Congenital clubfoot (pes equinovarus) DEFORMITY
What is the Congenital clubfoot (pes equinovarus) deformity?
Latin for “congenital pes equinovarus deformity” known as congenital clubfoot deformity in children is defined as a deformity characterized by inversion and equinus of foot. The deformitiy is found more frequently in boys then girls. The incidence is 1 in 1000. In some cases, there is a family history.
What type deformity is seen?
While front part of the foot turned inwards horizantally, hindfoot, heel also shows inversion in frontal plane. Due to calcaneal equinus position, posterior part of heel bone seats above the original place. That gives That is why if one palpates heel, he/she can feel it soft as if heel bone is missing. Particulary, in unilateral cases, one can easily realize that the foot is smaller and calf is thinner in pev site.
There are several theories about the etiology of the deformity. We may conclude in summary that genetic and enviromental factors are together may cause clubfoot.
The diagnosis can be made clinically. However, with the advanced intrauterine ultrasonography, it can be diagnosed in intrauterine period. Your doctor may order foot x-rays. Some children with clubfoot may have associated hip problems. So, evaluation of the hips is crucial.
We treat pes equinovarus deformity successfully with serial cast treatment of Ponseti. We apply serial cast at weekly intervals. After 5-6 serial casts depending of the severity of pes equinovarus. Percutaneous Heel cord lengthening is performed and last cast is applied. Last cast stays for 4 weeks.Later patients are to use Ponseti device.