Club Foot - Causes, Symptoms & Orthotic Treatment
Club foot, or congenital talipes equinovarus, is clinically an equinus deformity, in which the hindfoot is inwardly angulated and supinated, while the forefoot is adducted, which can, in some cases, be associated with internal rotation of the tibia.
Club Foot Causes
Approximately 50% of cases are bilateral. Its etiology is diverse, and many different theories exist about its causes, such as mechanical disturbance due to poor uterine position, disorders during embryonic development, genetic causes due to malformation in chromosome maps, or those that consider it to be a result of an imbalance in internal and external peroneal musculature. In club foot, osteoarticular and musculoligamentous disorders are evident. Other congenital foot deformities include those that affect the forefoot, such as metatarsus varus and metatarsus varus-adductus, distinguished by their clinical presentation and evolution, which can involve supination of the forefoot at the Lisfranc joint.
Club Foot Symptoms
An equinus deformity with hindfoot varus-supination and forefoot adduction. Metatarsus varus is characterised by a deviation in forefoot adduction, while metatarsus varus-adductus shows adduction and supination in the Lisfranc joint, which can be combined in some cases with adduction-supination in Chopart’s joint.
Club Foot - Orthotic Treatment
In patients with unilateral and bilateral club foot, a combination of Bebax-type multi-articulated corrective footwear and Dennis Bown-type splints, in which the positioning of the forefoot and hindfoot can be equally adjusted by section, enables the foot to be placed in the position indicated by the prescriber, in order to gradually correct and realign the various deformities present. The Dennis Brown splint provides support for corrective footwear, corrects the equinus deformity and enables the external angle of rotation to be selected by means of an adjustable joint, facilitating full mobility of the lower limb, hips and knees. In the case of unilateral club foot, treatment can be carried out with an orthosis featuring Bebax-type multi-articulated footwear connected to a lateral leg element that can adjust the dorsal-plantar flexion of the foot. Multi-articulated boot-type orthoses enable correction of metatarsus varus and metatarsus varus-adductus, as prescribed by the doctor, through a forefoothindfoot adjustment system.