Most Common Birth Defect You've Never Heard Of

Most Common Birth Defect You've Never Heard Of

What parents can expect from clubfoot.
It's the most common congenital birth defect you probably know nothing about, affecting one in 500 babies. A diagnosis of clubfoot can be frightening. So, parents should be aware of what to expect from clubfoot.

Comedian Damon Wayans, quarterback Troy Aikman, and Olympic figure skater Kristi Yamaguchi all share the same condition.

Baby Kilian Ferner has it too. They have clubfoot, a common birth defect affecting boys twice as often as girls.

It's something Kilian's mom had never heard of.

"I thought the word clubfoot was really scary. I thought it meant that they had this foot that didn't work, and it followed behind them, and they dragged it with them wherever they went," Erin Ferner, Kilian's mom, told Ivanhoe.

With clubfoot, one or both feet are twisted inward. 

"It's a lot of fear and it's a lot of wondering if he will be okay," Erin said.

However with advances in treatment, Dr. John Herzenberg says it's nothing to be afraid of.

"Yes, your child will be able to grow up, play sports, and do just about anything he wants," John Herzenberg, MD, Director of Pediatric Orthopedics, Sinai Hospital of Baltimore, told Ivanhoe.

The best treatment option is the Ponseti Method, which uses a series of casts over several months to straighten the foot.

"It's kind of like braces on your teeth where you move it slowly, little by little, about ten degrees every week until the foot is twisted out," Dr. John Herzenberg said.
You can see the difference after six months.

Kilian had seven casts in all, each telling a story.

"Each week there was a different quote about how we overcame whatever we had to cross that week.  For example, one said, 'this one is my last one. This makes my mommy happy because she can't wait to hold and kiss my little feet.'" Erin explained.

Now, little Kilian can follow along in his big brother's footsteps when he's ready.

Dr. Herzenberg says once out of the casts, babies with clubfoot then must wear special shoes for three months to keep their feet in the right place. Then, they just need them at night until age four.

The Ponseti Method was once only used for newborn babies. Now, it's also being used in developing countries to help older children with clubfeet return to normal.

BACKGROUND:  Clubfoot describes a range of foot abnormalities that is usually present at birth in which a baby’s foot is twisted out of shape or position.  In clubfoot, the tissues that connect muscles to the bone (tendons) are shorter than usual.  The term “clubfoot” refers to the way the foot is positioned at a sharp angle to the ankle, similar to the head of a gulf club.  It can be mild or severe.  About half of children with clubfoot have it in both feet.  If a child has clubfoot, walking normally will be difficult.  So, doctors recommend treating it soon after birth.  (Source: www.mayoclinic.com)

SYMPTOMS:  If a baby has clubfoot, his or her foot may have the following appearance:
•The foot may be turned so severely that it actually looks as if it’s upside down.
•The calf muscles are usually underdeveloped.
•The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
•The affected foot may be up to half an inch shorter than the other foot. (Source: www.mayoclinic.com)

TREATMENTS:  Stretching and casting, Ponseti Method, is the most common treatment for clubfoot.  The doctor will move the baby’s foot into a correct position and then place it in a cast to hold it in that position.  Then, the doctor will reposition and recast the baby’s foot once or twice a week for several months.  Towards the end of this process, the doctor will perform a minor surgical procedure to lengthen the Achilles tendon.  After the shape of the foot is realigned, parents will need to maintain it by doing stretches with their baby, putting them in special shoes and braces, and making sure they wear them as long as needed (usually three months at the most). Another approach is called the functional method or the physiotherapy method, which consists of stretching and taping.  For this method parents work with physical therapist.  First, they move the foot daily and hold it in position with adhesive tape.  When the baby is asleep, a machine continuously moves the baby’s foot.  After two months, treatment is cut back to three times a week until the baby is six months old.  Once the shape is corrected, parents still perform daily exercises and use night splints until the baby is old enough to walk.  This method requires a much greater time commitment than the Ponseti Method.  (Source: www.mayoclinic.com)

 For More Information, Contact:

Lee Brady, RN
Education Nurse Specialist
Sinai Hospital of Baltimore
Icll@lifebridgehealth.org



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