 Talipes
One to two children in every thousand are born with a condition most
commonly known as clubfoot but unless your child has been diagnosed with
the condition you probably know very little about it. Clodagh Foelster
investigates the causes and treatments for talipes, a congenital deformity
of the foot.
What is talipes?
Talipes is the medical term for the congenital deformity of the foot,
usually marked by a curled shape or twisted position of the ankle, heel
and toes. There are four different types of talipes but the most common
is known as Congenital Talipes Equinovarus (CTEV) or clubfoot. The name
can be broken down into more simple terms;
- Congenital - meaning something that is present at birth
- Talipes - which means the foot and ankle
- Equinovarus - which refers to the position of the foot, pointing inwards
and down.
My child has talipes calcaneus. Is it
the same thing?
There are different types of talipes and all refer to the the sometimes
alarming angle at which the foot and ankle lie. The four different forms
are;
- Talipes equinovarus - the most common form
- Talipes equinovalgus - where the foot points outwards and down
- Talipes calcaneovarus - where the foot points inwards and up
- Talipes calcaneovalgus - where the foot points inwards and down
Talipes is the word which encompasses all the different types of deformity
but clubfoot refers only to talipes equinovarus, the most common form
of the condition.
Is it hereditary?
There is a hereditary or genetic factor although it can occur when there
is no family history. One in a thousand children will have talipes and
50 per cent of these will be affected in both feet. If one parent has
clubfoot, then there is a 3 to 4 per cent chance of a baby being affected
and if both parents have clubfoot, this risk increases to fifteen per
cent.
What causes it?
There are no definite answers to this. It has been accepted that there
are some hereditary factors but it is also believed that the position
of your baby in the womb could be a cause. Sometimes there is too little
fluid surrounding the baby, a condition known as oligohydramnios, and
this may also be a factor in talipes. Boys tend to be affected more than
girls.
Is it my fault my baby has clubfoot?
Absolutely not. There is nothing that either parent can do before, during
or after pregnancy that will prevent clubfoot.
How is it detected?
The condition can be detected before birth during routine ultrasound
scan. However, it is often not recognised until birth. CTEV is one of
the most common abnormalities at birth and all new-born babies are routinely
checked.
What are the treatment options?
Mild cases will not need any active treatment but some children with
CTEV will need medical intervention and there are a number of treatments
available. These include;
Gentle manipulation - this means gently holding and stretching the foot
into a more natural position
Manipulation with the added use of strapping, splints, plaster casts
or special boots, all of which help maintain the position of the foot.
Surgery - often carried out on the tendons and muscles of the foot to
correct their length and loosen them. Some children may require further
surgery as they grow.
In a lot of cases the treatment begins as soon after birth as possible
as the outcome tends to be better the earlier treatment starts.
As your child grows, a relapse is possible and because of this, he will
require check-ups throughout his growing years.
The Osteopathic Centre for Children is quickly gaining recognition as
an alternative form of treatment to many childhood problems, including
talipes and you can read
Clodagh's story " I had an irritable 16-month-old who was desperate
to walk but physically couldn't"
Will treatment cure my child?
The charity Steps, which aims to help people with lower limb disorders,
says that the final outcome of treatment depends on the severity of the
deformity.
"Nowadays, health professionals are becoming increasingly skilled in
correcting CTEV," they say. "With early, effective treatment there is
every reason to believe there will be few long term side-effects."
Orthopaedic surgeon, Mr Peter Hopel, says, "Treatment in the past often
meant children developed a severe limp and had difficulty walking properly
when they grew up. However, with the correct treatment and regular check-ups,
most children born with CTEV grow up with no lasting problems. They lead
perfectly normal, active lives."
Where to next?
- "At 16 months, Rio stood upright for the first time in her life."
Read
one mother's account.
- Steps is a charity that aims to help people with lower limb conditions
and provides support for families and individuals. It also provides
vital services such as a helpline, annual events and publications. It
also now offers a free DVD on talipes - visit their website www.steps-charity
- The Osteopathic Centre for Children (OCC) have clinics in London and
Manchester. Find out more on their website: www.occ.uk.com
- Find out about homeopathic
treatments for childhood ailments
- Check out our A-Z of child
health
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