Clubfoot Treatment

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The method we use

What is a Clubfoot (Congenital Talipes Equinovarus)?

It is a significant deformity of one or both feet of the child present at birth.

To the extent that its causes are unknown, it is said to be "idiopathic".

It most often affects boys and affects about one in 500 births in developing countries.

The foot rolls inward and positions itself in downward flexion.

Apart from this foot deformity, the child is perfectly normal physically and psychomotorically.

Why is it necessary to treat clubfoot?

It is important to diagnose clubfoot and treat it if possible before the age of three, otherwise the untreated child will walk on the outer edge of the foot and then on the dorsal side, which will change the shape of the foot and lead to other deformities.

This is called a major locomotor disability.

Eventually, the child will have pain when walking and the bone deformities will be irreversible. This disability is part of a cycle of isolation and poverty.

Why the Ponseti Method?

The treatment of clubfoot, often controversial, has long been surgical, but the complications observed in the medium and long term after surgical treatment explain the renewed interest in the conservative treatment of this pathology over the last 30 years.

Conservative treatment is essentially based on two techniques: the functional method and the Ponseti method.

The Ponseti method is the least expensive, most anatomically conservative and most effective in terms of results in recent years.

It is an excellent method of reduction, provided that it is carried out rigorously and meticulously and that there is a learning phase.

This is why Step By Step uses this method, in which its professionals are trained and competent.

First Phase of the method

It is the manipulation and application of plaster.

In order to soften the child's foot before the cast is put on, it is very important to manipulate the foot for a minimum of five minutes to obtain maximum correction, and this at each cast change session.

Then, a check-up is done to verify the good evolution of the foot.

Then, the cast is placed in a precise position determined by this assessment.

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Second Phase of the method

This is the percutaneous tenotomy of the Achilles tendon.

The casting phase alone is not sufficient to correct all deformities in the clubfoot.

Tenotomy is a very important step to regain full mobility of the foot and ankle.

This minimally invasive and painless procedure takes only five minutes in the operating room, and will leave only a very small scar.

It consists, under local anesthesia, of a small incision under the skin of the Achilles tendon, which is much stiffer in clubfoot children.

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Third Phase of the method

This is the wearing of an abduction brace.

This will allow the maintenance of the correction that has been acquired during the two previous phases.

The child should wear it immediately after removal of the post-tenotomy cast.

It is very important for parents to get their child used to wearing the brace according to the protocol because not wearing brace is the main cause of relapse in children treated by the Ponseti Method.

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