knock-knees and club feet
Correcting club feet (For details, see Chapter 60.)
115
A club foot should be held
in a cast; or strapped in a
straighter position, soon after
birth—until it is corrected
past normal.
After correcting the
foot, daily stretching
exercises are often
needed to help keep
the foot straight.
A brace is used
(day and night
if necessary) to
keep the foot from
bending in again,
until finally,
normal use and
exercise keeps
the foot straight.
club foot after correction with casts,
by village workers (PROJIMO)
About 60% of club feet can be effectively
straightened without surgery in 6 to 8 weeks, using
either strapping or casts. These methods are described
in Chapter 60.
Correction of club feet should begin soon after the child is born—if possible, in the first
2 days. At birth, a baby’s bones and joints are still soft. As the child gets older, his bones
get harder and become less flexible.
Usually, good correction without surgery is only possible in the first year of life. If
the deformity is not severe, however, a club foot can sometimes be corrected with
casts, even if the child is already 2, 3, or even 5 years old or more. But in an older
child, it takes longer, and surgery is more often needed for good, lasting results.
Some children with very deformed feet will need surgery, even if strapping or casting
is done early. However, we have found that some children for whom surgeons have
recommended surgery can have their feet straightened with casts at a village center.
Keeping the feet straight once they are corrected
Once a club foot has been straightened, great care must be taken to keep it straight. The
whole family must make sure that the following precautions are taken:
• An ankle brace should be worn night and day at least until the child is
walking, and often until the child is 15 or 18 years old.
• Foot-stretching exercises will be needed,
especially if there is any sign that the foot is
clubbing again. Gently and steadily stretch
the foot past its normal position in the
opposite direction of the deformity. Do this
exercise 2 or more times a day.
Bend foot out.
Push foot
up and
twist it out.
Pull down
on heel
and twist
it out.
• Check the foot regularly. Return quickly to the rehabilitation center for an
evaluation if there is any sign that the clubbing is coming back.
disabled village children