Clubfoot in Adults

Clubfoot in Adults

Clubfoot, medically known as talipes equinovarus is an inborn foot deformity that causes significant changes in the feet’s normal alignment and flexibility. It can cause problems to one or both feet and can be mild or severe.

Typically, clubfoot is treated few weeks after birth while the tendons, bones, ligaments, muscles, and other feet structures are soft and are easy to move. If the treatment did not work during the early stages of life, clubfoot might remain present until adulthood.

Signs and Symptoms of Clubfoot

Clubfoot may be evident to the naked eye, but sometimes, diagnostic test such as ultrasound (before birth) can be used for early detection. In general, signs and symptoms of clubfoot include:

  • Inward distortion of the foot: The soles of the feet do not lay flat on the ground; instead, they face towards each other (inner side). The ball of the foot also appears lower than the heel
  • The feet are stiff: The feet cannot be moved, and the joints do not work normally.
  • Smaller calf muscles: The affected foot has smaller calf muscles.
  • The affected foot does not lay flat on the ground: The deformity causes the patient to walk on the side of the foot
  • Difficulty in wearing footwear: Shoes does not fit most of the time

Tendons and Clubfoot

Tendons are tough fibrous connective tissues that connect bones to muscles. They provide support to the feet and are capable of withstanding tension. If the tendons connecting the leg muscles and the bones of the feet become too tight or short, clubfoot can manifest.

Risk Factors of Clubfoot

In some cases, clubfoot’s causative factor remains an enigma, but several studies show that the following factors can contribute to the development of clubfoot:

  • Baby’s position in the womb – this type is believed to be a result of an abnormal feet positioning while still in the womb.
  • Inherited genes – This is the most common type of clubfoot. Several cases are linked to family history.
  • Congenital disabilities In some cases, clubfoot occurs as a sign of an underlying abnormality in the muscular or nervous system or as a part of a congenital disability.

Diagnosis of Clubfoot

Family history and a thorough physical examination help make a diagnosis of clubfoot in adults. Radiology studies are useful in determining if the clubfoot is mild or severe.

Management of Clubfoot

Clubfoot in adults is commonly managed by casting or surgery. Depending on the severity of clubfoot, the physician may recommend either of the two.

  • Casting – This is a less invasive approach to treat clubfoot. It is frequently done via the ‘Ilizarov method’ which works like a brace on the teeth. An external fixator is applied, and the patient will be advised to adjust it at home as per doctor’s instructions. The fixator that serves as a ‘cast’ helps the bones to move into normal position gradually.
  • Surgery – Clubfoot may also be corrected through surgery. The affected tendon on foot is adjusted to increase its length and is loosened if it is too tight. In some cases, individuals with clubfoot undergo a procedure called ‘tendon transfer’ to loosen contracted tendons.

Surgery may be extensive because the normal anatomical structure in adults is already established. However, if clubfoot is not treated, it may affect everyday life and may lead to a permanent condition.

If you suspect you have one of these conditions, contact us to discuss different options with one of our podiatrists.

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References:

  • Anand, Ashish, and Debra A Sala. “Clubfoot: Etiology and Treatment.” Indian Journal of Orthopaedics1 (2008): 22–28. PMC. Web. 21 Mar. 2018.
  • “Clubfoot in Adults – Healthery.” Your Health Resource – healthery.  <http://healthery.com/clubfoot-in-adults/>.
  • “Clubfoot (Talipes Equinovarus).” Internal Medicine and Pediatric Clinic – Family Health Care for New Albany, MS.  <http://www.impcna.com/intranet/Nelson%20Pediatric/Newborn/Clubfoot%5B1%5D.pdf>.
  • “Clubfoot Causes, Symptoms, and Treatments.” WebMD – Better information. Better health. <http://www.webmd.com/a-to-z-guides/tc/clubfoot-topic-overview#2>.
  • “Clubfoot.” Midwest Bone and Joint Institute, Illinois, Orthopedic Surgery.  <http://midwestbonejoint.com/child-orthopedics/clubfoot/>.
  • “Clubfoot (Talipes Equinovarus)..” The Royal Children’s Hospital – Melbourne. The Royal Children’s Hospital – Melbourne, Web. <http://video.rch.org.au/ortho/fact_sheets/CLUBFOOT.pdf>.
  • “Clubfoot Overview.” Client Login – Patient Education Institute. <http://online.x-plain.com/modules_v3/ortho/op860103/op869103.pdf>.
  • Brodsky, James W. “The Adult Sequelae of Treated Congenital Clubfoot” Foot and Ankle Clinics. Volume 15 , Issue 2 , 287 – 296. Web. <http://www.foot.theclinics.com/article/S1083-7515(10)00025-2/abstract>.
  • “Club foot – NHS.UK .” NHS Choices Home Page.  <http://www.nhs.uk/conditions/club-foot/>.

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