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Clubfoot in children

Orthopedists try to treat clubfoot.

Dr. Nikonov
Dr. Nikonov

In this article, I will comment on the knowledge I have acquired at the Medical Academy. I will also talk about the knowledge I received as a myologist by really restoring normal gait in children with a diagnosis of clubfoot.

 

Orthopedists believe that congenital clubfoot, i.e. CCF for short, is a congenital anomaly of the development of the child's limb accompanied by changes at the ankle level, in transverse tarsal and tarsometatarsal joints. As a result, it leads to a strong dysfunction of the lower limb and of the entire locomotor apparatus.

Dr. Nikonov
Dr. Nikonov

The problem of swollen muscle fibers of the ankle joint, calf muscles, buttocks and lumbar muscles does not let muscles in some areas stretch completely. Therefore, muscles that are not stretched completely pull bones to which they are attached. Bones do not pull muscles!

 

Muscles pull bones because they cannot stretch.

To make sure that my opinion is correct, let us look in an electron microscope and see what is inside muscle cells of ankle joints:

Muscle cells of ankle joints in an electron microscope

Figure 1. Muscle cells of ankle joints in an electron microscope

Because of the fact that cell nuclei are shifted, motor proteins of muscle cells actin and myosin cannot move easily and freely.

This deformation is one of the most common congenital defects of the locomotor apparatus and constitutes up to 40% of the lower limb deformations.

Now the World Health Organization considers congenital clubfoot to be a manifestation of a dysplastic process, when the muscular system of the lower limbs is affected below the knee joint. The concept of “dysplasia” means improper tissue development. It is believed that this pathology is a general name for consequences of improper formation in the process of muscle tissue embryogenesis. In a majority of cases, dysplasia is congenital.

Congenital (clubfoot of newborns)

A congenital defect is easy to detect by week 16 of fetal development at a routine ultrasound. When a baby is born, a neonatologist can detect signs of clubfoot. If you have four main symptoms, you can diagnose it:

Acquired clubfoot

Acquired clubfoot is the result of parents not paying attention to:

All aspects named by Dr. Nikonov are signs of muscle cell swelling and the impossibility of free movement of the child's muscles.

Violations of the foot position of a healthy child begin to manifest at the age of 2-3 years. Note that the following symptoms gradually begin to develop:

  1. Gait irregularity (“Bear” gait: a child “shovels” with one leg).
  2. A child does not position feet right. This can be seen by the footsteps left in the snow or wet sand. A footprint from one foot will be always turned towards the other.
  3. The knees often look inside.
  4. Poor mobility of the ankle joint.
  5. You can see violations when a baby sleeps and the muscles are relaxed.
  6. The thumb of the foot is turned inside: it is called valgus deformation, and bumps are formed at the inner edge of the foot.

Clubfoot in children develops because of swelling of muscle cells due to the load on the waist, buttocks and legs of a child. Child's bones continue to grow but muscles do not stretch because of swelling. They pull a bone so joints do not have the full range of motion.

Dr. Nikonov
Dr. Nikonov

Therefore, some groups of muscles are severely swollen (you are more familiar with a name high muscle tone), the others, on the contrary, are completely relaxed. This is manifested in the form of a foot deformation.

 

Clinical picture of clubfoot

The clinical picture consists of several main features:

In severe cases, there are also the high position of calcaneal tuberosity and inner torsion of the shank bones. As the child starts walking, all clinical manifestations of clubfoot get worse.

Dr. Nikonov
Dr. Nikonov

A load on the external edge of the foot in the pathology of fibular muscles quickly leads to the progression of supination, thus skin callosity develops with the formation of mucous bags.

 

As a result, adults walk stepping on the back of the feet, covered with callosities, with one or more mucous bags. At this, the plantar surface looks up. Due to the dysfunction of the shank muscles, they overgrow.

A baby with congenital clubfoot must be cured by the time a child starts walking.

Normal foot and clubfoot

Figure 2. Normal foot and clubfoot

Treatment of congenital clubfoot

Dr. Nikonov
Dr. Nikonov

My technique of the emendic procedures restores the normal muscle length, thus eliminating clubfoot in children.

 

Child's normal gait can be restored only thanks to the emendic procedures.

Child orthopaedists believe that treatment includes the application of plaster bandages and gradual manual correction of the child's deformation. It looks like this: plaster bandages are put on a thin layer of cotton, bandage, stocking fabrik or a simple cotton sock without rubber and heel part.

Congenital clubfoot during treatment

Figure 3. Congenital clubfoot during treatment

Dr. Nikonov
Dr. Nikonov

Today, orthopedists of the world believe that treating congenital clubfoot and its recurrent forms is a difficult task. In the case of surgical treatment, there is no evidence of good results after the intervention.

 

Complications non-treated clubfoot

Many parents make a serious mistake, do not treat the disease and hope that the deformation will pass with age. Irresponsible parents miss the fact that clubfoot not only contributes to the development of other diseases of the musculoskeletal apparatus (flat-footedness, scoliosis), but a non-treated disease may even lead to disability and to a number of complications:

Dr. Nikonov
Dr. Nikonov

Due to the fact that a child steps on the external part of the foot when walking, skin callosities and the lesions can form in this area. Some muscles and ligaments atrophy, others are swollen, causing a child to feel pain. Because of the pain, a child can't stand and walk. A child turns into a disabled person sentenced to a wheelchair.

 

Moreover, clubfoot in children may cause developmental and psychological problems. Children at school will constantly hear about their physical inferiority. And the child himself will realize that he is physically lagging behind the normally developing peers.

The complications of clubfoot also include spine curvature disorders, which lead to hernia and complete immobility, violation of the knee joint functions, frequent ankle dislocations. A child will complain about headaches and sleep disorders.

Diagnostics

Congenital clubfoot cannot be diagnosed during pregnancy with an ultrasound, as there is no change in bone tissue and joints. Only responsible parents can see that their baby has problems with the legs.

Dr. Nikonov
Dr. Nikonov

To recover effectively from clubfoot to normal condition we use the emendic procedures aimed at restoring normal function of problem muscles.

 
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