Club foot repair





Definition

Club foot repair, also known as foot tendon release or club foot release, is the surgical repair of a birth defect of the foot and ankle called club foot.


Purpose

Club foot or talipes equinovarus is the most common birth defect of the lower extremity, characterized by the foot turning both downward and inward. The defect can range from mild to severe and the purpose of club foot repair is to provide the child with a functional foot that looks as normal as possible and that is painless, plantigrade, and flexible. Plantigrade means that the child is able to stand with the sole of the foot on the ground, and not on his heels or the outside of his foot.

Demographics

In the United States, club foot is a common birth defect, and occurs at a rate of one to four cases per 1,000 live births among whites. Severe forms of clubfoot affect some 5,000 babies (about one in 735) born in the United States each year. Boys are affected with severe forms of clubfoot twice as often as girls. The risk increases 30-fold in individuals who have a relative of the first-degree affected by the defects.


Description

A newborn baby's club foot is first treated with applying a cast because the tendons, ligaments, and bones are quite flexible and easy to reposition. The procedure involves stretching the foot into a more normal position and using a cast to maintain the corrected position. The cast is removed every week or two, so as to stretch the foot gradually into a correct position. Serial casting goes on for approximately three months.

In 30% of cases, manipulation and casting is successful, and the foot can be placed in a brace to maintain the correction. In about 70% of cases, manipulation and castings alone do not correct the deformity completely and a decision will be made concerning surgery.

The type of surgery depends on how severe the club foot is. The deformity features tight and short tendons around the foot and ankle. Surgery consists of releasing all the tight tendons and ligaments in the posterior (back) and medial (inside) aspects of the foot and repairing them in a lengthened position. Metal pins may also be used to maintain the bones in place for some six weeks. Surgery usually involves an overnight stay in hospital. After surgery, the foot is casted for some three months, followed by the use of a brace to hold the correction. The brace is worn for approximately six to 12 months after surgery.


Diagnosis/Preparation

Presurgical diagnosis requires radiography. The evaluation usually includes only the acquisition of weight-bearing images because the stress involved is reproducible. In babies, weight-bearing is simulated by the application of dorsal flexion stress.

Some surgeons prefer to wait until the child is about one year old before performing surgery, so that the foot may grow a little larger to facilitate surgery. Other surgeons operate as early as three months of age when it becomes clear that further castings will not achieve any more correction.


Aftercare

The patient usually stays in the hospital for two days after club foot repair. The foot is casted and kept elevated, with application of ice packs to reduce swelling and pain. Painkillers may also be prescribed to relieve pain. During the 48 hours following surgery, the skin near the cast and the toes are examined carefully to ensure that blood circulation, movement, and feeling are maintained. After leaving the hospital, the cast is usually left on for about three months. Skin irritations due to the cast or infections may occur. A course of physical therapy may be indicated after removal of the cast to help keep the foot in good position and improve its flexibility and to strengthen the muscles in the repaired foot. The well-treated clubfoot is no handicap and is fully compatible with a normal, active life. Most children who have undergone club foot repair develop normally and participate fully in any athletic or recreational activity that they choose.


Risks

The risks involved in club foot repair are the general risks associated with anesthesia and surgery.


Risks associated with anesthesia

  • adverse reactions to medications
  • breathing problems

Risks associated with surgery

  • excessive bleeding
  • infections

Normal results

If club foot repair is required, the foot usually becomes quite functional after surgery. In some cases, the foot and calf may remain smaller throughout the patient's life.


Morbidity and mortality rates

If left untreated, club foot will result in an abnormal gait, and further deformity may occur on side of the foot due to preferential weight bearing.

Alternatives

The Ponseti non-surgical treatment

Dr. Ignacio Ponseti developed this method which consists of a weekly series of gentle manipulations followed by the application of casts which are placed from the toes to the upper thigh. Five to seven casts are applied every week. Before applying the last cast, which is worn for three weeks, the heel-cord is cut to finalize the correction of the foot. By the time the cast is removed the heel-cord has healed. After this two-month period of casting, a splint is worn full-time by the patient for a few months and is then worn only at night for two to four years. Special shoes also maintain the foot in the corrected position.


The French treatment

This method consists of daily physical therapy, featuring gentle and painless stretching of the foot. The foot is then taped to maintain the corrected position until just the next day's visit. At night, the taped foot is inserted into a continuous passive motion machine at home to maximize the amount of stretching. The tape is removed for a few hours each day to wash the foot, air the skin, and to perform exercises. Removable splints are also used to support the taped foot. The one-hour physical therapy sessions are conducted five days each week for approximately three months. Taping is stopped when the child starts walking.


Resources

BOOKS

Lehman, W. B. The Clubfoot. Philadelphia: Lippincott, Williams and Wilikins, 1980.

Ponseti, I. V. Congenital Clubfoot. Fundamentals of Treatment. Oxford: Oxford University Press, 1996.

Simons, G. W. The Clubfoot: The Present and a View of the Future New York: Springer Verlag, 1994.


PERIODICALS

Aronson, J. and C. L. Puskarich. "Deformity and Disability from Treated Clubfoot." Journal of Pediatrics and Orthopedics 10 (1990): 109–112.

Cooper, D. M. and F. R. Dietz. "Treatment of Idiopathic Clubfoot. A Thirty Year Follow-up." Journal of Bone and Joint Surgery 77A (1995): 1477–1479.

Herzenberg, J. E., C. Radler, and N. Bor. "Ponseti Versus Traditional Methods of Casting for Idiopathic Clubfoot." Journal of Pediatrics and Orthopedics 22 (July-August 2002): 517–521.

Ideka, K. "Conservative Treatment of Idiopathic Clubfoot." Journal of Pediatrics and Orthopedics 12 (March-April 1992): 217–223.


ORGANIZATIONS

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000. http://www.aap.org .

Shrine and Shriner's Hospitals. 2900 Rocky Point Dr., Tampa, FL 33607-1460. (813) 281-0300. http://www.shrinershq.org/index.html


OTHER

American Academy of Pediatrics. "Club Foot." Essentials of Musculoskeletal Care [cited April 2003]. http://www.aap.org/pubserv/essenexp.htm .

The Club Foot Club [cited April 2003]. http://home.ica.net/~maudefamily .

"Help for Patients with Club Foot." Shrine and Shriners Hospitals. March 28, 2003 [cited April 2003]. http://www.shrinershq.org/patientedu/clubfoot2.html .

"List of Physicians Qualified in the Ponseti Method." Virtual Children's Hospital [cited April 2003]. <http://www.vh.org/pediatric/patient/orthopaedics/clubfeet/physic ans.html> .

"Patient Guide to Club Foot." John Hopkins Department of Orthopedic Surgery [cited April 2003]. <http://www.hopkins medicine.org/orthopedicsurgery/peds/clubfoot_new.htm> .


Monique Laberge, Ph.D.

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


Club foot repair is performed in a hospital. Club foot surgery is difficult and requires meticulous attention to details. It is accordingly performed by experienced pediatric orthopedic surgeons who are specialists in the field.

QUESTIONS TO ASK THE DOCTOR


  • Is there any treatment needed to prevent the club foot from coming back after surgery?
  • What are the chances that my child's club foot will get corrected?
  • How long will it take to recover from the surgery?
  • What procedures do you follow?
  • How much club foot surgery do you perform each year?

User Contributions:

Don Pincivero
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Mar 1, 2006 @ 7:19 pm
I have a son diagnosed with mild clubfoot of the left foot only. He was casted at birth and went through a series of splints. The foot has not really turned in too much since but it has become stiff and will not stretch very well.

Is/are there a series of exercises or stretching movements that we can perform to loosen and/or straighten the foot to where it was after the casting and splints?
Judy Gray
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Nov 23, 2007 @ 3:15 pm
I myself was born club footed (bilateral) and I am doing a presentation on this subject. I found this site very imformative and now I better understand what I really had to go through to get my feet to look somewhat normal. I am very thankful to my parents and my doctors for all they did for me. One of my doctors told my mom that I would never be athletic or socialable. Well I ran track in high school, played volleyball, played softball in the summer and walk (still) 4.5 to 5 miles a day. So anything is possible. Thank you for all you have done for all of us who have been born with this deformity I truly appreciate all of your research.

Sincerely,
Judy M. Gray
marwa
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Sep 1, 2008 @ 4:04 am
thanks for this intersting subjects,i have some questions,
exercises for club foot ,what's its frequency \week?
can we use ultrasonic for club foot ?what " indication?
Tangela Shurelds
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Mar 31, 2009 @ 12:00 am
My grandson was born with club foot on the right foot. He was placed in cast 2 weeks after birth and later had the heal-cord cut, the doctor then placed him in the special shoes which were supposed to be worn 22 hours out of a day...She never let him wear them, now my baby has to have the surgery to move his joints,MAJOR SURGERY I'm so scared and mad with that lady to put my baby through that. please someone tell me is it as bad as I think it will be on my grandson he's only 9months and I hate this, I'm so worried.......Thank You
Tiffany
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Apr 23, 2009 @ 12:12 pm
I am about to undergo surgery to fix my right foot which is club foot, then in 9 months my left foot. i am 25 years old and had surgery at 1 year. my condition is hereditary my father has it and my sister, plus several cousins. I should have had follow ups since the first surgery, but now am having surgery at such a old age. the docter said I would have had better results at a younger age I am extremely nervous. The surgery is only 5 days away and i am hearing more surgerys on young children. what are the chances at such an older age.
Julie Harper
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Apr 24, 2009 @ 2:14 pm
I have a 7 month old grandaughter that hs severe club feet and was treated with castings from the age of 1 week to 6 weeks. The orthopedic doctor told us that all we had to do after that was stretching excercises, which have not helped. She is trying to stand now and we are trying to get her into the Shriners' Hospital in St Louis, MO. I'm just wondering what the success rate is for a surgery of this nature.
K Withrow
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Jun 2, 2009 @ 9:09 am
My son was born with a severe club foot (left foot only). We had used the Ponseti method until approx 18 mo's of age. We then had used the plastic casting for 8 more months, but is apparent that although he doesn't walk fully on the side of his foot, he will need surgery to have the foot completely treated. He is 2 1/2 yrs old now, and will be having surgery in approx 3 wks from today - of course, I am nervous, tho I have received excellent care & have faith in his pediatric orthopedic surgeon. Wish our family luck &/or prayers as we go thru this difficult time. Poor kid, he will be casted for yet another entire summer! Will comment again after surgery to update his condition.
Roberta Lamonica
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Jul 6, 2009 @ 9:09 am
Hope to be helped and get information.. My sister in law has got a club foot. She is 50 now.. she got herself operated 6 times... But she still suffers pain in her foot and needs to swallow pills to reduce pain....Could you tell me where to go to have further help?
Thanks a lot
Roberta Lamonica
Julie Redden
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Aug 31, 2009 @ 2:14 pm
I was born with bilateral clubfeet. My first surgery was at 9 months of age. I can't tell you how many surgeries I have had altogether. My last one was at 12 years old. I had a wonderful doctor, who genuinly cared about myself and my feet. Without him I may never have been able to walk. The only complaints I have is mild arthritis. I have had 3 children and they were born healthy and free of the deformity. Surgery was my only option and it worked along with the casting and bracing. Thanks Julie
Teresa
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Sep 21, 2009 @ 1:13 pm
My daughter had surgery on both feet at 3 months old because her feet were severe. She then again had the right one done at 5 and now she is having the right one done again, but they think it will be the last one. She also is having surgery on the left, but that is minor and for her heel. The surgeries were great. She has always been active in sports and one foot is completely straight. It's just the foot that was almost turned back when she was born that she still has a problem with. However without those surgeries her feet would be nothing like they are today. She has a great doctor that she's had since she was born (10 years ago)and I trust in him completely and what he recommends. So if you're scared about the surgery, it really does work, it's worth it.
kappi
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Oct 11, 2009 @ 10:22 pm
My son is going in for surgery on the 16th of November for club foot. This site was very informative. I am nervous about surgery in general, but know it is what is best. Maybe this will be his first and last!
Misty
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Dec 8, 2009 @ 9:09 am
My son was born with bilateral clubfeet. He has had 2 surgeries (one when he was 6wks and 11months). The doctor we used left a pin in his foot be accident and he has had problems with it since then. We have seen several different doctors since then and we have found one that is sincerely concerned and is truly doing everything we need. My son just turned 5 in Novemeber and we are going to have surgey after Christmas. Please pray that everything goes well. He will be in cast on both feet for 6 to 8 weeks without walking and he is a very active little boy.
Ashley Morse
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Jan 13, 2010 @ 9:21 pm
My son has a r clubfoot and will soon have his 3rd surgery, we have casted, inserted,exercised turned, prayed and everything you can imagine for this little foot. My son has 1 foot that is a size 8 and 1 foot a size 12 and ahalf. We just deal with what life gives us. We have a heating pad with his name on it, Motrin with his name on it, he runs, plays soccer and plays t ball and does well. He is 4 years old, my mother who is 60 years old is also a bilateral club foot as so does my 1st cousin who is a bilateral clubfoot. but we all function well, one day at a time and one shoe at a time. This article was very down to the point and very self explanitory.
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Feb 23, 2010 @ 5:17 pm
I have had this correction to my right foot, I have no memory of the event now as I am 31. I know it happened though as there are three significant stitching scars on my foot and I have a small cast which I am told covered my leg, but now I can get only my littlest two fingers into.
Mobility I would say I have had a good 90% over the past 31 years, walking 100% though my foot cramps up after 15 miles (I rarely do this distance now). Running 80%, I can only manage 1500m max, then I start to turn to the right as I take shorter and shorter steps. Driving 90% I thought this would be un-affected but after 3H I get cramp. I have noticed my right leg is now visually smaller then my left, my foot was always smaller, this is new.
What I would like to know is if there is any way to correct my foot further now I have stopped growing? Is it possible to move my tendon back to its correct location?
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Jun 18, 2010 @ 4:16 pm
I was born with severe bilateral club feet. I have huge scars that cover both my feet. I am worried though because I still get really bad pain and cramping in my ankles and the muscles around my ankles. I haven't had surgery since I was a baby and am worried if I might need it again. My cramps sometimes get so bad you can actually see my feet trying to move back to the way they developed. I really don't know what to do. I've tried stretching but it doesn't seem to help. What should I do?
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Jul 21, 2010 @ 3:15 pm
hi my daughter sasha she is now 4 was born with a club food (right).i have tried casting several times ,she wore the brace and still can't seem to make her foot better .so now we decided to have surgery for her. this article was helpful it made it more clear as to what will be done for her. i just hope and pray that this will be it ,make all better ...
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Jul 27, 2010 @ 4:04 am
i have a club foot (right) and ive had 3 operations to release my tendans had pins and plates in and had my leg broken.. im 18 now and my foot it causing me so many problems ive been to the hospital and they have told me i have to wear hospital shoes again and if this dont work then i will have to have bone fusing surgery!
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Jul 31, 2010 @ 10:22 pm
im a 50 year old female that was born with club feet due to being a severe asthmatic they decided that even though i really need the surgery that it want worth the risk now as the years have gone by the pain and difficulty in walking has gotten much worse i no longer can manage to do much of anything and have applied for disability of course they have fought me for 5 years or more now im waiting on an answer on another appeal, but im in so much pain now and dont want to take pain killers due to other medical problems like chrones/ulcercolitius asthma is there any thing you can suggest. respectfully ms. sally taylor
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Aug 29, 2010 @ 8:20 pm
Yes i had club feet as a baby & had 4 surgeries by the time i was 14 months old.Now that i'm 16 years old & i my senior year i've had alot trouble with my feet for like 2 to 3 year now.The pain meds do not work anymore at all.I have serious back pain and my feet hace turned in now & i'm walking on the inside of my feet where my ankle are.I have caluses on the inside ankles and the pain has really got so bad now that i don't sleep well,i also never have played any sports at all.I also can't walk or run ride a bike.I was wondering has anyone had this problem with there club feet?
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Aug 29, 2010 @ 8:20 pm
I have real alot of your threads on club feet in here and i'm james father,i have alot trouble with james feet and now i'm afraid i'm going to have to put him on the stronger pain meds!I was informed by DHS that i should file disability for him so i started the ss with the help of DHS on getting him help wityh ss and insurance to help me with the surgeries they say he's going to need at such a young age.His feet or so bad tho i mean i never seen feet where you actually walk on your ankles on the inside.I can also tell that the pain has got so much worse since he;s become taller and heavier.I have DR app's set up for him but i really don't see where there going to beable to do alot to fix what they tried fixing when he was a baby!
Katherine
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Aug 30, 2010 @ 11:11 am
I am a 75 yr old woman born with a severe right Club foot. I had early surgery/manipulation etc I led a fairly normal lifestyle for many years. I loved horse riding as a child, rode my bike and went swimming. I loved the outdoors and kept as
as fit as possible although I did not participate in running sports.I married, had three normal children and now four grandchildren, none of whom were born with club feet. My foot has become quite painful and arthritic for a number of years, with a severe arthritic flare-ups over the past year. Consultation with a rehabilitation specialist in Vancouver, BC recommends immediate bracing and or splints. What are the surgical alternatives if any?
Mia
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Aug 31, 2010 @ 7:19 pm
I was born with a very severe form of bilateral club feet. They did not use the Ponseti method on me (as it was not popular at the time), and I've had many many surgeries. I can't say that I'm doing particularly well (I'm preparing for yet another one). I will advise you to do the Ponseti method if possible, it sounds a lot less painful, and more successful. For me, they rearranged my bones, did many heel-cord releases, and put many metal appliances in my feet, and they still haven't gotten to were some clubfeet patients are.
Iris
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Sep 15, 2010 @ 2:14 pm
I was reading the article and just wanted to know the answer to question #1 posted by Don Pincivero. For a child who undergone surgeries and splinting at birth and whose foot is now stiff and the ankle, are there exercises or stretching movements that can be performed to loosen and/or straighten the foot to where it was after the casting and splints?
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Sep 23, 2010 @ 8:20 pm
My son was born with severe clubfeet, the right was worse than the left. He got his first set of cast the day he left the hospital, and a new set every 2-3 wks. They went all the up to his hips. We did manipulation in between each set, he had no improvement. When he was 10 months old it was decided that he was going to have surgery. It was the longest 5-6 hours of our life, they put pins in his right foot to hold everything together and then they casted hid feet.He was in these cast for about 2 months,and then he had special braces made specially for him. He wore these every day for about a year. Christian is now almost 12 yrs old and he still has some pain, his right foot is still not perfect, but functional. We went through Rainbow babies in Cleveland and they did an amazing job. My husband was also born with clubfeet and had casting,surgery, and therapy and he still has some pain but is also doing well. It is highly hereditary more common in boys is what I was always told. He's our 3rd and last son and he was the only one born with clubfeet. I get concerned though with the never ending question "are they growing well enough, is this normal to have a concaved area where is ankle bone is on the rt foot, and should I get a second opinion" You always wonder if there is more you can do to help, I worry all the time, he gets alot of aches in his feet and ankles. We have always given him the best we can, but I think I'm going to get them checked out by a new orthopedic doctor just to ease our mind. Please feel free to ask me any questions and I will answer them the best I can.
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Sep 29, 2010 @ 1:13 pm
My granddaughter will be 5 years old in February, 2011. She was born with 1 club foot. She underwent casting, tendon release surgery, and those special shoes with the bar until age 2. Now, a doctor wants to do a heel osteotomy--which seems to be very invasive and painful. My questions are as follows:
1. Couldn't soft tissue methods still work?
2. What about physical therapy (which was never prescribed for her)
3. What about a brace?
4. Is this surgery 100% effective?
Thanks for your help
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Oct 7, 2010 @ 9:21 pm
My son was born with club feet and after years with Ponseti methods, braces and 2 surgeries, he is still in braces and when he walks, his big toes point upwards. He is now 9 and still has trouble. I take him to the orthopedic surgeon and they give us stretches and adjust his braces but it still seems like nothing is working. Any suggestions for new stretches to avoid another surgery??
Judy
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Feb 19, 2011 @ 2:14 pm
My son was born with a right club foot on May 6th, 2010. We was put in casting for several weeks, followed by a minor surgery, and afterwords we chose to use the Ponseti method. For the first 4 months he used the brace 23hrs/day and now at 9 months old he wears it when he sleeps. Leg looks pretty good. He is not able to walk yet but we will continue to use the brace and do lots of praying. So far I recommend the Ponseti brace and hopefully he doesn't have to go through any major surgeries in life.
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Feb 26, 2011 @ 7:19 pm
I had corrective surgery at 2 years of age after casts and then splints etc... I am now 40 and suffering from chronic pain after standing for over 2 hours. I had an appointment with a surgeon recently who suggested fusing two ankle together that make up my ankle joint in my lower foot to "make it straight" but the success rate did not seem good. Some of the questions listed on this blog/site are interestig. I would love to see teh replies. Does anyone in the know actually respond to the inquiries here?
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Mar 1, 2011 @ 3:15 pm
Question:

I was born with Bilateral Talipes and I am now 30. I assume the technology and methods to repair Club Foot is far greater now than in 1979. I have undergone 7 operations so far since birth and my left rood is still deformed somewhat and affects my self esteem and Gym excercise.

Can I go for reconstructive surgery now to flatten my foot more and make it look more normal? Also I am considering having Calf Muscle implants as my left calf is quite small.

Any ideas and thoughts??
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Mar 13, 2011 @ 9:09 am
hi,my son has right clubfoot,he is now 9mos old and he had casting 4 3mos.and brace 4 6mos. and now the ortho asked me 2 hav surgery he can walk w/o pain but hs foot is still not straight.pls.help me,what we gonna do? do he need surgery that makes me afraid for any cnsequenses.what is better,streching or surgery?

thank u..donna
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Mar 23, 2011 @ 5:17 pm
Hi, my daughter was born with Bi-lateral club feet they were severe. She wore the casts for 5 weeks. At 7 weeks of age she had the tendon achilles lengthning. Everything was going fine then her right foot just stiffed back up. Dr. said have to do it again and maybe reposition the bones then use pins to keep it set go back 2 weeks later put her asleep again recast. 4 weeks later take the pins out. So I wanted a different route so I tried the physical therapy, stretching, and taping. And even ordered a brace from dynasplint to give her a constant stretch. I can say I was very disappointed in the results. So now we are set for the 31st for surgery. Hopefully it will be just the tendon achilles again.I also have a 14 year old who had club feet he went to Shriner's for the surgery and his feet are awful he has so much arthritis set up in them he can't walk for long periods of times, and he had the major surgery done cut from one side to the other.
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Apr 17, 2011 @ 11:11 am
Our son was born with a fairly severe case of bilateral clubfeet.We by coincidence have a friend now in his 60"s that was one of the first children in the U.S. to have the "new" (non-Ponseti)method of full surgery used on his feet where all the tendons were cut and both feet completely rebuilt. It sounded great at the time and much quicker. Unfortunately it has resulted in a life-time of pain for him.With our son we luckily had the Ponseti Method and the resultant castings and bracing with minor surgical release. I believe there is no "fast method" to successfully correct this condition.The parents of these children need to put in the work of (in our case 15 weeks of castings)correcting the condition and then braces and boots to get them turned-around.This is not simple and it is not easy and if you do not follow what the doctor tells you then you will not correct the issue.
Our son is now going to turn seven. He just ran four miles the other day and continues to jump, hit baseballs and get into just about everything a normally footed kid of that age does.
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May 16, 2011 @ 11:11 am
@ Julie Harper im sorry her doctors was frankly stupid but its still not to late,Its now almost 2 years later and if you still havnt had good success serch for a doctor who is famliar with the Ponseti method of correcting club foot. I have a daughter that is 4 and going to have surgery tommarrow at Loma Linda Univerity childrens hospitol in Loma Linda Ca. She has been treated for club foot since she was 3 days old in both feet she had a very severe case. She was casted for 3 months weekly, then had her heelcord cut and then casted for 4 weeks straight then she recieved speacial shoes with a bar in the middle to keep them pointed out and her heel streched for 22 hrs a day. She wore those till she was walking 1 year old. Her surgey tommarrow will be Bilateral heelcord lenghening. She would not be having this surgery if I were consistant with the shoes which is not easy to do, or is if you know what the alternative is.
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Jun 3, 2011 @ 5:05 am
Hi, It was bad enough living this experiance(1 foot) but to have one of my children(both) going thru the same thing, Terrified me!(So I thought) 1/ For those parents who lived it, think about that! and even though your child might be in a little pain, it is in THEIR best interest that you tough it out!! 2/ I HIGHLY recommend the Ponseti Method. Don't be afraid, your child will be in alittle pain but nothing that loving cuddles cant fix. 3/ Find a Doctor YOU are happy with, someone who explains procedures step by step and doesnt sugar coat anything(so you are prepared), when you ask questions, you are not only answered but you are satisfied! Believe me, its harder than it sounds but worth it in the end. 4/ Treat your child No different(if you have other children) if its your first, you are not doing yourself favours by treating them like a porcelin doll, I say this in the kindest regards. It is already going to be demanding, so you do not want your child to be the same. My son is my 4th child, he did everything the rest did and then some with casts on! He crawled(10mths) walked(12mths) It was in his eyes that I could see he was going to be my little solider and he still is. 5/ USE THE BOOTS AND BAR!! You need strong will and determination(remember-Its in your childs best interest) Its because you love them and it will pay off in the end. It will never be 100% fixed but I think 80% is just the same. Final last things: Massage with soothing oils in between changes of casts and boots, normally after a bath when limbs are relaxed, 10min is enough so your child doesnt get used to not having them on. Share the responsibility with partner and children, believe it or not they want the same thing too. DONT look at it as a disability - believe it to be your fault - give up hope - show your frustration - allow family(ALL) to make fun of your child. the world is going to be a cruel enough place without having to hear from the ones you love! SOO, DO enjoy those little moments in between doctors visits(they are there) - outings with fun intended - Time to yourself - show confidance. Everything you do reflects on your child as they are mirror images of ourselves with their own little twist in it. Ive based this not only on my son but that of my own. I wish they had the skills today back when I was a baby, I wouldnt be so severe. I dont wear shorts as it is very noticeable. My right leg is not only shorter but it is also skinnier which left my self esteem at an all time low, thus my determination to correct my son. He was severe, has had 2 tendon releases(4mths,22mths) and will need 1 more especially with 1 foot. It was amazing what the Ponsetti method achieved, I thought there was no hope. Left foot back to front upside down but now its face forward and up the right way, still got a slight curve/arch. Its still great news to share though. We are still waiting on shoes from the UK as we live in Australia, $250 a pop every say 6-8mths as his feet are constantly growing but necessary. The shoes are a heavy boot so it stops them from curving in and under, also helps with correcting and alligning hips. Not too heavy they cant walk just enough weight to help correction. At this time I do not have the name of the place as we have just shifted(hassel) but I will post it asap. I really hope that this helps someone. Its not the end of the world. Be strong and determined and you wont regret it and thats for everyone involved!
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Jun 6, 2011 @ 8:20 pm
I was wondering if at the age of seven would it be too late to get my grandson's foot corrected? he is experiencing a lot of pain in his hip and thigh. His left foot points inward at about 40 degrees. What are his options? he wants to start hip-hop dance, but he easily stresses his hip, and ends up in pain for several days afterward.
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Jun 17, 2011 @ 10:10 am
I notice the right foot of my eight-year son is twisted or curled when walking. is it considered as club foot? if it is so, what is the solution?
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Jul 24, 2011 @ 11:23 pm
I'm a 26 yr old who had a SEVERE club foot. When my mother asked the Dr. what could be done he suggested amputation above the knee! By the grace of God my mother took me to KU Medical center and met with Dr. Mark Asher. Needless to say I dont remember much of the surgurys. I did everything my friends did as a kid ie: track volleyball...so on. The only thing I've run into is I tend to ache in the winter before it snows. As for the exercises question, I use one of those big rubber band thingys it really helps. Also I use a splint every night.
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Aug 23, 2011 @ 12:12 pm
sir i had this ctev problem in my right foot it has been treated surgically by doctors in 2005 and they have straightened up my foot by implanting four holding pins in between the bones. And at after that my height grows normally upto 2008 and then after 2008 one of those implated pins came out a little bit of my foot and due to this i have now again got surgery in 2011 and got those pins out. Now my right foot is smaller dan my normal left foot and also right leg calf mucsle is smaller then the normal one
so please tell me will my normal height will grow further or not now my age is 18 years n my height is 5foot 5inch.
Priti
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Sep 8, 2011 @ 8:08 am
I am 21 weeks pregnanant and in my 2nd level ultrasound, my baby has been diagnosed with left club foot. We want to do a second opinion ultrasound and also want to consult some pediatric orthopedian right away to understand how severe it looks to be in my unborn baby and can it be cured. It would be very very helpful if you send me any of your advices and help me out in this situation. The doctor is asking us to decide whether we want to continue with the pregnancy and so the matter is a very serious.
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Sep 28, 2011 @ 12:00 am
There is absolutely no reason to terminate a pregnancy due to a clubfoot. My baby girlnwas born with bilateral club feet and yes it is hard. But SO worth it. I can't even believe a dr. Would suggest such a thing! You can meet with a pediatric orthopedist and all they will tell you is there is nothing they can do until the baby gets here. It is treatable. Whatever method you choose.
Chris
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Sep 28, 2011 @ 2:02 am
Priti- Clubbed foot can be fixed. Our son was born in July with both feet severely clubbed and his feet are coming along nicely with the ponseti method. Best case scenario, your child will never have any issues after the foot is fixed. Worst case scenario your child may have to deal with some stiffness or pain issues. Even looking at the worst case, I dont believe clubbed foot or clubbed feet is a good enough reason to terminate a pregnancy. Our son is beautiful and perfect in every other way and I wouldnt change a thing.
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Sep 30, 2011 @ 3:15 pm
@Priti- Please don't terminate your pregnancy due to clubfoot, especially at 21 weeks! OMG, I cannot believe that would even cross your doctor's mind at this point! My sweet, precious little boy is now almost 9 weeks old, born at the beginning of August, and he was born with severe bilateral clubfeet on both sides. He has a wonderful Pediatric Orthopedic Doctor who practices the Ponseti method. My baby had weekly castings since he was 1 week old, then had the heel cord release and is now, as of this week, in the Poseti brace (boots with bar). Of course it has not been easy to watch such a tiny baby go through all of this, but his feet and legs now look great. He has tolerated the castings, cord release procedure and boots very very well, I think it has been harder on my husband and I than on him! He is such a blessing and is healthy in every other way. I did not know beforehand that he would be born with clubfeet so I was hit hard with this info upon his delivery. It was hard because I was unprepared mentally and emotionally about what to expect, and the pregnancy hormones didn't help either. The advantage you have is that you can be well-educated about this and be prepared mentally and emotionally for the treatment that your child will undergo to correct the clubfeet. It really does go by fast, though it does not seem like it at the time. The Ponseti method really is gentle, my son would only be a little more fussy on the days that he got a new cast and then adjusted quickly and was back to normal within about 12 hours until he got the next cast. Same thing even when he had the heel cord release. I was an emotional wreck, thinking about him having surgery, but it was a very minor procedure with no anesthesia and he was still only slightly more fussy for about 12 hours afterward. I know we still have a long road to go with the Ponseti brace, as he will have to wear it 22 hours per day for 3 months and then only when he sleeps until he is 4 or 5 years old, but it is definitely worth it. He brings us so much joy. This birth defect is treatable and basically cosmetic, so it is definitely not a reason to terminate your pregnancy. Hang in there! You will not regret it!! :)
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Oct 19, 2011 @ 12:00 am
1.Is there any treatment needed to prevent the club foot from coming back after surgery?
2.What are the chances that my child's club foot will get corrected?
3.How long will it take to recover from the surgery?
4.What procedures do you follow?
5.How much club foot surgery do you perform each year?
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Nov 4, 2011 @ 4:16 pm
thses facts need to be checked as i was born with clubfeet and had pure opps some 34 years ago and i,m now 35 and i,m in so much pain of late due to the bones in my feet caving in.my g.p told me nothing could be done as the bones in my feet are to small and when i say pain i meen pain and i limp everywear and my feet swell.is there any help out threr
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Nov 11, 2011 @ 6:06 am
My son was born with a clubfoot he was in cast from 4 days old he had the tendons niped twice and now he is 4 and a half he has been out of his brace since his 4th birthday and now hes foot is turning back in and the doctor that he attends in our ladys hospital said he may be nipped again given botox in his foot and back into cast. i have read peoples comments that is older now does this get easier my son has two different size feet which i have to by two pairs of shoes at once which is costly but i dnt mind as i would do anything for him but is this going to be harder for him as he gets older
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Nov 18, 2011 @ 10:22 pm
so.. im 20 years old I was born with club feet (they were like candy canes pointed in towards each other). I had reconstructive bone surgery at 9 months old, so here's the short story:

i have about $5000 dollars worth of debt.. After 4 hours of standing my feet start to hurt very bad 10/10 on the pain scale and it last for days. My doctor will not prescribe me pain killers for some odd reason. I can't find an office job, or a job were i don't need to stand. I am becoming very depressed, and I don't know what to do anymore. I've dug my self into such a deep hole, and I can't get out(credit card, school loans, doctor bills, work needed on my vehicle, etc). I need some advice, and I need it now. Why wont my doctor prescribe me painkillers so I can work 8-10 hour days like a normal human-being.. I'm on the verge of giving up, I can't take this bullshit any longer... My family has always been here for me, but we just don't know what to do. Please someone get back to me ASAP!
hayley
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Jan 1, 2012 @ 6:06 am
I am 27 year old female born with talipes both feet, sevred right foot toes, also had a constriction band around my right hand and left leg. Just above the ankle,I have had more than ten surgerys scince birth ,but I would like any advice on my present problems, due to the band on my ankle I have a snaped, broken , what ever lynph node that swells the lower part of the band until its doubled in size then it weeps. The pain is very unconfortable ,would like to also get intouch with prof klenimen, worked in alder hey childrens hospital from around 1985-1993 aprox. Just to say thankyou also mr bruse. Also worked at alder hey, although I am having troubles due my birth defect , these doctors realy helped me in every which way humanly possable, would just like to say thanks so if anyone can advise me on either issues I would be very thankful,.
Thankyou again. Hayley King liverpool uk my email is hayleyking84@live.co.uk
K.L.Raja
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Jan 25, 2012 @ 9:21 pm
Our son under went corrective surgery for unilateral club foot at the age of 1.he was put on with splint shoes till 3 yrs.now he is walking normally but he corrected foot is smaller than his normal one.is there any form of exercise to make muscles of calf & foot normal size
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Feb 29, 2012 @ 4:04 am
Our son Jesse wore the brace, had strapping, cast and 3 different surgeries when he was little. He is now a very active, busy 9 year old who is beginning to notice how different his left foot and leg are. He is experiencing some soreness. We are in Qld Australia does anyone know of shoe options and further procedures that can help with the differences presenting in his little body such as the shorter leg, smaller calf muscle and limited mobility in his ankle. As we have moved a fair bit with work we have lost touch with our initial support.
Rachel
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Apr 30, 2012 @ 10:22 pm
Our son was born in 2011 and he was born with bilateral club be in both feet. When he was the pediatric doctor called in a pediatric orthopedic surgeon and he helped us better understand what was going on and what the treatment was. He told us that this is a curable condition and that soon our son was going to be running around with his big brother. It scared us to think that he may not be able to walk with the help of the doctor he helped us better understand what it was. The first step we started with was three days after he was born we started a series of casts for manipulation. The first cast was changed after three days and continuing on to the forth cast after the fourth cast we had a fifth cast that was to be on for a week after that was over the doctor then gave him splints and also referred me to a pediatric rehabilitation therapist. The splints were just like cast and that they were able to be taken off. From the physical therapist I learned that you can stretch him to make his feet more pliable to straightening. For a while he was set up with a set of braces called dobbs brace. He was then in them for 23 hours a day and a one hour out where I would stretch him for 10 minutes two minutes each leg in intervals. Soon the doctor started letting him be out of his braces for more and more hours till now he is only able to sleep at them. But the stretching times increased to three times a day. My son is now 13 months old and started walking at 10 months old. the only problem he is having right now is intoeing for his toes are turning in a bit but his feet still stay out. So far he is doing really well the best thing I recommend is to find the best doctor for you that has very big confidence in himself or herself. He has yet to have had surgery so I still hope and pray that he will not need it. This condition is not that bad there're worse things out there best thing to do is do your research
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May 18, 2012 @ 11:11 am
If a person who was born with a clubfoot did not get treated it ,and it had gotten worst even as the article stated,not including his mental state because of the pain and growth of hardening skin kelos, as well as the opening up of his toes, what would be the best way to go about treatment? Doctors have told him as he is now experienceing while attempting to maintain a study job that his hip alignment and back would be the first main problems as he continues to grow and live and it has been a problem concerning him recently to the fact that it has and continues to effect his job and his relations because of the mental and physical stress.
Neil
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Jun 12, 2012 @ 3:15 pm
I'm 45 years old and was born with a Telipes Foot, left foot only thank goodness. I had this corrected by around 4 years old while under the care of Great Ormond Street Hosital, London. Previous to that I was under the care of another hospital that was trying (and failing) to correct it with plaster casts and a leg/foot calliper. Anyway, as soon as I reached 16 years of age I was discharged from Great Ormond Street as this is just a children's hospital. So, from then until now the only care I get is from my GP and the only care I get is the odd X-ray to see if the steel pin has moved in my foot and stronger and stronger pain killers, I'm now on Tramadol's 1 or 2, three times a day. I don't know if any of you have taken these but, they are horrific, they give you head aches and make you very dizzy and sleepy. Because they are like this I don't take them, oh, the other reason is that they don't take the pain away. My foot is a full size smaller then my right foot, my left leg is over an inch smaller in length than the right leg and the calf looks about half its opposing calfs size. My foot gets a constant "knocking" which is audible while walking and the sole goes numb, and recently I'm having more back problems because of the difference in leg length. Anyway, I'd be really grateful if anyone else has had these problems and had a successful resolution to them or indeed if there is something I should be doing to ease my problems.
G.K.S.Dilshan Koralage
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Jul 24, 2012 @ 5:05 am
I'm 23 olds now. I was born with club feet(both legs) then i was done a surgery and i'm 100% ok now. happy to say that i do sports really well. the thing is my feet are little thin. i'm asking you to give me information to build up my legs. please let me know if it is possible. thank you.
Adam
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Sep 16, 2012 @ 7:19 pm
I'm 31 years old, born with congenital bilateral clubfeet. I had corrective surgery on both feet, including the pins in heels, brown's bar, etc. I participated in sports, rode a bike almost every day for many years, but still had pain. Tried to hide it for the longest time, or ignore it for the most part. At around age 22, had to leave work because the pain was getting so severe. Social anxiety set in and has progressed over the years. Have not been able to find any jobs because of these conditions. I have been on disability for about 6 years now, which took over 5 years, and a lawyer...to get approved. It really sucks because I want to work and be successful, meet someone and raise a family. But at this point, I've pretty much given up. I'm not happy sitting on my butt doing nothing, have always loved being more physical. Had to change doctors recently because there is only one place in town that works with medicare/medicaid patients. Now I'm having to prove myself all over again, the doctors act like it's a joke and/or fake just because I'm not on the floor in tears about it. They will not prescribe me pain meds anymore even though I'm not an at-risk patient. Life is hard enough as it is, not sure how much longer I can cope with this pain and the added weight issues. Kind of gave up on other things also like meeting a woman to share life with. Trying so hard to stay positive in life, but things have really got me down and out. I wish you all the best. It's not easy by any means!
John Grillo
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Jan 18, 2013 @ 11:23 pm
I had club foot surgery done on my left ankle in the late 60's and the last surgery i had was in 1978... I have had a total of 8 operations on my left ankle The doctors name was Samuel Clayton located in Bayside N.Y. Does anybody remember that doctor?? He was one of the best in the country at the time.
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Mar 30, 2013 @ 7:07 am
My daughter was born with a single club foot, her left. She went through casting and surgery as a young child with the final surgery being to halt the growth in her right leg to allow the two legs to be even. She is now 40 and suffers with constant pain and extreme difficulty in walking, which makes working while on her feet a life challenge. She is currently working with an orthopedic podiatrist to create a toe to just below the knee brace which forces her ankle , which is malformed, to be rigid. She has gained some relief with this but it has not been as much help as desired. What, if anything, can be done at her age to eliminate pain without creating a noticeable limp in order to make daily life less challenging..
Laura
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Oct 8, 2013 @ 10:10 am
For adults, have your go refer you to an orthopaedic surgeon. the surgeon can prescribe orthotics and have better specialist. please see a specialist I meant GP ... my tablet is acting up
Marta
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Dec 11, 2013 @ 5:17 pm
My son will be 5 years old in January, 2013. He was born with bilateral club foot. He underwent casting, and those special shoes with the bar until age 2. Now, a doctor wants to do a tendon release surgery. My questions are as follows:
1. What is soft tissue method?
2. Could physical therapy or massage avoid sugery?
3. Is this surgery 100% effective or club feet still can come back?
Thanks for your help
Rebbecca Lees
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Feb 3, 2014 @ 6:18 pm
This is for marta my son is 9 years old and here we do the ponseti method. My son has had the tendon release surgery and it was the best descision that i went with he had this surgery performed when he was 2 and a half years of age. we did try massage and had an option for therapy, he also had a calliper made up for him which was inserted in to his shoes. However where the cuts are made for both tendants release it will help the foot rather than the tendants being so tite and uncomfortable for him.
HASHIR BARLAS
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Jul 17, 2014 @ 1:13 pm
I have my right foot which was the club foot. I have a twin who is perfectly normal . I had the operation when i was 9 months ago which was a sucess at that time (15 years ago). I started to search on club feet as my foot is paining alot these days . I am almost normal with it as i do shooting at international level. My point is is it necessary to have a operation again if you develop severe pain .

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