What Is Clubfoot Surgery?

Horseshoe foot varus is a common and frequently-occurring disease in children. The etiology is unknown so far. Most scholars believe that the malformation is caused by abnormal development or imbalanced muscle development caused by internal and external factors during early embryonic development. It may also be related to the malposition of the fetal foot in the mother's womb.

Horseshoe Inversion

Horseshoe foot varus is a common and frequently-occurring disease in children. The etiology is unknown so far. Most scholars believe that the malformation is caused by abnormal development or imbalanced muscle development caused by internal and external factors during early embryonic development. It may also be related to the malposition of the fetal foot in the mother's womb.

Traumatic horseshoe foot varus is a special ankle position caused by indirect or direct violence caused by ankle fracture, talar dislocation or ankle sprain.

Chinese name

Horseshoe Inversion

Foreign name

congenital talipes equinovarus

Classification

Congenital malformations and ankle varus injuries

Treatment

Surgery, rehabilitation, correction

Horseshoe foot varus is a horseshoe shape. There are two types of congenital malformations and ankle varus injuries. It is one of the most common congenital malformations that occurs after birth. There are genetic factors in the condition. The formation of varus varus foot is mainly caused by the imbalance of foot muscle strength, that is, the varus muscle (front tibialis and posterior tibialis muscle) is strong and shortened, and the varus muscle (fibula) is weak and extended Long, plantar flexor (calf triceps) is stronger than dorsiflexor (anterotibia). Muscle imbalance forms bone and joint deformities for a long time, and the deformity is more serious due to the weight.

First, congenital horseshoe deformity

The etiology is unknown so far. Most scholars believe that the malformation is caused by abnormal development or imbalance of muscle development caused by internal and external factors in the early stage of embryo development. It may also be related to the malposition of the fetal foot in the mother's womb. ^[1]

1. Performance: Sagging, heel up, the lateral edge of the foot landing and the soles of the foot backwards, resembling a golf club, so this disease is also called club foot. Due to the above phenomenon, heel inversion and adduction of the front of the foot were observed, and the talar head was raised on the dorsal and lateral sides.

2. Type: There are two types:

Slim and long (relaxed) foot shape is thin, deformity is light, it is easy to put the foot in neutral position by hand, the calf circumference is similar to the healthy side. Non-surgical treatment is effective.

Short fat type (stiff type) The foot is short and fat, the heel is small, and the deformity is serious. The circumference of the calf is thinner than the healthy side. The deformity is not easy to correct by hand, and often requires surgery.

3. X-ray performance: The normal X-ray film shows the talar angle (the intersection angle of the talar axis and the calcaneal axis) <30 °. The intersection angle between the longitudinal axis of the talus and the longitudinal axis of the sacrum is 0 ° to 20 °. The combination of the above two angle measurement results is helpful to the diagnosis. Lateral X-ray films show that the intersection angle between the talus longitudinal axis and the calcaneus zygomatic plane tangent is less than 30 °, otherwise there is foot drop.

1. After the baby is born, there will be one or two foot plantar flexion and varus deformities.

2. Forefoot adduction and varus, talar plantar flexion, calcaneal plantar flexion and varus flexion, Achilles tendon and plantar fascia contracture; forefoot widens, heel narrows, holy, arch high, outer edge of the foot raised; lateral ankle The ankle is protruded, the medial malleolus is posterior and inconspicuous.

3. Load the outer edge of the foot when standing, and load the outer side of the foot in severe cases.

4. Unilateral deformity, walking lame; bilateral deformity, walking sway.

5. X-ray shows that the talus and the longitudinal axis of the first metatarsal and the calcaneus are not parallel to the longitudinal axis of the fourth and fifth metatarsals to form an angle; the angle of the talus and the longitudinal axis of the calcaneus is less than 30 ° (normally 30 ° to 35 °).

1. For those with congenital foot inversion, manipulative rejuvenation and suspension can be performed at an early stage to facilitate the restoration of foot function.

2. For ankle fractures, according to the different types of symptoms, manual surgery or surgery, combined with plaster fixation, can be combined with traditional Chinese medicine to strengthen bones and bones to facilitate fracture recovery.

1 Clinical manifestations: When walking, the foot is tilted to the outside, the support is touching the ground with the medial foot, and the plantar flexion deformity. It can cause pain on the inside of the foot, which significantly affects the weight of the support phase. When walking, the body's center of gravity falls mainly on the inside of the ankle. Ankle dorsiflexion is limited, affecting the forward and backward movement of the tibia and increasing valgus. Pain from the calf joint, poor stability. Early support phase may have overextension of the knee joint, lack of strength in pedaling, and obstruction of limbs in swing phase.

2 treatments

(1) Passive exercise: the child takes a supine position, the patient controls the lateral edge of the child's foot, and repeatedly pulls inward and outward to stimulate the excitability of the tibialis anterior and posterior tibialis; The posterior muscles make rapid thumps to induce muscle contractions.

(2) Active exercise: Allow the child to walk on a long wooden board with a triangular cross-section, and promote the weight of the lateral edge of the foot. If the child has partial mobility from the calf joint, the therapist can assist the child to complete the full joint For a range of activities, if the child can complete walking, a small cloth or pad should be placed in the child's shoes and under the arch of the foot to support the arch and allow the lateral edge of the foot to bear part of the weight.

Horseshoe foot varus is not terrible.It is a common and frequently-occurring disease in children. It can be seen by parents after careful observation of the baby after birth. It can be divided into two types: soft and rigid.The former can be corrected by manual correction. Newborns can undergo massage therapy a week after birth, and the latter often requires surgery. Whether it is conservative treatment or surgical treatment, early detection and early treatment have the best effect. Not only can restore the normal shape of the foot, but also restore the ankle function, reduce sequelae, and can carry normal weight bearing and healthy walking. "Many children can run freely like normal people after treatment, without causing disability." ^[2]