult an orthopedic surgeon.
- Keep track of your baby’s gait. Especially when he is sleepy or keen on the game, at such moments he does not control it, and deviations can easily be detected.
- It is necessary to engage in physical education with the child: slow running, bike, squatting, snowboarding. The child should always take care of himself and not "rake" the leg.
- You can not overwork the baby with long walks, especially when he is just learning to walk.
- The best measure for the prevention of flat feet and clubfoot is swimming.
- Nutrition with the obligatory presence in the menu of fish, milk, cottage cheese and other fermented milk products.
- High-quality shoes with a hard back and arch support.
- Walking barefoot on pebbles and sand.
- Walking up the stairs.
Parent Tips
Indoor installation of stops is a solvable problem, but this will have to be worked on. If you let it drift, then it will lead to other disorders: scoliosis, flat feet, uneven foot growth, lameness, disability. It is necessary to consult a doctor - orthopedic surgeon.
If clubfoot is associated with increased muscle tone, the doctor will recommend gymnastics, as well as a massage course that will help relieve muscle tension.
Do not swap shoes, that is, put the right shoe on the left leg, and the left - on the right. This will not solve, but will aggravate the problem and lead to curvature of the knee and hip joints.
In addition, it is necessary to bathe the child every day in coniferous salt baths, which relieve hypertonicity and have a strengthening effect on the whole body.
The recipe for the bath is as follows:
- 3-4 tablespoons of liquid needles extract.
- A glass of sea salt (buy at the pharmacy).
- A bucket of warm water (the temperature should be familiar to swimming).
The water in the bath should not reach the heart. Take bath procedures should be up to 18 hours, otherwise the baby will have difficulty falling asleep. After taking a bath, the child needs to be washed with warm fresh water.
Tips orthopedists. What can not be done?
Orthopedists argue that you should not encourage the child to walk early, that is, drive by the hand, put the kids in the walker. Doctors believe that both muscles and bones should be ready for him to walk. In addition, most urban children have mild rickets, so early placement of the child will certainly bend his legs and lead to flat feet or clubfoot.
If the child at 10 months still wants to walk himself, he should take an additional massage course to strengthen his muscles.