Club foot

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Clubfoot
Classification & external resources

ICD-10	M21.5, Q66.8
ICD-9	736.71, 754.5-754.7

A clubfoot, or talipes equinovarus^[1] (TEV), is a birth defect. The foot is twisted in and down. Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet. It is the most common birth defect, occurring in approximately one to two per 1000 live births. Approximately 50% of cases of clubfeet are bilateral. In most cases it is an isolated abnormality.

Contents 1 Causes 2 Treatments 2.1 Ponseti Method 3 Famous people 4 In literature 5 External links 6 References

Causes

Researchers do not know exactly how clubfoot is caused. Some think it may sometimes be caused by intrauterine compression (possibly from oligohydramnios). Others think it is caused by a genetic malfunction during first trimester development. It can run in families, with incidence rates increasing significantly when multiple direct family members have the condition. Incidence in males is higher than in females.

Treatments

Clubfoot is treated with manipulation by an orthopedic surgeon or physiotherapist. In North America, manipulation is followed by casting. The French "physiotherapy method" uses taping to maintain correction. Foot manipulations usually begin within one week of birth. Surgery is usually performed if the foot has not been corrected by ~3 months after birth. Even with successful treatment, the affected foot (if unilateral) may be smaller than the other foot and the calf is frequently noticeably smaller than the normal side.

Ponseti Method

Another form of correction is known as the Ponseti Method ^[2]. Foot manipulations differ subtly from the Kite casting method which prevailed during the late 20th century. Although described by Dr. Ignacio Ponseti in the 1950s, it did not reach a wider audience until it was re-popularized by Dr. John Herzenberg in 2000. The Ponseti method is successful in correcting clubfeet using non- or minimally-surgical techniques in >95% of cases ^[3] when performed by an experienced physician, usually within 12 weeks from initiation of treatment. Approximately 80% of infants may require an Achilles tenotomy (microscopic incision in the tendon requiring only local anesthetic and no stitches) performed in a clinic between 6 and 9 weeks of age. Maintenance of correction requires the full time use (23 hours a day) of a splint called a 'Denis Browne Bar', also known as a foot abduction brace (FAB), for three months after achieving correction. Part time use (generally at night, usually 12 hours/day) is frequently prescribed up to 3-4 years of age. Approximately 20% of infants successfully treated with the Ponseti casting method may require a surgical tendon transfer after two years of age. While this requires a general anesthetic, it is a relatively minor surgery that corrects a persistent muscle imbalance while avoiding disturbance to the joints of the foot.

The long-term outlook ^[4] for children who experienced Ponseti Method treatment is comparative to that of non-affected children.

Watch a Video on the Ponseti Method

Famous people

Many notable people have been born with club foot, including the poet Lord Byron, statesman Prince Talleyrand, Civil War politician Thaddeus Stevens, the comedian Damon Wayans, actors Gary Burghoff and Dudley Moore, and film director David Lynch.

Kristi Yamaguchi was reportedly born with a club foot, and went on to win figure skating gold in 1992. Soccer star Mia Hamm was born with the condition. Baseball pitcher Larry Sherry was born with club feet. So was Jim Mecir who was born with two club feet, yet pitched a long career ending in 2005. Pittsburgh Pirates infielder Freddy Sanchez cites his ability to overcome the defect as a reason for his success ^[5].

The prominent Nazi Josef Goebbels was born with a right club foot (or, at any rate, a right leg malformation), a fact obscured from the German public by censorship. Because of his malformation, Goebbels needed to wear a leg brace. That, plus his short stature, led to his rejection for military service in World War I.

In literature

The main character, Philip Carey, in W. Somerset Maugham's novel Of Human Bondage, has a club foot, a central theme in the work.

Hippolyte Tautain, the stable man at the Lion D'Or public house in Gustave Flaubert's novel Madame Bovary is unsuccessfully treated for clubfoot by Charles Bovary, leading to the eventual amputation of his leg.

Wikipedia information about Club foot This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Club foot". It may not have been reviewed by professional editors (see full disclaimer). Help contribute to Americola and edit this article.