Baby/child

If a child is born with a clubfoot, the treatment must begin immediately in the first days after birth.First and foremost, this means that the infant’s clubfoot is first gently treated to stretch and loosen the shortened, tight ligaments, muscles and tendons on the inside of the foot, the sole of the foot, the back of the foot and the calf. Then the clubfoot is treated according to the so-called Ponseti method. For this purpose, the clubfoot is brought into a position that is as corrected as possible and fixed with a plaster cast from the toes to the groin.

This plaster is initially changed daily, later at weekly intervals. The correction of the clubfoot is increased step by step. The procedure sounds painful, but it is not for the infant, as its cartilage and bone tissue is still very flexible. The aim of this treatment is to bring the incorrectly positioned bones and joints into the correct position. Only in this way can a functionally good and pain-free foot develop.

Rail

Once the clubfoot has been completely corrected – either by the plaster treatment alone or with an additional Achilles tendon extension – the therapy is continued with specially made splints. The infant is usually 3 months old at this time. The splints are necessary because the clubfoot often reoccurs without continuous treatment.

The splints therefore serve as a recurrence prophylaxis and are successful in 90% of cases. They consist of two shoe-like brackets which are connected with a metal splint. If only one foot is affected, the healthy foot is attached to the splint in 40° abduction (=spreading) and external rotation.

This corresponds to the normal, healthy foot position. The clubfoot, on the other hand, is abducted by about 70° and rotated outwards. The splint must be worn continuously for the first 3 months and may only be removed for personal hygiene and physiotherapy.

Afterwards, the splint must be worn until the child is 4 years old while the child is still sleeping, if possible 12-14 hours daily. The children need a few days to get used to the splint, but then they will have good leg mobility and later on they will not have any restrictions when sitting or walking. Even if the child cries at first or does not want to sleep, the splint must not be removed. Otherwise the risk of a relapse is very high!