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I'm really nervous that I might have screwed up with my baby. She was born with a clubfoot on the right side. The pediatrician sent me to a special clinic where they teach parents how to stretch the foot and use elastic tape to hold it in place. There's a little splint she wears over the tape, too. I think I've done everything right, but the foot isn't getting better. This is my first baby and I want her to be perfect. How much longer should I wait before I say something to the doctor?
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As you know, with clubfoot, the foot is turned under and towards the other foot. The medical terminology for this position is equinus and varus. Equinus means that the toes are pointed down and the ankle flexed forward (like the position of the foot when a ballet dancer is on her toes). Varus means tilted inward. The ankle is in a varus position when you try to put the soles of your feet together. Clubfoot primarily affects three bones: the calcaneus, talus, and navicular. Other bones can be involved as the deformity can affect the growth of the entire foot to some degree.
Uncorrected, this twisted position of the foot can cause other problems. The ligaments between the bones are contracted, or shortened. The joints between the tarsal bones do not move as they should. The bones themselves are deformed. This results in a very tight, stiff foot that cannot be placed flat on the ground for walking. To walk, the child would have to walk on the outside edge of the foot rather than on the sole of the foot.
Treatment as you described is called the French Functional Method. The French Functional Method stretches the soft tissue and bony structures along the inside (medial) edge of the foot. Then the muscles along the outside (lateral) side of the foot are stimulated to contract to help actively correct the foot placement. Exercises, elastic taping, and splinting are part of a daily home program that requires parents to participate. At first, the family must bring the child into the physical therapist's clinic daily for hands-on therapy. Gradually, the parents take over the program and visits to the therapist decrease to a more manageable once a week trip.
Correction of the foot is usually successful with this approach, but it can take several months. If you are unsure of your technique or the results you are getting, make a follow-up appointment with the pediatrician or orthopedic surgeon and get their opinion. The therapist can also review your home program and the way you are applying the steps. If the French Functional Method is really not working as it should, there is a second (also very successful) technique available.
That's the Ponseti method. The Ponseti method involves placing the foot in as neutral a position as possible and holding it there with a cast. The bones are manipulated into place one at a time by the doctor or therapist until the full correction has taken place. The cast is removed each week, the foot and ankle position corrected, and a new cast is put on to hold the new position. It takes five to eight of these sessions to get the desired results and does not rely on parents involvement (beyond bringing the child to his or her appointments).
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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