Causes of clubfoot - Delhi

Who is the best orthopedic doctor in Delhi?
Orthopedic doctors often referred to as orthopedic surgeons; focus on helping you with musculoskeletal issues. Their duties include:
Diagnosing and treating conditions that affect your musculoskeletal system
Assisting with rehabilitation, which helps you regain movement, strength, range of motion, and flexibility following an injury or surgery
Forming strategies to prevent injury or to keep chronic conditions, such as arthritis, from worsening
While orthopedic doctors know about all parts of the musculoskeletal system, some choose to specialize further. Some subspecialty areas of orthopedics include:
•Spine
•Hip and knee
•Hand
•Shoulder and elbow
•Foot and ankle
•Sports medicine
•Trauma surgery

Top 5 Orthopedic Doctors in Delhi
•Dr. Nargesh Agrawal
•Dr. Abhishek Mishra
•Dr. Abhishek Mishra
•DR. DARSH GOYAL
•Dr. Akhilesh Rathi

What is the cause of clubfoot?
The cause of clubfoot is unknown (idiopathic), but it may be a combination of genetics and environment.
The exact cause of clubfoot is still not known (Idiopathic). Other reasons for this could be genetic, the position of the baby in the mother's womb, neuromuscular disorders, etc. The parents must get the child screened immediately to assess his health condition and identify the exact cause of the congenital deformity. There is no correlation of clubfoot in any type of deficiency, deformity, and other ritual myths like “GRAHAN”.
Clubfoot (also known as Congenital Talipes Equino Varus) is one of the most common congenital foot deformities in which the foot is turned inwards and downwards mimicking a golf club. It can be present in one foot or both feet (in 50% cases) and is more common in males. It can be present as an isolated deformity (Idiopathic clubfoot) or in association with other abnormalities of the musculoskeletal system, eg. Arthrogryposis multiplex congenital (AMC), Developmental dysplasia of the hip (DDH), Metatarsus adducts, congenital muscular torticollis (CMT), etc. Syndromic clubfeet are more stiffer and complex to correct in comparison to Idiopathic clubfeet.

The exact etiology is still not known and various theories regarding the roles of muscle, bones, neurovascular abnormalities and genetics have been described. Children with club feet present with painless deformities of feet which are obvious and can be appreciated by anyone. This deformity is not fully correctible in comparison to the postural clubfoot which does not need treatment.


What are the symptoms of clubfoot?
The deformity is obvious and apparent and can be diagnosed immediately after birth.
• The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
• The foot may be turned so severely that it looks as if it’s upside down.
• The affected leg or foot may be slightly shorter.
• The calf muscles in the affected leg are usually underdeveloped.
Despite its look, clubfoot itself doesn’t cause any discomfort or pain at the time of birth.
The most important symptom of clubfeet is the foot looking deformed and twisted like the club of the golf stick. But the child will experience discomfort and find it difficult to walk if clubfoot is not treated properly and timely. The child may find it difficult to wear shoes and participate in physical activities. Sometimes foot size of the affected side appears smaller than the normal side.

The good news is that if treatment is started early (preferably within the first week of life), this grotesque-looking deformity can be fully corrected with Ponsetti casting treatment within few weeks without any major surgical intervention. At the final cast, a percutaneous Tendoachilles tenotomy is done to correct the equinus. This can be done under local anesthesia. Ponsetti casting treatment (devised by Ignacio Ponsetti) is one of the most successful and popular treatments with published long-term results and is considered the workhorse of clubfoot treatment. It is possible to treat clubfoot in older children, however, if not treated early, it can lead to a more rigid deformity which will need soft tissue and bony surgery for correction.

There are Two Type of Treatment

Nonsurgical Treatment
The initial treatment of clubfoot is non-surgical as it depends on the severity of the foot deformity.

For clubfoot Ponseti method Is one of the most commonly used techniques throughout the world which uses gentle stretching and casting to gradually correct the deformity.

Treatment should ideally begin shortly after birth, but older babies have also been treated successfully with this method. Elements include:

-Manipulation and casting.
-Achilles tenotomy
-Bracing.


This method has proven extremely effective for many children. It does, however, require the not worn as prescribed family to be highly committed to applying the braces properly every day. If the brace is not worn as prescribed, there is a high likelihood that the clubfoot will recur.

Surgical Treatment

Although many cases of clubfoot are successfully corrected with nonsurgical methods, sometimes the deformity cannot be fully corrected or it returns, often because parents have difficulty following the treatment program or some infants have very severe deformities that do not respond to stretching.

Major reconstructive surgery for clubfoot involves the extensive release of multiple soft tissue structures of the foot. Once the correction is achieved, the joints of the foot are usually stabilized with pins and a long-leg cast while the soft tissue heals.

After 4 to 6 weeks, the doctor will remove the pins and cast, and typically apply a short-leg cast, which is worn for an additional 4 weeks. After the last cast is removed, it is still possible for the muscles in your child’s foot to try to return to the clubfoot position, so special shoes or braces will likely be used for up to a year or more after surgery.

The most common complications of extensive soft tissue release are overcorrection of the deformity, stiffness, and pain.
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