Clubfoot
June 3rd is World Clubfoot Day.
Clubfoot, or talipes equinovarus, is a term used to describe a range of unusual positions of the foot. Generally it involves the twisting deformation of one or both feet such that the sole can’t be placed flat on the ground. The affected foot (or feet) appears to be rotated internally at the ankle. The foot points down and inwards and the soles of the feet face each other.
Talipes is a congenital deformity, meaning it is present at birth. It’s actually a fairly common condition, occurring in about one of every 1,000 newborns. It affects boys twice as often as girls, and 50 % of clubfoot cases affect both feet (bilateral). We still don’t know exactly what causes it. There is certainly some genetic component, and a new-born is more likely to be affected with it if one of their parents had it.
The gorgeous wee girl in the photo was born with unilateral talipes - only her right foot was affected. When she was two weeks old she began treatment in the Ponseti method of talipes correction.
Back in the 1940s Dr. Ignacia Ponseti developed a comprehensive method for the treatment of talipes that involves the gentle manipulation of the clubfoot, followed by an over-the-knee cast to hold the foot in a stretched position. This is repeated each week. The major principle of this technique is that the tissues of a newborn’s foot, including tendons, ligaments, joint capsules, and certain bones, will yield to gentle manipulation and casting of the feet at weekly intervals. Utilising this principle and his understanding of clubfoot anatomy, Dr. Ponseti began employing this technique in 1948 at the University of Iowa. His observations have recently been confirmed using modern techniques, including magnetic resonance imaging (MRI).
By starting the Ponseti technique within the first few weeks of birth, most talipes can be successfully corrected without the need for major reconstructive surgery, and the Ponseti method has become the standard for treatment.
After the weeks of manipulations and casting, an Achilles tenotomy (cutting of the tendon) is usually required to release the Achilles tendon. This is a simple outpatient procedure performed using local anaesthetic. Unfortunately, following correction of the clubfoot deformity, relapse tends to occur. To prevent this, when the last plaster cast is removed a splint must be worn full-time (23 hours per day) for two to three months and then at night for 3-4 years.
The really great thing is that these days, having a clubfoot is no big deal. With modern medical science the issue can be resolved fairly easily. And lots of people had it, that you may not have even been aware. A few examples:
Damon Wayans, comedian and actor
Dudley Moore, comedian and actor
Kristi Yamaguchi, professional figure skater
Sir Walter Scott, novelist and poet
Tiberius Claudius Caesar Augustus Germanicus (a.k.a. Claudius I), fourth Roman Emperor of the Julio-Claudian dynasty
So there you go. Clubfoot. Really not as bad as you may have thought :)