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Definition: clubfoot from The Columbia Encyclopedia

or talipes (tăl'Әpēz´´), deformity in which the foot is twisted out of position. Maldevelopment is usually congenital, although it can result from injury or disease (e.g., poliomyelitis) after birth. It can affect one or both feet. Often the foot is twisted downward, with the heel and toe turning inward, causing only part of the foot—the heel, the toes, or the outer margin—to touch the ground; walking is difficult or impossible. Correction can be made in infancy by manipulation, braces, and casts; in severe cases only surgery can correct the condition.


Summary Article: Clubfoot
from Encyclopedia of Special Education: A Reference for the Education of Children, Adolescents, and Adults with Disabilities and Other Exceptional Individuals

Clubfoot is a descriptive term for a number of congenital deformities of one or both feet that vary in severity and etiology (Clubfoot.net, ). Involving both the soft tissues and the bone of the leg and foot, clubfoot generally occurs in isolation with no known cause, but it may also occur with chromosomal abnormalities and neurological disorders such as cerebral palsy and spina bifida (Dietz, Rebbeck, Blake, & Mathews,; Dormans & Batshaw,). Milder deformations of the foot that apparently arise from the fetus’s position in the womb and may correct themselves or need minimal intervention are generally not described as clubfoot (Clubfoot.net, ). Most cases of true clubfoot are talipes equinovarus. This is where the joints, tendons, and ligaments incorrectly develop in the foot and ankle. It is characterized by a drawn up heel and pointed downward toes so that the bottom of the foot points straight back. (Clubfoot.net, ). This complex disorder affects twice as many boys as girls and has an incidence of 1 in 1,000 children.

Clubfoot requires treatment, and early treatment is the most successful. If uncorrected, an affected child will walk on the outside-top surface of the foot, leading to other problems (Clubfoot.net, ). Type and timing of treatment vary with severity of the disorder. In mild cases, the only treatment that may be needed is a regimen of regular stretching of foot muscles that parents can be taught to do at home. In most cases, orthopedists use casting as the first treatment, and the cast is put on soon after birth or at a few weeks of age. In casting, the foot is twisted into the correct position and held so that the bones and muscles grow appropriately. This can be mildly painful, but the pain usually lasts only during the casting itself. Casting can take from 3 to 6 months, with the casts changed weekly or biweekly. A splint or special shoes may then be used to prevent regression (Clubfoot.net, ). In about 50% of cases, manipulation and casting alone are sufficient to correct the deformity, but regular checkups are required to ensure that the foot does not return to the deformed shape. In the remaining cases, corrective surgery, performed between 3 and 12 months of age, is needed to release all tight tendons and ligaments. The surgery is complex and difficult, with recurrences of the deformity occasionally occurring. Again, regular checkups are called for.

With early and effective treatment, prognosis is good, and those born with clubfoot can have normal or near-normal foot appearance and mobility. If untreated, the foot will continue to grow in its twisted position and cause permanent mobility problems. No further intervention is generally needed, but parents should consult with their orthopedist concerning sports and physical education activities.

References
  • Clubfoot.net (2001, March 20). Clubfoot. Retrieved from http://www.clubfoot.net/clubfoot.php3.
  • Dietz, F. R.; Rebbeck, T. R.; Blake, D. D.; Mathews, K. D. (1996). An idiopathic clubfoot family does not show linkage to the chromosome region linked to distal arthrogryposis I. Pediatrics, 98, 560-561.
  • Dormans, J. P.; Batshaw, M. L. (1997). Muscles, bones, and nerves. In Batshaw, M. L. (Ed.), Children with disabilities (4th ed., pp. 315-332). Paul H. Brookes Baltimore MD.
  • Robert T. Brown
    Amy M. Morrow
    University of North Carolina at Wilmington Wilmington North Carolina
    Copyright © 2014 by John Wiley & Sons, Inc. All rights reserved.

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