The ratio of doctors to the population, of 12 million people, is one of the lowest in the world. It is estimated that there are 5000 children with untreated clubfeet in Malawi with 500 more born each year.

 

When a baby has club foot, one or both feet points down and inwards with the sole of the foot facing backwards.

Untreated, it can become extremely painful and make it very difficult to walk in later life.

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Club foot is quite common, affecting about 1 baby in every 1,000. Both feet are affected in about half of these babies.

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Treating club foot

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Treatment for club foot ideally starts within a week or two of the baby being born.

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A technique known as the Ponseti method is the main treatment for club foot. This involves gently manipulating the baby's foot into a better position, then putting it into a cast. This is repeated every week for about 5 to 8 weeks.

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After the last cast is removed, many babies need a minor operation to loosen the Achilles tendon at the back of their ankle.

This helps to release their foot into a more natural position.

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The introduction of the Ponseti Technique by Steve stipulating a specific technique of corrective manipulation followed by plaster immobilisation thereby avoids the need for invasive surgery.

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Outlook

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Nearly all children treated with the Ponseti method will have pain-free, normal-looking feet. Most learn to walk at the usual age and can enjoy physical activities, including sports, when they're older.

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Children who only have one affected foot may be left with a slightly shorter leg and smaller foot on one side. This may mean a child is slightly less mobile and gets tired more quickly than other children.

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Before the Ponseti method, club foot was often treated with surgery to alter the position of the foot. This wasn't always effective, and led to long-term pain and stiffness in adult life.

Relapses

Sometimes club foot can recur, especially if treatment isn't followed exactly. If it comes back, some of the treatment stages may need to be repeated.

Causes of club foot

In most cases the cause of club foot isn't known, but there may be a genetic link as it can run in families. If you have one child with club foot, your chance of having a second child with the condition is about 1 in 35.

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If one parent has club foot, there's about a 1 in 30 chance of their baby having it. If both parents have the condition, this increases to about a 1 in 3 chance. In rare cases, club foot is linked to more serious conditions, such as spina bifida.

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Feet First are now involved in providing educational programs about this technique in Malawi and in other less developed countries around the world.  Clubfoot is not the only problem that is addressed by Feet First.

 

There are also many other types of congenital musculoskeletal abnormalities which require treatment as well as neglected traumatic orthopaedic injuries. Over recent years there has been an increase in children with burns of varying degrees. Training is to be given in the best methods of managing such cases.

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