• 22 DEC 16
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    Pes Equinovarus (Congenital clubfeet)

    Pes Equinovarus (Congenital clubfeet)

    Congenital clubfeet is seen in every 1 of 1000 live births. This means 1500 children with clubfeet every year in Turkey. This problem, which begins in mother’s womb is mostly seen in boys and can be identified by ultrasound. The position of the baby in the womb and genetics can be the reasons. During birth, the feet are introverted and positioned upwards. This situation creates a fear for the family who are waiting for the baby with eagerness; however, the family can be calmed down by informing them that this problem can be solved by easy techniques and they should also see the pictures of previous patients.

    The babies who are diagnosed with clubfeet should be examined for hip dislocation with ultrasound as soon as possible because these babies have a high percentage of having hip dislocation. Newborns usually have feet that are introverted, which causes the family to think their child has a problem. The introverted feet are generally physiologic and returns back to normal in 3-6 months after birth. In pes equinovarus, the feet are also introverted. This situation that is mostly see at birth can also be genetic. The reason is not known, but the position of the baby in the mother’s womb can affect the feet. Pes equinovarus that can be identified with an examination after birth can be treated with a series of casting called ‘Ponseti” only in early diagnose. There is no tolerance in being late for diagnose. Treatment should be started as soon as the child is born. In late or severe cases, some surgeries might be needed for the feet to get back to normal. Even though it has decreased nowadays, untreated pes equinovarus is a serious cause for disability. Totally normal feet can be achieved with the treatment of the pediatric orthopedist. With the treatment, the child can step fully to the ground, wear normal shoes, and most of the time it won’t even be recognised that the child had a treatment in the first place. If only one side is affected, one foot can be shorter one size than the other, or there can be 1-2cm difference at the thickness of the leg muscles. The patients who see the orthopedist at a later period (older than 1-years-old) need surgical treatment. The treatments usually consist of muscle lengthening and correction of feet shape. In babies with unsuccessful treatment or children older than 4, bone surgeries in addition to soft tissue lengthening is needed. The surgery gets harder with age.