Clubfoot
(talipes equinovarus) means a foot deformed or malformed.
It could be varus (turned inward), equinus (plantar
flexion), innate (exists before the birth without
hereditary cause), irreducible (the movement can't be
totly accomplished by the physiotherapist), or idiopathic
(without any cause).
The clubfoot is characterized by:
Triple
deformation, vicious articular postures, back-foot
osteo-articular deformity (in serious cases), a stiffness
caused by shrinkness of the soft parts: ligaments and
muscles.
Triple
déformation:
The
equinus is found on the levels: tibia-ankle bone joint
and ankle bone-calcaneum joint.
The
varus or adduction is located in the lump calcaneum-foot,
in the midtarsal (Chopart joint) and in the articulations
tarsus-metatarsus (Lisfranc joint).
Supination,
or full rotary movement of the foot, is a consequence of
the
two
preceding postures.
Anatomical reminders:
Grown-up
foot.
Gravity :
Though
serious, this pathology taken of load without delay by a
team of experienced specialists: paediatric orthopedist,
hospital physiotherapists and city physiotherapists, will
evolve favorably. The participation of the parents in the
process is a determining element of the infant
treatement. The doctors, the physiotherapists and the
parents share with equal shares the success of the
process.
Pathogenese:
This
deformation which touches more readily boys, is
constituted since the end of the second month of
gestation and is visible since the first echography.
At
present the etiology of the clubfoot is still dubious.
There is a stop of the "morphogenesis" at the end of the
second month and several factors may be at the origin of
this deformation. Among them: "the malformatif" factor.
Some muscles are short: the triceps with the Achilles
tendon responsible for equinus and former leg and
posterior leg muscles in charge of the varus and the
supination. The "positional factor" will worsen the
deformations at the end of the pregnancy, when the baby
is cramped for room.