In Bangladesh a large number of children are born with a clubfoot deformity. Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which baby’s foot is twisted out of shape or position. The term “clubfoot” refers to the way the foot is positioned at a sharp angle to the ankle, like the head of a golf club. The foot turns inward and downward at birth, and is difficult to place in the correct position. The calf muscle and foot may be slightly smaller than normal. Clubfoot is a common birth defect and is usually an isolated problem for an otherwise healthy newborn. Touching Souls International provides free clubfoot surgeries for disadvantaged patients of Bangladesh.
Clubfoot can be mild or severe, affecting one or both feet. Clubfoot won’t hinder a child’s development drastically until it’s time for the child to walk. At that stage, the awkward positioning of the foot may force the child to walk on the outside edge of his or her feet.
More often clubfoot is caused by a combination of genetic and environmental factors that is not well understood. The condition is fairly common. It happens in 1 out of 1,000 infants and is more common in boys than girls. If someone in the family has clubfoot, then it is more likely to occur in an infant.
Clubfoot present at birth can point to further health problems because clubfoot is associated with other conditions such as spina bifida. For this reason, as soon as clubfoot is noticed, it’s important that the infant be screened for other health conditions. Clubfoot can also be the result of problems that affect the nerve, muscle, and bone systems, such as stroke or brain injury.
Clubfoot typically causes no problems until a child starts to stand and walk. While a child’s mobility may be slightly limited and the affected foot may up to 1 1/2 shoe sizes smaller than the unaffected foot, treating clubfoot generally lets the child having a relatively normal foot, both in the way it looks and functions.
Left untreated, however, clubfoot can become a burden. Not only that the child likely to have arthritis, but the unusual appearance of the foot may make body image a concern during the teen years. The twist of the ankle may not allow the child to walk on the soles of the feet. To compensate, he or she may walk on the balls of the feet, the outside of the feet or even the top of the feet in severe cases. These adjustments may inhibit natural growth of the calf muscles, cause large sores or calluses on the feet, and result in an awkward gait
Treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible — ideally, shortly after birth — when reshaping the foot is easiest.
Gentle stretching and recasting occurs every week to improve the position of the foot. Generally, five to 10 casts are needed. The final cast remains in place for 3 weeks. After the foot is in the correct position, a special brace is worn nearly full time for 3 months. Then it is used at night and during naps for up to 3 years.
Often, a simple outpatient procedure is needed to release a tightened Achilles tendon.
Some severe cases of clubfoot will require surgery if other treatments do not work, or if the problem returns. The child should be monitored by a doctor until the foot is fully grown.
There are many kids with clubfoot in Bangladesh who hardly gets any treatment for their clubfoot although it can be treated with a simple operation. Touching Souls International, a nonprofit organization in joint program with Nurture, provides free clubfoot surgery for the needy patients.