Clubfoot in adults: Medically known as congenital talipes equinovarus, or CTEV, Clubfoot is a condition in which the ankle and foot are permanently twisted. In this condition, the foot usually points downward and turns inward. It's usually present at birth and occurs in about 1 of every 1000 births.
When noticed, treatment should begin a week after birth to fix clubfoot. At this time, the tendons, ligaments, and bones are soft and can easily move into the correct position. However, this will not work for all babies.
Sometimes the condition goes untreated, and children grow with it into adulthood. Or, clubfoot in adults may also be present because of poor treatment when an individual was still young. This is because the manipulation of the foot into the correct position when one is still young depends on the facility, the doctor, and the extent of the condition.
The reasons for clubfoot are not always clear, but the chances of being born with this condition are higher in instances where the child's mother smoked while pregnant, the child is male, there is a family history of the disorder, or the individual has spina bifida.
Adults with clubfoot will appear to be walking on the sides of the feet or the ankles. Such people walk with difficulty, and it's usually impossible for them to buy or wear normal shoes. This is because their feet don't flatly touch the ground.
In some cases, you'll find that some adults that received treatment while still young have good foot function, but have limited range of motion and feel pain when they participate in activities such as running and walking for hours. In the past, people who didn't receive treatment while babies were advised to get treatment during adolescence. However, some adolescents who received clubfoot treatment have reported problems after surgery, including weakness, pain, and difficulty using their feet.
The two common options for repairing clubfoot include casting and surgery. The doctor will recommend an option depending on the extent of an individual's condition.
This is a simply a non-surgical approach to repairing clubfoot, and there are two types of casting: Ponseti method, which is commonly used on babies and children, and Ilizarov method for adults.
In Ilizarov method, a podiatrist will place wires through the bone of the clubfoot and attach them to an external fixator. The patient will then adjust the fixator at home according to the instructions given by their doctor. This process works like braces on the teeth. The fixator helps to move the bones gradually into the correct position over time.
The patient will need to have the fixator on their foot for about 5 to 6 months for this treatment to show progress. After this period, the external fixator is surgically removed, and the podiatrist places a below-knee cast on the foot for about 2 to 3 months to hold the corrected foot in position.
At first, the patient will find it hard getting used to the fixator on their foot but will start adjusting after two to three weeks of use. This treatment is a great alternative to other forms of treatment if the case is not severe.
Clubfoot in adults can also be repaired using a surgical operation. During the procedure, the surgeon increases the length of the Achilles tendon located close to the heel and loosens tissues around the foot. In some cases, patients will need to undergo a tendon transfer. The doctor will make incisions in the affected foot to loosen the contracted tendons and ligaments. This makes it easier for the podiatrist to manipulate the foot into position.
A surgical repair is usually extensive in adults because their tendons and ligaments are already grown. In some cases, adults may need several surgeries. The doctor might need to cut into the bone through a procedure known as osteotomy to correct the foot. When this happens, screws or metal plates are used to hold the foot in position. The leg is put in a cast after the correct position is attained.
Clubfoot in adults can be very inconveniencing for many people and may affect everyday, normal life. If you suffer from clubfoot and didn't get treatment early enough, visit a podiatrist to help you understand your treatment options before it leads to a permanent condition.
Physical therapy is also necessary after undergoing surgery, but keep in mind that the muscles in the foot are likely to remain permanently smaller.