What causes congenital clubfoot? What are the symptoms of congenital clubfoot?

It may be due to poor muscle development of the legs, or it may be caused by leg deformities, it may be caused by bone valgus, it may be caused by the ball of the foot is turned out, or it may be caused by poor genes in the hooves. This symptom is that you walk with a limp, need someone to support you, you don't have sound limbs, you walk with bumps, and your legs are underdeveloped.

Now the specific ** is not clear, it is likely to be genetic factors, it may also be embryonic factors and intrauterine factors. The specific symptoms are that the feet are adducted, inverted, and sagging, the feet will become smaller, unable to walk, the state will be stiffer, and the feet will be deformed.

<> the probability of congenital clubfoot in newborns is not very high, about 1%, and it is often a male child. It can be unilateral or bilateral, and can be divided into rigid (difficulty standing, delayed walking, claudication) and flaccid (corrected with passive dorsal extension valgus, and the relative symptoms are not very severe).

Since the abnormality can be seen right from birth, it is not difficult to identify the disease. Parents of patients diagnosed with this disease do not need to worry, most children are generally corrected through a period of systematic correction, manual reduction, and plaster correction**.

**Parents still need to pay more attention to their children's living habits and avoid their children's daily habits such as sitting in a W-shaped position, kneeling and sleeping on their stomachs for a long time

Congenital clubfoot is one of the most common congenital malformations of the foot, which is characterized by hindfoot clubfoot, varus, internal rotation, forefoot adduction, varus, and high arch. After the birth of congenital clubfoot, the degree of display of one or both feet varies, the anterior adduction of the foot and the fold of the plantar surface of the drooping foot in patients with mild varus deformity, the elastic resistance of dorsal extension and abduction to the pediatric learning to walk, the deformity gradually worsens, the muscle balance of the foot and calf is imbalanced, and the contracture of healthy muscles is affected by weight.

Congenital clubfoot is a common deformity in children, which seriously affects the growth and development of children's bones and joints, and may be the most common congenital malformation in the field of orthopedics. In China, due to the lack of medical resources, a large number of advanced cases are caused, and the traditional surgical method is too late, the surgical trauma is large, and the foot tissue damage is large, which often causes joint stiffness, and there are many problems in the long-term functional results, which affect the activity of the foot and ankle.

First of all, the use of massage techniques and plaster fixation for the early stage of the disease, if the conservative effect is not ideal, then surgery can be used, in the operation is generally divided according to different age groups, commonly used surgical methods are soft tissue release, calcaneal wedge osteotomy, soft tissue release, tendon displacement, osteotomy orthopedics, tarsal three-joint fusion, osteotomy orthopedics, etc.

Within three months, most patients tend to be conservative** and engage in manual massage. Move the inverted foot outward, try to achieve back extension, stretch the tendon and contracture tissue on the back side, and after pulling to a certain extent, wear a brace to fix it. After one year of age, patients can choose surgery, the most commonly used surgery is posteromedial extensive release, the contracture tissue is released, fixed with a cast, it is recommended to do the anterior tibial tendon transposition at the age of three to six years to restore valgus function.

Anterior tibial tendon transposition can also be appropriately selected to assist in posterior release and perform clubfoot surgery**.

The symptoms are that the feet are very stiff, the instep will be raised, the feet will be deformed, the feet will be thin, the legs will be very thin, and there will be very obvious muscle atrophy. In such a situation, it is necessary to diagnose it in time, and then it should also be operated in time, or it can be assisted by drugs, or it can also be assisted by acupuncture.

The most obvious manifestation is the appearance of inversion of the heel, and the appearance of deformity. The appearance is very abnormal. It is necessary to have a good improvement as early as possible, otherwise it may affect a lifetime. It can be done by corrective means, or you can choose to have surgery.

Walking posture is not normal, sometimes the foot will turn inward, the foot will be deformed, and the ankle joint will turn inward. It can be corrected by follow-up ****, or you can go for surgery, or you can go to a Chinese medicine doctor for **, and you should also pay attention to your posture.

The foot is inverted, the foot is particularly high, and the front of the foot is a little retracted. In the early days, it should be carried out by massage**, or according to the actual situation, professional medicine**.

The foot is inverted, the foot is particularly high, and the front of the foot is a little retracted. At the time of the period, the treatment should be performed using the technique of massage, or professional medical treatment should be carried out according to the actual situation.

Clubfoot varus is the most common pediatric foot deformity, and its clinical description of its symptoms is adduction and inversion of the anterior half of the foot, calcaneal varus, plantar flexion, and Achilles tendon contracture and horseshoe deformity. Ordinary people may be confused when they see these descriptions, what does clubfoot varus look like?

丨What does clubfoot varus look like?

Illustration of an infant clubfoot varus.

Illustration of an infant clubfoot varus.

As shown in these diagrams, clubfoot varus is explained in layman's terms that the baby's feet appear to tiptoe and flex in the direction of the center of the foot, which looks very similar to the horse's hooffoot, so it is called clubfoot varus.

丨How does clubfoot varus occur?

Illustration of an infant clubfoot varus.

The baby's clubfoot is due to the abnormal development of the tendons and ligaments (posterior and medial) of the foot during development, so that the tendon ligaments in this part of the tendon and ligament are not synchronized with other developments, causing these tendon ligaments to pull the foot downward and medially, causing the foot to twist downward and medially, forming the appearance of clubfoot varus.

丨Why is there such abnormal development?

Illustration of clubfoot varus.

This is related to many factors, such as neonatal foot varus, neurogenic clubfoot, cerebral palsy clubfoot, etc., among these factors, some of which can be recovered after a period of manipulation**, and some are heavy ones that require surgery or even lifelong training**.

Of course, no matter how severe it is, the most important thing is to do early examination, so that the mild disease can be directly skilled, and the serious can also be effectively controlled, so don't shy away from medical treatment when encountering such a problem.

1. The symptoms of the two are different:

1. Symptoms of foot varus: unilateral or bilateral foot ankle plantar flexion, inversion, and adduction deformity.

2. Symptoms of clubfoot: tiptoe landing, heel hanging, shaped like horseshoe, foot inversion and stiffness.

Second, the reasons for the two are different:

1. Causes of foot inversion: foot inversion is mostly due to the pressure of the fetal foot in the uterus and long-term abnormal posture, resulting in abnormal shape. There is a genetic factor, which belongs to polygenic inheritance.

2. Causes of clubfoot: most of them are caused by cerebral hypoplasia, in the process of development, due to the failure of the tendons and ligaments of the foot, they fail to keep pace with the development of other tendons and ligaments of the foot, and these tendons and ligaments pull the posteromedial side of the foot downward, and twist the foot downward, so that the bones of the foot are in an abnormal position, resulting in the foot inversion, stiffness, and can not return to the normal position.

Third, the overview of the two is different:

1. Overview of foot varus: foot varus deformity is a subluxation of the scaphoid joint, which immobilizes the foot in an adduction, supinated varus posture.

2. Overview of clubfoot: Clubfoot is also known as "vertical foot" and "pointed foot". It is a developmental malformation that can be detected at birth and is a manifestation of cerebral palsy.

Clubfoot is more common in newborns and can be divided into two types. One is caused by external factors, most of which are caused by abnormal posture of the fetus in the womb. There are many skin lines on the inside of the foot, the outer side of the foot is tight, the heel is small, and it cannot lie flat on the ground.

The other is clubfoot caused by internal factors, which is mostly caused by familial genetic factors and usually has more severe symptoms. In addition to the above symptoms, stiffness and deformity of the feet are also present. It can also be judged by the image, it is clear that the foot is tilted inward.

Congenital clubfoot should be selected according to the age and degree of deformity of the child.

1.Early non-surgical**.

1) Ponseti orthopedic method: It has been affirmed all over the world, and the specific methods are as follows:

1) Manual massage and plaster fixation (ponseti plaster fixation): suitable for children under 1 year old, the deformity components are corrected one by one according to a certain procedure, and then fixed with plaster casts (usually outpatient fixation 4 to 6 times).

2) Achilles tendon release: Achilles tendon release surgery can be performed when the plaster immobilization reaches more than 75 degrees of foot abduction, and the plaster cast will be fixed for 3 weeks after the operation, and the plaster will be removed after 3 weeks, and the orthopedic shoes will be replaced at the same time.

3) Orthopedic shoes**: Wear Dennis-Brown orthopedic shoes further after surgery**, usually up to 4 years of age.

2) French massage technique: newborns should immediately manipulate **, bend the knee 90 degrees during the operation, hold the heel with one hand, push the front half of the foot to abduct with the other hand, correct the adduction of the forefoot, then hold the heel for valgus, and finally drag the soles of the feet with the palm of the hand to stretch the back, correct the horseshoe, and correct the manipulation several times a day until the deformity is corrected.

2.Surgery**.

For children who miss the opportunity for non-surgical orthopedics or who are deformed** due to not wearing an orthopedic brace as required by the doctor, symptomatic surgery** will be performed according to their different conditions.

1) Extensive soft tissue release: Surgical methods include turco, mckay, carroll and other methods, which are aimed at the release of soft tissues of foot and ankle contracture and restore the normal anatomy between tarsal bones. The general principles of clubfoot for any stage of extensive release** include:

1) Loosen the tourniquet when the operation is completed, and electrocoagulate the bleeding;

2) If necessary, put the foot in a plantar flexion position, and carefully suture the subcutaneous tissue and ** to avoid excessive tension;

3) When the cast is changed for the first time 2 weeks after surgery, the foot can be placed in a fully corrected position.

2) Achilles tendon lengthening: For children who miss the age of Achilles tendon release surgery (generally 2 to 3 years old), the Achilles tendon needs to be released and the calcaneus bone should be dropped, and the Achilles tendon should be incised. Postoperative casts were immobilized for 6 weeks.

3) Anterior tibialis muscle transfer: suitable for children with mild ** in the early stage of clubfoot or ** residual forefoot adduction deformity after ***.

4) External fixation stent: For older children with stiff clubfoot (generally over 5 years old), the foot bones have ossified, and the deformity cannot be corrected by soft tissue alone, external fixation stent technology can be used, and the stent needs to be adjusted regularly after surgery, and the appearance is basically satisfactory, but the stiffness of the foot and ankle joint will remain.

5) Foot osteotomy and orthopedics: there are many surgical methods, generally the age of the child is more than 5 years old, according to the deformity of the osteotomy of different parts of the selection, can be combined with the external fixation bent to correct the clubway varus deformity.

6) Three-joint fusion: the indication is for children over 10 years old; There are three deformities: metatarsal adduction, hindfoot varus, and plantar flexion; This procedure may be considered.

Surgery should take into account the development and growth factors of the limbs, and the surgical correction can be carried out in stages, and the damage should not be too great.

First, clubfoot in children can be treated non-surgically**. If the patient's clubfoot condition is not very severe, it can be immobilized with some manipulation and casts**. Second, minimally invasive surgery**.

Because clubfoot has a varus of the foot, the muscles on the inside of the foot are stronger than on the outside, so the force of the varus needs to be surgically transferred to the outside to balance the forces on both sides of the foot. Children with clubfoot should be found as soon as possible**.

Hello, it seems to be a little late, from the moment of birth, the sooner **, the better the effect. **Methods vary depending on age and degree of deformity. Guidance, but it can also be **, can do triple arthrodesis, suitable for patients over 12 years old with serious deformity. Wishing you good health!

At present, the ** of congenital clubfoot in children is: after a series of plaster orthotics combined with percutaneous Achilles tendon lengthening**, the prognosis of most children is better; It is recommended to take your child to the orthopedic surgery department of a regular children's hospital, and the professional doctor will tell you how to deal with it appropriately.

My son is now more than two months old right foot congenital clubway varus, more than 40 days to see the first massage, back in the plaster **, so small ** should not need surgery, if the operation should be about 10,000, because it is a minor operation, I wish our babies can grow up healthily.

Congenital clubfoot is a common deformity in children, which seriously affects the growth and development of children's bones and joints.

Clinical presentation.

Because foot deformities can be seen immediately after birth, diagnosis is usually not difficult. Congenital clubfoot can generally be divided into stiff (intrinsic) and floppy (extrinsic).

1.Stiff.

The deformity is severe. The ankle and subtalar joints are deformed in plantar flexion, the talus is plantar flexed, and the protruding talus head can be felt subcutaneously on the dorsal side of the foot. Because the posterior end of the calcaneus is upturned and hidden behind the lower end of the tibia, the heel seems to be smaller, and at first glance it looks like a rod-shaped foot without a heel, so it is also called a club-shaped foot.

Achilles tendon contracture is severe. Viewed from the back, the calcaneus is varus. The forefoot also has adduction and varus, the scaphoid bone is located deep inside the foot and close to the talus head, the cuboid process is lateral to the foot, the medial side of the foot is concave, the inner side of the ankle and the inner heel are increased, and the lateral and dorsal sides of the foot ** are tightened and thinned.

When the passive dorsal extension is turned outward, it is stiff and fixed, and this deformity is not easy to correct. The child has difficulty standing, has delayed walking, limps, and can be seen bearing weight on the outside of the foot or on the back of the foot when standing with support. Older age, significant claudication, stiffness of soft tissues and joints, small feet, thin calves, and obvious muscle atrophy, but feeling normal.

Thickened bursa and callosum may appear on the dorsolateral side of the foot after long-term weight bearing, and ulceration may occur rarely. Patients often have other deformities at the same time.

2.Fluffy type.

The deformity is mild, the heel size is close to normal, there are mild** folds on the lateral side of the ankle and dorsum of the foot, and the atrophy and thinning of the calf muscles are not obvious. The biggest feature is that it can correct the clubhoof varus deformity when the passive dorsal extension valgus, which can make the affected foot reach or close to the neutral position, easy to correct, easy to consolidate the curative effect, not easy to **, and good prognosis. This type is caused by an abnormal position in the utero.

3. The diagnosis can be made according to the clinical manifestations, and the diagnosis is generally not confirmed by X-ray examination. However, for judging the degree of clubfoot deformity and the objective evaluation of the curative effect, X-ray photography is indispensable. X-rays of the feet of normal neonates show the bony centers of the heel, talus, and dice bones.

In children with clubfoot, the ossification center of the bones of the foot appears later. The scaphoid bone does not appear until after the age of 3 years. The metatarsal shaft is well ossified after birth.

1.Positive piece.

The normal angle between the longitudinal axis of the talus and the longitudinal axis of the calcaneus is about 30°, and if it is less than 20°, it indicates that the posterior part of the foot is varus. When the longitudinal axis of the first metatarsal and talus of the normal foot and the longitudinal axis of the fifth metatarsal and the calcaneus are parallel or crossed, the angle of intersection is less than 20°, and when the angle of intersection is less than 20°, the anterior part of the foot is adducted.

2.Lateral view.

The longitudinal axis of the talus of the normal foot is parallel to the first metatarsal, and in clubfoot patients the two intersect at angles.