Dollface
07-10-2008, 10:16 AM
A club foot is defined as an abnormal angle of the foot with the bones of the lower leg. Normally, feet protrude at the ankle joint 90 degress, or at a right angle, from the bones of the lower leg. In a club foot, the foot is twisted inward and more in line with the bones of the lower leg. This is caused by abnormal muscles in the lower leg and an abnormally formed ankle. It can occur in one leg, or be bilateral or affecting both legs. Club foot is a fairly common birth defect, affecting about one in one thousand fetuses.
It is difficult to diagnose club foot on ultrasound. In fact, ultrasound is not nearly as accurate for this birth defect as many others. This is largely because the appearance of the ankle can be dependent of fetal position. If a normal foot is just pressing against the wall of the uterus, a club foot may be misdiagnosed. This is one birth defect that 3-dimensional ultrasound can play an important role, when there is question about the diagnosis.
In the ultrasound pictures above, the left picture is the normal relationship around the ankle, designated by the arrow. On the right is a club foot, not the sharp angle of the foot in relation to the bones of the lower leg in a club foot.
Sometimes the club foot is the only abnormality of the fetus. In this case, it is usually treated with serial casting of the leg. Sometimes surgery on the Achilles tendon is required. Rarely with a full surgical repair of the tendons of the ankle. The prognosis for an isolated club foot is very good overall. Most children are fully able to walk and run with a proper repair.
However, not uncommonly a club foot can be associated with other birth defects and other syndromes. There are over 200 syndromes that have been described in association with club foot. Therefore a comprehensive anatomy scan of the fetus, performed by a specialist in this area, is absolutely required. Associated birth defects can be seen in every system of the body. In addition, this finding is more common in fetuses with abnormal chromosomes. For this reason, patients should consider amniocentesis. See link below for more on amniocentesis.
Club foot, when isolated is not associated with developmental delay. Club foot is considered to be surgically correctible when there are not associated findings or syndromes.
It is difficult to diagnose club foot on ultrasound. In fact, ultrasound is not nearly as accurate for this birth defect as many others. This is largely because the appearance of the ankle can be dependent of fetal position. If a normal foot is just pressing against the wall of the uterus, a club foot may be misdiagnosed. This is one birth defect that 3-dimensional ultrasound can play an important role, when there is question about the diagnosis.
In the ultrasound pictures above, the left picture is the normal relationship around the ankle, designated by the arrow. On the right is a club foot, not the sharp angle of the foot in relation to the bones of the lower leg in a club foot.
Sometimes the club foot is the only abnormality of the fetus. In this case, it is usually treated with serial casting of the leg. Sometimes surgery on the Achilles tendon is required. Rarely with a full surgical repair of the tendons of the ankle. The prognosis for an isolated club foot is very good overall. Most children are fully able to walk and run with a proper repair.
However, not uncommonly a club foot can be associated with other birth defects and other syndromes. There are over 200 syndromes that have been described in association with club foot. Therefore a comprehensive anatomy scan of the fetus, performed by a specialist in this area, is absolutely required. Associated birth defects can be seen in every system of the body. In addition, this finding is more common in fetuses with abnormal chromosomes. For this reason, patients should consider amniocentesis. See link below for more on amniocentesis.
Club foot, when isolated is not associated with developmental delay. Club foot is considered to be surgically correctible when there are not associated findings or syndromes.