Equinus foot: what it is, types and how to treat it
The foot is one of the most important and at the same time most complex organs in the human body. It is the foot, in fact, that helps the body to remain upright and to move with balance and coordination. This is why it is essential to choose the right shoes for children, able to follow and respect their physiological growth.
Made up of 28 bones and many ligaments and joints, due to its delicacy the foot is subject to numerous pathologies that can affect it, putting a person's normal physical activity at serious risk. Among these are the flat foot, the hallux valgus, the cavus foot and, last but not least, the congenital clubfoot, which appears from birth. But, specifically, what is the clubfoot, how many types there are and, above all, how is it treated? All questions that we will try to answer.
Equinus foot: most common causes and symptoms
As we said at the beginning, the clubfoot is a malformation that particularly affects the sole of the foot. In detail, the outermost part of the sole of the foot tends to go towards the median part of the body, causing a twist towards the inside of the foot. Equine foot sufferers are generally prone to walk with the tip of the foot resting on the ground, with the forefoot drooping, the heel raised and the rear area of the sole not aligned with the legs and knees. In short, the description is sufficient to understand that it is a disorder that can cause very serious walking problems.
What are the causes of clubfoot? Good question. The triggering factor is not clear at the moment, but it is thought that it may depend on genetic factors. The only certain thing is that this pathology occurs when the external muscles of the lower limbs are much weaker than the internal ones, leading to an imbalance that causes the foot to point to the ground. In 20% of cases the clubfoot is reconnected to serious health disorders such as spina bifida, cerebral palsy and arthrosis.
As for the symptoms of clubfoot, since the problem occurs from conception, they are well recognizable from the birth of the child. In the case of a newborn's clubfoot, it is easy to notice if the foot is bent down or, even worse, if the soles are able to touch each other completely. In addition, the club foot is shorter and wider than normal. Other symptoms are excessive pallor of the skin, reduced sensitivity, frequent pain and later blisters, ulcerations and necrotic areas.
Equino-varus-supinated foot and other types of clubfoot
The clubfoot can come in various forms. In 70% of cases we speak of equinovaro-supinated foot, which occurs when the foot is bent inwards and downwards and the affected people give the impression of walking on the ankles or on the outside of the lower limbs. It affects one or two babies for every 1000 live births, is not linked to other malformations, 50% of the time it is bilateral and seems to affect more boys than girls.
Another type of congenital clubfoot is the so-called varus or adoptive foot (or metatarsal varus or adoptive) in which the foot is deviated inwards and downwards, as in the case of the equino-varus-supinated foot, but limited to the " forefoot (the heel is fine). This shape has a 15% chance.
Rarer, with a frequency of 10% and 5% respectively, are the thallo-valgus-pronated foot (the foot is deflected outwards and upwards) and the flat-valgus or reflex foot (there is a subversion of the "arch of the foot, so that the concave face of the limb is no longer the plantar one but the dorsal one).
Clubfoot remedies: the Ponseti method
A newborn with clubfoot will not have the opportunity, once grown, to remain standing, since his body will only be able to lean on the external portion, that is, the one with a narrower surface. It is therefore necessary to solve the problem as soon as possible, intervening in the first weeks of the child's life, and fortunately there are remedies for clubfoot. The most common therapies are the Ponseti method and the surgical operation according to the Codivilla method.
The Ponseti method is a treatment that has as its fundamental point that of minimizing the surgical aggression of the congenital clubfoot. In fact, with this clubfoot therapy, surgery is quite marginal and consists only of a micro incision of 2 or 3 mm in the back of the ankle, which allows for the section of the Achilles tendon. This "tenotomy" procedure is performed after a series of plastering operations (6 on average, lasting 5/7 days each) aimed at correcting the deformation. The correction is then maintained after the tenotomy through the use of braces to be worn up to 3 or 4 years of age to avoid the risk of recurrence. With the Ponseti method the probability of complete recovery is approximately 90-95% : in the rare cases in which the foot does not respond to treatment with cast braces (this can happen due to particularly severe bone malformations of the foot), it is necessary to resort to a "proper surgical operation.
Equine foot: surgery according to the Codevilla method
If the desired effect is not achieved with the Ponseti method, it is necessary to undergo a surgical operation according to the Codivilla method, which consists of a corrective intervention to be carried out at the age of 3 or 4 months. (in this case the newborn must have reached at least 6 kg of weight). The operation involves a double surgical incision, one in the back and one in the inner part of the foot, and therefore a release or lengthening of the tendon, muscle and joint structures which lock the foot in the deformed position. The Codevilla method also offers good morphological and functional results, and has the advantage of being able to obtain the correction of clubfoot in a single step (while the Ponseti method provides for 3). However, a "surgical operation on a baby of a few months should never be considered the" main option if there are (as in this case) equally valid and less invasive alternatives.
Opinions and testimonies of mothers on the clubfoot of children
The mothers who flock to the Alfemminile forum every day also discuss the delicate issue of children's clubfoot, exchanging opinions, opinions and testimonies. If you want to deepen the topic, then connect to our forum to get in touch with many mothers sensitive to the problem, for example because they discovered that they have a child with congenital clubfoot or because they saw a crooked foot in the ultrasound of their little one who the stork is about to carry. You will discover a world made up of mothers who are always ready to listen to you and answer your questions, giving you advice and suggestions to never make you feel alone.
