Congenital clubfoot is very common and reaches 33-38% of all congenital malformations of musculoskeletal system. This is the most common of all congenital malformations of musculoskeletal system. The boys congenital clubfoot occurs twice as often as girls. Usually it is bilateral.
The cause of congenital clubfoot - a violation of the proper development of bones of the foot or lower leg muscle developmental disorder (peroneal) and their innervation.
Clinically manifest congenital clubfoot following features: flexion of the foot at the ankle joint in the direction of the sole (plantar flexion or ekvinus) podgibanie forefoot (bringing the feet). Thus there is an increase in the height of the foot rotation of the foot plantar to the midline (supination).
The back of the foot is turned in such a way sideways and outwards, and the plantar side of the foot is turned to the midline. All this is accompanied by a limitation of motion in the ankle joint. When a child begins to walk, he relies on the outer edges of the feet, rather than on the plantar side of the foot. At the same time developing a specific gait. A child with every step, like steps over his foot. Gradually develop skeletal deformity of the foot.
In the long clubfoot occur subluxations of the foot bones to each other. The skin on the outside of the foot callous. Calf muscles are not involved in walking atrophy. Disrupted the normal functioning of the knee. The diagnosis is usually established on the basis of a typical clinical picture of disease. And the earlier the diagnosis and treatment is started, the best results are achieved.
Conservative treatment begins with the first weeks of life, because the soft tissue tensile child can hold the foot in proper position and to ensure its normal development. Assigned to physiotherapy (redressatsiya), which is combined with massage of feet and apply 3-4 times a day. Apply three types of exercises, they are repeated 20 times. Foot is fixed into position with a soft bandage of flannel. The essence of all actions performed in an attempt to restore the shape and motion in all joints of the foot.
When the correct shape of the foot is achieved, the foot and lower leg impose a special bus. In more severe cases, apply casts for the phase-correction form of the foot. Bandage orthopedic surgeon on a table. After three weeks, remove the bandage and put the next one. Then assigned to wear orthopedic shoes. A baby sleeps at night with tires made of polyethylene. Simultaneously applied massage, physiotherapy, exercise therapy. If all these measures prove ineffective, surgical treatment is assigned. Operations are performed in the child's age from 1 to 2 years.
Performed plastic surgery on the tendons, ligaments, aponeuroses of the foot. Most often, the operation is performed by the method of TS Zatsepin. After elimination of foot deformities by surgery, the foot superimposed cast. Term wear plaster for 6 months. Some patients with severe clubfoot surgery is carried out at the age of 12 years. Results of surgical treatment is usually best to conservative methods.