Club foot

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For the Kasabian song, see Club Foot (song)
Clubfoot
Classifications and external resources
ICD-10 M21.5, Q66.8
ICD-9 736.71, 754.5-754.7
Club foot.
Enlarge
Club foot.

A clubfoot, or talipes equinovarus[1] (TEV), is a birth defect. The foot is twisted in and down. Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet. It is the most common birth defect, occurring in approximately one to two per 1000 live births. Approximately 50% of cases of clubfeet are bilateral. In most cases it is an isolated abnormality.

Contents

[edit] Causes

Researchers do not know exactly how clubfoot is caused. Some think it may sometimes be caused by intrauterine compression (possibly from oligohydramnios). Others think it is caused by a genetic malfunction during first trimester development. It can run in families, with incidence rates increasing significantly when multiple direct family members have the condition. Incidence in males is higher than in females.

[edit] Treatments

Clubfoot is treated with manipulation by an orthopedic surgeon or physiotherapist. In North America, manipulation is followed by casting. The French "physiotherapy method" uses taping to maintain correction. Foot manipulations usually begin within one week of birth. Surgery is usually performed if the foot has not been corrected by ~3 months after birth. Even with successful treatment, the affected foot (if unilateral) may be smaller than the other foot and the calf is frequently noticeably smaller than the normal side.

[edit] Ponseti Method

Club foot.
Enlarge
Club foot.

Another form of correction is known as the Ponseti Method [2]. Foot manipulations differ subtly from the Kite casting method which prevailed during the late 20th century. Although described by Dr. Ignacio Ponseti in the 1950s, it did not reach a wider audience until it was re-popularized by Dr. John Herzenberg in 2000. The Ponseti method is successful in correcting clubfeet using non- or minimally-surgical techniques in >95% of cases [3] when performed by an experienced physician, usually within 12 weeks from initiation of treatment. Approximately 80% of infants may require an Achilles tenotomy (microscopic incision in the tendon requiring only local anesthetic and no stitches) performed in a clinic between 6 and 9 weeks of age. Maintenance of correction requires the full time use (23 hours a day) of a splint called a 'Dennis Brown Bar', also known as a foot abduction brace (FAB), for three months after achieving correction. Part time use (generally at night, usually 12 hours/day) is frequently prescribed up to 3-4 years of age. Approximately 20% of infants successfully treated with the Ponseti casting method may require a surgical tendon transfer after two years of age. While this requires a general anesthetic, it is a relatively minor surgery that corrects a persistent muscle imbalance while avoiding disturbance to the joints of the foot.

The long-term outlook [4] for children who experienced Ponseti Method treatment is comparative to that of non-affected children.

Watch a Video on the Ponseti Method

[edit] Famous people

There are many famous people who were born with club foot or club feet, including Lord Byron, Thaddeus Stevens, Damon Wayans, Gary Burghoff, and Dudley Moore. Clubfeet.net has information on a number of other celebrities born with the defect. Football kicker Tom Dempsey used an uncorrected club foot as his kicking foot, setting the record for the longest field goal in NFL history in 1970, a record that still stands (though it has since been tied by Jason Elam). Kristi Yamaguchi also was born with the defect, and went on to win figure skating gold in 1992. Soccer star Mia Hamm was born with the condition. Major League Baseball pitcher Jim Mecir was born with two club feet, yet pitched a long career ending in 2005, while current Pittsburgh Pirates infielder Freddy Sanchez cites his ability to overcome the defect as a reason for his success [5]. Film director David Lynch was also born with club feet.

Josef Goebbels also had club foot, a fact which was obscured from the German public by censorship campaigns. Goebbels' club foot meant that he was rejected for military service at the beginning of World War I. Because of his club foot, Goebbels wore a metal leg brace for most of his life.

[edit] In literature

The main character, Philip Carey, in W. Somerset Maugham's novel Of Human Bondage, has a club foot, a central theme in the work.

  1. ↑  The term talipes is from Latin talus, ankle + pes, foot. Equino-, of or resembling a horse and -varus, turned inward.

[edit] External links

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