Congenital Pes equinovarus

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WHAT IS CONGENITAL PES EQUINOVARUS?

HOW IS THE TREATMENT?

img0Pes Equinovarus is the introverted position of foot from the ankle and toe. It is a clear deformity that is present immediately after birth. The soles are positioned towards one another inward. It is a frequent congenital anomaly. The frequency is 1 in 1000 live births. The feet are smaller and shorter than the normal size. The cause of the deformity is unknown. The feet are on fetus position. The deformity is present in males 2-3 folds more than females. The incidence rate will be higher if there is a family history.

Treatment
Treatment must be initiated immediately. The aim is to relieve pain, enable plantigrade walking and fully functioning foot. The feet will remain in intovert position in untreated patients. Stretching exercises and massage are applied in the following days of birth. Gentle exercises must be applied because tough practises may cause damage on the cartilage. Orthopedic cast treatment is applied in the following days. The foot is corrected as much as possible and the position is preserved using the cast. Gradual correction will be provided by the application of a new cast each week. Approximately 6-7 weeks of cast treatment is required. Fingertips are checked after each application to see if the cast is tight. There is a tendency towards the former position if the feet go out of the cast. Special splints, made of plastic  are used after the required correction is provided with a cast. The children must be monitored until the age of 2-3 after providing special shoes for use. In some cases, the expected correction may not be provided.

img1Surgery is performed in the region where the correction is not adequate. Generally, the ankle correction is difficult. Therefore, Achilles tendon is lengthened. The procedure is generally performed when the infant is 6-12 months old. Various surgeries may be performed considering the  degree of the deformity.

The children will have normal functioning feet and there will be no pain at all after accurate treatment.The parents must be confident that their children will have normal physical appearance and normal functioning feet  after the treatment of the specialists if there is no more accompanying problems. Properly treated pes equinovarus is not a disability and a totally normal and active life can be maintained. The success rate is 95%.