Congenital clubfoot photo

What is clubfoot in children and ICD 10 code

Flat feet and club feet in young children are deformations of the arches of the feet, leading to a change in location. A person faces many inconveniences (unaesthetic, pain while walking). The heel moves during movement, rather than being placed over the entire area. As a rule, the pathology concerns two legs.

The International Classification of Diseases (ICD code) includes clubfoot in the list of diseases under the code Q-66. The gradation of the disease systematizes information. Qualified doctors will be able to diagnose the disorder and select the optimal treatment regimen. Often the disease is a consequence of incorrect formation of the bone skeleton, dysfunction of muscle tissue and joints. The pathology should be treated comprehensively, under the strict supervision of a physician.

Signs of appearance in children

The first signs of clubfoot in children can be detected visually, when the child gets to his feet and takes his first steps. Symptoms of the disorder:

• the sole is turned to the inside;
• the inner edge of the foot rises during movement, the outer edge goes down;
• the plantar part has a bend in the foot;
• gait is incorrect (as with cerebral palsy);
• a person's movement is limited, the ankle cannot cope with fundamental functions.

Due to the large number of therapeutic methods, symptoms and signs of pathology appear in every person. In some children, atrophy of the ankle muscle structures occurs, leading to foot subluxations. The knee joints become pathologically immobile. The skin becomes rough around the outside of the sole.

How parents can notice the disease

In some cases, caring parents can quite accurately suspect their child has clubfoot.

If they are parallel to each other, then we are not talking about any violations. But if the traces are developed, then such parents and their child have a direct path to a specialist .

The disease can be indicated by the baby's gait and the way he places his legs when he does not control himself and his body is completely relaxed, for example, in the morning, when he just woke up. Also, a child’s clubfoot is most noticeable during play, when he naturally behaves in the process of hobby.

To determine the muscles that influence the pathology, it must be placed on the stomach in such a way that the lower limbs to the level of the ankle protrude beyond the edges of the surface on which it lies. When trying to move the legs and with a relaxed body, the child will immediately feel which muscles are most tense at the moment. Parents can also feel these tense muscles themselves. In practice, most often they are the muscles of the lumbar region and back. It is they who need to be relaxed during the treatment process by performing massages and special exercises.

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Types of clubfoot

Congenital clubfoot in children is a common ailment in the field of defects of the musculoskeletal system. The disease does not allow the child to fully place the sole on the surface due to abnormalities in the development of the ankle joint. Depending on the etiology of the disease, there are types:

1. Congenital is divided into typical and atypical deformities. In the first option, the foot has a bend in the direction of the sole, the heel is shifted upward. Varus, adduction, and supination are observed. In the second case, pronounced signs are observed. Deep folds form on the sole. The feet are short and plump. The metatarsal bones transform over time into a rigid cavus. A different treatment protocol is prescribed.
2. Acquired occurs due to nervous disorders, incorrect fusion of the ankle bones. The disorder is affected by inflammatory processes and various tumors. Severe burns are the initial sources of the formation of the disease.

There are a number of key factors influencing the development of congenital leg deformities. First of all, heredity. Next come serious genetic disorders in the form of Edwards disease. A dangerous pathology leads to an increase in 18 pairs of chromosomes. Systematic consumption of alcohol and smoking cigarettes negatively affect the condition of the musculoskeletal system of the mother and unborn child.

Amniotic bands directly in the uterus of a pregnant woman in most cases do not affect the development of the fetus. However, strong constrictions can provoke the formation of clubfoot in a newborn.

How is it classified?

Clubfoot in a child can be from birth or acquired. Congenital is more common. The reasons leading to them differ. There is also a distinction between unilateral and bilateral clubfoot in children. It depends. one or both legs are involved in the process. The latter is more often diagnosed.

There is also a classification that divides clubfoot in a child into two forms - typical and atypical. The first is formed as a consequence of defective development of muscle tissue and the ligamentous-tendon apparatus and is divided into contracture, soft tissue and bone. The complexity of their correction increases from the first to the last. The second form is the result of a serious pathology of the musculoskeletal system that occurs during embryonic development.

Another classification is carried out according to the degrees of clubfoot, of which there are three.

1. First. She is of a light current. The child makes movements with his fingers and ankle joint. The size of the foot angle does not exceed 15°. The defect can be corrected passively or overnight by moving the foot into the correct anatomical position.
2. Second degree or moderate severity. This form of the pathological process is characterized by limitation of joint movements in the ankle. The angle reaches 30°. Although the foot can be adjusted, it is only partial. Therefore, the defect still remains.
3. The third or severe clubfoot in a child is almost completely impossible to correct. The joint between the foot and the lower leg is severely limited in mobility, and the inclination angle is greater than 35°.

Treatment methods for children and adolescents

The early stage of clubfoot is corrected in children using conservative therapy. The child's feet are fixed for a healing massage. Physical therapy (physical therapy) is performed from the first week of birth to 12 months. Using orthopedic shoes is an effective option for correcting uneven feet. Popular options are splints worn at night. From the age of 8, it is rational to conduct complex sports activities, swimming exercises, and special dances. If conservative approaches do not give a positive result, surgery is prescribed.

The therapeutic method according to Vilensky is known all over the world. Treatment is based on the use of a series of ordered actions:

• plastering of legs (“boots”) at different stages;
• use of orthopedic devices with types of splints;
• the use of medical physiotherapeutic procedures (paraffin applications);
• performing a relaxing massage every 24 hours for different muscle groups;
• taking warm baths to which pine needle extract is added, the liquid helps reduce hypertonicity and strengthens the body;
• systematic implementation of prevention at home.

Treatment methods for clubfoot in a child

It is important not only to correct the defect, but also to do everything to prevent clubfoot from recurring. For congenital clubfoot, treatment should begin immediately after birth. What is the treatment?

The child's foot is fixed using a plaster cast. It needs to be changed every week until the foot condition completely improves. After the plaster is removed, in order to avoid relapse, a splint is made for the baby and put on before bed. The technique is effective for infants and slightly older children.

Mechanisms of development of flattopia and clubfoot

Flat feet and club feet are a scourge for the musculoskeletal systems. If pathologies are not treated, the child’s fragile body may encounter a number of additional disorders and complications. The pathogenesis of diseases has similar causes of development. Only in individual cases the causes of diseases differ.

Classification

There are different types of diseases based on their genesis:

• Congenital clubfoot is formed during intrauterine development.
• Acquired - occurs against the background of organic lesions of the nervous system, musculoskeletal system, and inflammatory processes.

By etiology:

• Post-traumatic foot - deformation occurs against the background of injury to the limb.
• Paralytic (loose) - the work of all muscles of the lower leg is completely impaired, the foot cannot be controlled.

By volume of lesions:

• one-sided;
• two-way.

According to clinical form:

• Typical - characterized by typical characteristic manifestations.
• Atypical - characterized by a pronounced clinical picture.

According to the severity of the flow, the typical form is divided into:

• Varus (pronated) - mild course, amenable to manual correction.
• Soft tissue - the impossibility of fully fixing the foot on the surface, tissue resistance when trying to manually correct the defect.
• Bone - a rare form characterized by severe deformation due to the irregular structure of bones and soft tissues.

According to the severity of the course, the atypical form manifests itself:

• Arthrogryposis is a pathology of the musculoskeletal system, manifested by muscle atrophy, joint damage, deformation of the lower extremities, and severe limitation of the patient’s movements.
• Dysostosis is a hereditary skeletal pathology, manifested by the formation of bone tissue in unusual places (for example, replacement of cartilage tissue with bone tissue).
• Osteochondrodysplasia is a group of diseases of hereditary etiology, in which disorders of the osteochondral system occur in fetal development. Due to impaired maturation of cartilage tissue, ODA defects are formed.
• Longitudinal ectromelia is a complete absence or congenital abnormality of bone.
• Amniotic constriction (Simonard's bands) - the cause of the congenital form can be the threads connecting the two uterine walls during pregnancy.
• Congenital malformation of the bones of the tibia and tibia.

Stages of clubfoot in a child

• Mild - minor functional changes in the musculoskeletal system, preservation of the full range of motion in the ankle.
• Moderate—motor limitation in the ankle, joint deformity. Proper treatment can eliminate symptoms.
• Severe - severe ankle deformity, only surgical intervention will help.

Depending on the clinical manifestations there are:

• idiopathic form of childhood clubfoot, which is characterized by equinus (the inability to lift the foot up), a decrease in the supracalcaneal (talus) bone, a violation of the anatomy of the foot in front and behind, a decrease in the calf muscle, disorders in the joint capsule;
• positional form, in which there are no changes in the calcaneus and supracalcaneus, the articular structures develop normally, but are in a state of subluxation.

Possible complications and treatment prognosis

Neglect of a child's health is common. The danger is that the pathology can lead to a number of complications over a short period of time:

• atrophy of muscle structures (dangerous manifestation);
• the sole of the foot becomes rough;
• the knee joint ceases to function normally;
• the tendon gradually atrophies outward.

Improper walking at an early age is a source of callus formation. Muscle atrophy is accompanied by pain. The baby feels uncomfortable standing. If the disorder is left untreated, disability may develop. Clubfoot is the starting point for the development of spinal curvature. Over time, the disease affects hernia and joint dysfunction. Dislocations of the ankle are often observed.

A child's clubfoot affects his emotional state. Neuroses and the formation of an inferiority complex are common cases in pediatrics.

The article has been verified by the editors