Clubfoot is a congenital deformity where the affected foot or feet appear to have rotated internally at the ankle. Without treatment, people with club feet appear to walk on their ankles or on the sides of their feet. It occurs in about one of every 1,000 live births. Severity may vary. However with treatment, most patients recover completely during early childhood and are able to walk and even participate in athletics.
Causes: There is no known cause for clubfoot. It may be an isolated birth defector or it may be present along with other birth defects.
Screening before Birth: This helps identify possible clubfeet by ultrasonography [USG]. This helps in knowing if club foot deformity is present, and if present, whether there are other birth defects too. Knowing about clubfoot deformity before birth helps prepare for its subsequent treatment, because as Dr Kamlesh Devmurari says: ‘The best time to treat babies with club foot is soon after birth. Treatment should begin almost immediately for a successful outcome without the need for surgery.’
Treatment in the past: Cubfeet were treated with a complex surgical release, which had many complications. Then a novel idea of serial casting was introduced by Dr Ponseti with dramatic results. This treatment is used today for most clubfoot cases. In stretching and casting therapy the surgeon changes the cast multiple times over a few weeks, gradually stretching tendons until the foot is in the correct position of external rotation. The heel cord is released and another cast is put on, which is removed after three weeks. To avoid relapse, a corrective brace is worn for a gradually reducing time until it is only at night up to four years of age.
Surgeon & Scientist Dr Ignacio V Ponseti 1914-2009: His work of Genius Development of a non operative method of clubfoot treatment consists of serial casting, heel cord tenotomy, and wearing braces. This method has become the gold standard of clubfoot treatment and has benefited tens of thousands patients worldwide.
The Tragedy Club Foot Babies: Although Dr Ponseti wrote his paper on clubfoot management in1963, his method of treating Clubfoot without major surgery was accepted only in 1993!
How it happened: In 1990s Dr Ponseti came out of retirement and wrote a book called ‘Congenital Clubfoot'
Fundamentals Of Treatment’. It led to a renewed interest in his technique. Parents of clubfoot babies began requesting on operative treatment. So orthopaedic surgeons began to learn Ponseti method from Dr Ponseti. Today Ponseti Method is used worldwide. Countless children live normal lives without pain and disability due to his efforts. Every three minutes, one baby is born with ‘Clubfoot’.
The good news is: ‘Clubfoot Can be Cured!’ says Paediatric Orthopaedic Surgeon Dr Kamlesh Devmurari, who runs CLUB FOOT CLINIC for babies born with this deformity.