The Importance of Early Diagnosis and Treatment in Clubfoot
By Dr. Sujith Omkaram,
Consultant Paediatric Orthopaedician
Ankura
Hospital for Women and Children
Clubfoot,
or congenital talipes equinovarus (CTEV), is a common deformity affecting
approximately 1-2 in every 1,000 live births. If left untreated, it can lead to
significant physical disability and lifelong challenges. Effective management
of clubfoot relies on early diagnosis and treatment, which can dramatically
improve outcomes for affected children.
Antenatal
diagnosis of clubfoot is possible through ultrasound scans during the second
trimester of pregnancy. Informing expecting parents about the condition and its
treatment can alleviate anxiety and ensure adherence to treatment protocols.
The Ponseti method, the gold standard in treating clubfoot, involves weekly
changes of casts. Most cases can be completely corrected with 4 to 6 casts,
typically by the time the baby is 1 to 2 months old, thus avoiding surgical
intervention. Early onset of cast treatment and subsequent foot abduction
bracing until the age of 4-5 years are crucial for successful correction.
Initiating
treatment during the newborn period enhances the likelihood of successful
correction, as tissues in newborns' feet are more malleable and responsive to
corrective measures. Ideally, treatment should begin within the first week
after birth. Even cases presenting after a year can be treated successfully
with Ponseti casts, though the likelihood of needing surgical intervention
increases with age. Untreated clubfoot can result in chronic pain, difficulty
walking, and the development of calluses or sores due to abnormal pressure
points on the feet.
Early
treatment increases the chances of developing normal or near-normal feet,
leading to improved mobility and better participation in physical activities.
This ensures that children can engage in activities appropriate for their age
without significant physical limitations. Additionally, early intervention
reduces the need for extensive and expensive treatments later in life,
minimizing healthcare costs and the economic burden on families.
In conclusion, early diagnosis and treatment of clubfoot transform the lives of affected children by enabling normal foot development and an enhanced quality of life. This approach not only supports families in managing the condition confidently and effectively but also ensures that children can lead active, healthy lives free from the limitations imposed by untreated clubfoot.
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