home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
CD-ROM Today (UK) (Spanish) 15
/
CDRT.iso
/
dp
/
0361
/
03610.txt
next >
Wrap
Text File
|
1994-01-17
|
7KB
|
182 lines
$Unique_ID{BRK03610}
$Pretitle{}
$Title{Clubfoot}
$Subject{Clubfoot Calcaneal Valgus Calcaneovalgus Metatarsus Varus Talipes
Calcaneus Talipes Equinus Talipes Equinovarus Talipes Varus Talipes Valgus
Valgus Calcaneus}
$Volume{}
$Log{}
Copyright (C) 1986, 1987, 1989 National Organization for Rare Disorders, Inc.
265:
Clubfoot
** IMPORTANT **
It is possible the main title of the article (Clubfoot) is not the name
you expected. Please check the SYNONYMS listing to find the alternate names
and disorder subdivisions covered by this article.
Synonyms
Calcaneal Valgus
Calcaneovalgus
Metatarsus Varus
Talipes Calcaneus
Talipes Equinus
Talipes Equinovarus
Talipes Varus
Talipes Valgus
Valgus Calcaneus
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Clubfoot is a word used for several kinds of ankle and foot deformities
usually present at birth. The defect can be mild or severe, and it can
happen to one foot or to both.
Symptoms
There are several types of clubfoot. They are as follows:
EQUINOVARUS
The foot is turned inward and downward . If both feet are affected the
toes point toward each other instead of straight ahead. The heel cord often
is very tight, making it impossible to bring the foot up to a normal position
without a specialist's help.
CALCANEAL VALGUS OR VALGUS CALCANEUS
This type of clubfoot is more common. The foot is sharply angled at the
heel, with the foot pointing up and outward.
METATARSUS ADDUCTUS
The front part of the foot is turned inward.
METATARSUS VARUS
The front part of the foot is turned inward and inverted. Although
present at birth, this form of abnormality may not be diagnosed until the
infant is a month to a few months old. With treatment the foot can look
better and become more functional.
In general, clubfoot is not painful and doesn't bother the baby until he
or she begins to stand and walk. Since the ankle is twisted in place, the
foot can't move up and down as it normally would in walking. The child must
walk as if he were on a peg leg.
If both feet are affected, the child walks on the balls of his feet. If
the feet are badly twisted, the child will walk on the sides or even the top
part of the feet instead of the soles. The part that comes in contact with
the ground may become ulcerated, hard and lumpy, since it is not protected by
the thick skin of the sole of the foot. The entire leg is sometimes unable
to grow as it should.
For more information on Clubfoot, see the article in the Prevalent Health
Conditions/Concerns area of NORD Services.
Causes
The exact cause of Clubfoot isn't clear. In the past it was thought that the
fetus' feet were twisted in the mother's womb. This is true only of cases
that correct themselves after birth. Many scientists think the defect starts
early in pregnancy, before the fetus is large enough to stay in one position
very long.
Clubfoot probably is caused by a combination of hereditary and other
factors that may affect prenatal growth, such as infection, drugs, disease or
other factors in the environment.
Although most children with clubfoot have no other birth defects,
occasionally there are other abnormalities as well. Children with an open
spine (spina bifida) sometimes have a form of clubfoot. This is caused by
damaged spinal nerves that affect the leg muscles. In other cases, feet
which are normal at birth may become twisted as a result of muscle or nerve
disease.
Affected Population
Clubfoot is usually present at birth. Approximately 9,000 babies (about one
in 400 live births) are born annually in the United States with this
congenital defect. Boys are affected twice as often as girls.
Therapies: Standard
Treatment of Clubfoot is started soon after birth. The aim is to force the
twisted foot gradually and gently into place so that it can move up and down.
In the mildest cases parents can be taught how to exercise the baby's foot.
More often, plaster casts or surgery followed by exercise are needed. Most
often, the doctor turns the foot forward as far as it can go, and puts a
plaster cast on to hold it that way. At first, the cast is changed to bring
the foot closer to normal through frequent adjustments. After the foot is
straightened, it is tilted further upward to stretch the tightened heel cord.
It is kept in this over-corrected position for a few weeks. The treatment
usually requires three to six months, followed by checkups for many years by
an orthopedist.
In certain cases, some doctors use adhesive bandaging over a special type
of splint instead of hard casts. After the bandages are off (or in some mild
forms of clubfoot), the baby sleeps in shoes attached to a metal bar which
holds the feet in a corrected position.
Sometimes the heel cord is too tight to be stretched by a cast or
bandaging, and the patient must undergo surgery to lengthen it.
Immediate treatment for clubfoot using casts or strapping (not surgery),
works in more than half of the cases.
With expert early treatment, most patients grow up to wear regular shoes,
can take part in sports, and lead full, active lives.
Untreated, a clubfoot stays twisted and grows that way. If the defect is
treated too late in childhood surgery may be successful, but the rest of the
leg usually doesn't catch up in development.
Therapies: Investigational
This disease entry is based upon medical information available through March
1987. Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate. Please
check with the agencies listed in the Resources section for the most current
information about this disorder.
Resources
For more information on Clubfoot, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Institute of Child Health & Human Development (NICHHD)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5133
For information on genetics and genetic counseling referrals, please
contact:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
Clubfoot: Public Health Education Information Sheet, Health Education
Information Sheet, March of Dimes (1983).