Change in the severity of congenital clubfoot in the first week of life

Abstract

Backgrоund. Congenital clubfoot or congenital equino-cava-varus deformity of the feet is one of the most common pathologies of the musculoskeletal system in children. Numerous articles in global literature have been published about changes in clubfoot severity during treatment; however, there are very few reports on how the severity of foot deformities with congenital clubfoot changes during the first week of life in the absence of deformity correction.
 Aim. To analyze changes in the severity of congenital clubfoot in the first week of life without any treatment.
 Materials and methods. The study group included 28 newborns with idiopathic congenital clubfoot (a total of 40 feet). The severity of clubfoot was evaluated on days one and seven after birth using the Dimeglio and Pirani scores.
 Results. During the initial examination of the newborns on the first day of life, the clubfoot severity recorded on the Pirani score was between 2 to 3 points and between 9 to 15 points on the Dimeglio score. Thus, in the first seven days of life in all patients who did not receive treatment, there was a significant increase in the severity of the equino-cava-varus deformity of the feet (p 0.05). The results of this study confirm that the severity of congenital clubfoot increases in the first week of life. This necessitates the beginning of the correction of severe idiopathic clubfoot in the first days after birth.
 Conclusions. The severity of congenital clubfoot during the first week of life significantly increased in all feet studied (p 0.05: 2 higher than in the table). If left untreated in the first week after birth, the equinus deformity progresses followed by varus deformity, anterior forefoot reduction, and, to a lesser extent, rotation.

Initiating Ponseti management in preterm infants with clubfoot at term age

“…11 In particular, the optimal age at which infants with clubfoot who are born preterm (< 37 weeks of gestation) should begin treatment remains unknown. 3,[13][14][15][16][17] The first European consensus meeting on Ponseti clubfoot treatment recommended that Ponseti casting is neither indicated nor well-tolerated in the preterm population until the infant is medically stable. 18 Furthermore, the consensus states that management of clubfoot in preterm infants should be delayed until discharge from the neonatal intensive care unit (NICU) to allow the infant's foot to grow.…”