1.About congenital clubfoot
Congenital clubfoot is the presence of clubfoot at birth.
Clubfoot is one of the most common congenital anomalies.
Approximately 1 in 1,000 children born worldwide have clubfoot.
Regarding congenital clubfoot as a developmental malformation.
In about the third month of pregnancy, the foot of a normally developing fetus transforms into an inversion of the horseshoe foot. Due to pathological factors that may be active for several years, this type of clubfoot can recur after correction. We do not yet know the exact cause, but we are confident that it arises from a combination of genetic and extrinsic factors. Fibrosis (abnormal increase in connective tissue), is supposed to be the main cause of the deformity. In the medial and posterior aspect of the clubfoot, the muscles are shorter and increased tissue is found in the muscles, fascia, ligaments, tendons and tendon sheaths.
Heredity.
One parent with clubfoot: The chance of passing it on to the child is ~ 3-4%.
Both parents have clubfoot: the chance of passing it on to the child is ~ 15%.
Male infants have a higher rate of the disease than female infants
Bipedalism and unipedalism
Alone or with neuromuscular diseases, chromosomal abnormalities, syndromes and certain congenital anomalies such as
congenital polyarticular contracture (AMC), spinal cord spondylolisthesis (MMC), Larsen syndrome, distorted osteogenesis imperfecta, Moebius syndrome, amniotic band syndrome, metatarsal adductor deformity, limb deformities such as syndactyly, missing toes and polydactyly. See Appendix 6 for details.
2. Why is the Ponseti method used in China to treat clubfoot?
Children with clubfoot are often abandoned or forced to face a poor future, and by correcting their feet, they can have a chance to live a normal life.
The Ponseti method is a very effective, economical and long term treatment.
Primary care workers and surgeons are able to master this treatment technique and the technique of applying the cast.
Surgeons report that surgically treated clubfoot becomes weak, stiff and painful in adulthood.
3.The purpose and results of the Pansetti treatment
The goal is to completely eliminate or reduce all factors of clubfoot deformity in order to obtain a functional, flexible, painless, strong, normal-looking foot that can wear shoes with the sole of the foot on the ground.
The success rate (in infants and young children without other diseases) can usually exceed 95%.
The outcome of treatment depends on
a. The severity of clubfoot.
b. The presence of other health problems (e.g., neuromuscular disease, syndromes).
c. The age and physical developmental stage of the child when treatment is started.
d. The experience of the physician or other medical practitioner.
e. Cooperation of the parents.
f. The correct use of braces.
Minor differences that may be seen in a successfully treated clubfoot are
a. The affected side of the foot is slightly smaller than the normal other side of the foot.
b. Smaller circumference of the lower leg.
c. The peroneal muscle is shorter.
4.When should I start the Pansetti method of treatment?
Within a short time of birth (~7-10 days): Best
For children who are not yet walking: Very effective
Walking children up to teenage years: effective, correcting all or most of the deformity.
Older children may require additional surgery, depending on the severity of the condition and whether there are health problems associated with it.
5. Long-term goals in China
Raise awareness.
To raise awareness of clubfoot and the need for early and effective treatment. Doctors, midwives, and nurses should be well informed in Chinese hospitals, social welfare institutions, and even in small clinics, as should medical students. Every member of society, especially young couples, should be aware of the need to understand this treatment. This can be done through posters, newspapers, television and the Internet.
Create a consensus among all foundations that the Pansetti method is an effective treatment for congenital clubfoot.
Build capacity to treat congenital clubfoot through training.
To create a social awareness of not ignoring clubfoot in the future.