Club Foot/Talipes Equinovarus: Club foot is a condition that causes one foot (unilateral) or both feet (bilateral) to be twisted inward and often pointing downward. The exact cause of club foot is unknown. An abnormality of the tendons and ligaments in the foot causes an abnormal structure and position of the foot. The affected foot is often smaller and the leg thinner than normal, which may not be as obvious if both feet are affected. Club foot occurs more often in boys than girls. Club foot may, in rare instances, be associated with spinal deformities such as spina bifida. Treatment: One method of treatment involves a series of manipulations of the foot, which is held in place with a full leg plaster cast. This does not hurt the child. Each cast is left on for 3 – 5 days as the muscles and ligaments relax and the bones grow into the corrected position. The doctor must be specially trained in this method, called the Ponseti Method. This treatment is successful in about 90% of children with club foot. Children may need a tenotomy, a surgery that goes hand-in-hand with the castings, to lengthen the Achilles tendon. After surgery or casts, the doctor may have the child wear an adjustable brace in which a pair of special shoes are attached. This brace usually doesn’t interfere with learning to walk. Older children who have not had early intervention for club feet may require several surgeries. Prognosis: Most children with club foot can have healthy and pain free feet after treatment. They can walk, run, jump, and play sports like other children.
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