After the clubfoot is completely corrected, the foot may recur during the period when the child is wearing a brace. In general, the younger the child, the higher the likelihood of recurrence; recurrence after age 6 is rare in children with no other defects than clubfoot. Early detection and early correction of recurrences is important to continue to obtain good results.
1. Causes of recurrence
The pathological factors that lead to congenital clubfoot are also the main source of recurrence. As mentioned earlier, the cause of clubfoot may have an active period of up to several years.
2. Causes of recurrence
Failure to wear a brace
Failure to wear the brace correctly: more than 80% of recurrence cases.
Wearing the brace correctly: only a minority of recurrence cases.
Failure in treatment
1. Adequate abduction was not achieved, that is, the displacement of the navicular bone was not completely corrected.
2. Adequate dorsiflexion was not achieved.
It is possible that in a few cases, the medial and posterior sides of the foot are too severely fibrotic in the muscles, fascia, ligaments and tendons?
Other defects associated with clubfoot.
Congenital polyarticular curvature, spinal cord herniation . or other neurological defects may have a strong influence as an additional factor causing recurrence.
3. Prevention of recurrence
Correction of the “70° hyperextension” is given to the “young child”.
Strict use of the brace, following the protocol for its use.
Stretch the gastrocnemius muscle.
Recommendation: 2 minutes of pulling before the parents put on the brace.
Squatting with the foot on the ground: pulling the posterior tibial muscles.
Suggestion: Parents should have their child squat for 2 minutes each day.
Physical Therapy
To promote active movement of the foot and to help coordinate the foot with the physiological movement patterns of the whole body, neurophysiological treatments and techniques can be used.