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Clubfoot, a birth deformity that can be treated without major surgery

Club Foot Treatment

What is club foot?

Clubfoot, also known as congenital talipes equinovarus, is a developmental deformity of the foot. It can be mild or severe and occur in one or both feet. Clubfoot is not painful during infancy. However, if your child’s clubfoot is not treated, the foot will remain deformed, and he or she will not be able to walk normally.

At the Global Rainbow Foundation, with the help of the NGO step by step, clubfoot can be treated using the Ponseti method, which has a success rate of 90% and does not affect the child’s physical development.

Is there a treatment for club foot children?

The goal of treatment is to obtain a functional, pain-free foot that enables standing and walking with the sole of the foot flat on the ground.

The initial treatment of clubfoot is nonsurgical, regardless of how severe the deformity is.

The Ponseti method is the most widely used technique which uses gentle stretching and casting to gradually correct the deformity.

Elements of the Ponseti method include:

  • Manipulation and casting: The child’s foot is gently stretched and manipulated into a corrected position and held in place with a long-leg cast (toes to thigh). Each week this process of stretching, re-positioning, and casting is repeated until the foot is largely improved. For most infants, this improvement takes about 6 to 8 weeks.
  • Achilles tenotomy: After the manipulation and casting period, approximately 90 percent of children will require a minor procedure to release continued tightness in the Achilles tendon. During this quick procedure (called a tenotomy), the doctor will use a very thin instrument to cut the tendon. A new cast will be applied to the leg to protect the tendon as it heals. This usually takes about 3 weeks. By the time the cast is removed, the Achilles tendon has regrown to a proper, longer length, and the clubfoot has been fully corrected.
  • Bracing: Even after successful correction with casting, clubfeet have a natural tendency to recur. To ensure that the foot will permanently stay in the correct position, the child will need to wear a brace for a few years. The brace keeps the foot at the proper angle to maintain the correction. This bracing program can be demanding for parents and families, but is essential to prevent relapses.

For the first 3 months, the child should wear the brace essentially full-time (23 hours a day). After that, the child should wear the brace overnight. This bracing protocol will continue until the child is 5 years of age.

Long term goal of Ponseti Method

In the recent years, Ponseti method has been proven to be the most effective and the most anatomically conservative method of treating a clubfoot child.

Treating the children born with club foot will allow them to have a normal life and be more functional. This allows the club foot children to walk with flat foot and wear normal shoes. It minimises the progression of foot deformity by achieving and maintaining a structural stability of the foot and ankle, hence, preventing permanent deformity of the foot.

The Ponseti Method is the least expensive method of treatment for a parent having a child with clubfoot on the long term.

What is the impact of the clubfoot program?

The clubfoot project team has already consulted over 60 children with primary clubfoot or secondary clubfoot associated with different conditions such as spina bifida, metatarsus adductus etc. In Mauritius and Rodrigues, 24 children have already received the Ponseti method for treating primary clubfoot and are in their bracing phase of the treatment. 17 children with relapse went through previous highly invasive surgeries and out of which, 4 had to go through a second major surgery as they were older and are currently doing physiotherapy rehabilitations. All these children have shown remarkable improvement and have been cured using the Ponseti treatment. Even those who had major surgeries are progressing well and getting better with each physiotherapy session.

Below follows links for the Press conference, at Clinic Shifa in the reference section by the team.

 

Sunday times: https://sundaytimesmauritius.com/video-conference-de-presse-traitement-du-pied-bot-varus-equin-par-la-methode-ponseti/

ION News: https://www.youtube.com/watch?v=1QnmdiVSqGA

Testimonial by parent: https://www.facebook.com/globalrainbowfoundation/posts/3695716907113332?comment_id=3696230867061936

ONG Step by Step website: https://stepbystep-ngo.org/fr/

If you know of a child or parent who desperately needs advice on clubfoot, please do not hesitate to contact us at the following contact details:
keertisha@grftrust.org/ ongstepbystep.contact@gmail.com or call on the 283 0229/ 5826 8491.

 

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