114 chapter 11
SEVERE KNOCK-KNEES
To check for severe knock-knees, have the child
stand with her knees touching. If the distance
between the ankle bones is more than 3 inches in a
3 year old, or 4 inches in a 4 year old, the problem is
probably severe enough to need attention.
If the knock-knees are severe, braces may help
straighten the knees and keep the condition from
getting worse (see p. 539). In a child over 6 or 7
years old, braces usually do not help. In extreme
cases, surgery may be needed. Knock-knees may
also lead to flat feet.
Sign of a problem
3 years
old
4 years
old
more than
3 inches
(7½ cm.)
more than
4 inches
(10 cm.)
CLUB FEET
About 3 out of 1,000 children are born with a club
foot (or feet). Sometimes it runs in the family, but
usually the cause is unknown.
Sometimes a newborn baby’s feet turn inward, just
because they were in that position in the mother’s womb.
club foot before correction
If the front part of a
baby’s foot is turned
inward, it will often
straighten out by itself
before she is 2 years old.
front part
only bent
back part
straight
To find out whether the condition is likely to correct itself, or if it is a true
deformity (club foot) that needs special attention, try to put the foot in a normal
position.
Bent foot
straightens:
NORMAL
If you can easily
straighten the foot, and
bend it into a position
opposite to the way it
was turned, the foot
probably does not have
a bone deformity and
will get better by itself.
Also, if you scratch the
foot lightly, the child
often will move it into a
normal position.
Bent foot does
not straighten:
CLUB FOOT
If you cannot
put the foot in a
normal position,
it will need to be
straightened with
strapping or casts
(see Chapter 60).
Are club feet a sign of some other problem? Although club foot often occurs without any
other problem, occasionally it is a complication of spina bifida (problem in the spinal
cord, see Chapter 22). Always check the child’s spine and test if he has feeling in his
feet (see p. 39).
The feet may also gradually become deformed into a ‘club foot’ position, because
of cerebral palsy, polio, arthritis, or spinal cord damage.
Rarely, club feet occur together with a ‘clubbed hand’ or other weakness and
deformities of the body. See Arthrogryposis, p. 122.
Disabled village Children