116 chapter 11
How long will it take?
How difficult it is to straighten a club foot, how long it takes, and how long braces
and special exercises will be needed depends on a number of factors:
• The severity of clubbing. A severely deformed foot with abnormal bones is much
harder to correct.
• Abnormal muscle balance, if present, will keep pulling the foot to the inside, even
after it is corrected. (See muscle testing, p. 30.)
• Generally, correction is more difficult if both feet are clubbed.
• Club feet in girls (although less common) are likely to be more difficult to correct
than in boys.
• If there are any other abnormalities (such as a clubbed hand or stiffness in the
knees or elbows), club feet may be especially difficult to correct. Usually surgery is
needed.
• The older the child, the harder it is to correct a club foot. Past the age of 2 years,
it is often not possible without surgery.
• Children without feeling in their feet (spina bifida) require special precautions and
slower correction to avoid pressure sores (see p. 173). Casts, if used, must not
apply much pressure, and must be changed often.
If a child’s foot shows little or no improvement after 4 weeks of casting, or if
improvement stops in spite of continued casting, surgery is probably needed for more
complete correction.
BRACES FOR USE AFTER CORRECTING CLUB FEET
For some feet, a plastic ankle brace may work well.
For more difficult feet, a metal brace may be needed, with
an ankle strap that pulls the ankle inward.
A slight build-up on the outer edge of the sandal or shoe
may also help.
For instructions on making braces, see Chapter 58.
For babies under one year, or small children at night,
feet can be held in a good position using a bar that joins
the 2 feet. For a simple design, see p. 539.
For the child
whose feel bend
mostly at the
middle or front
wearing shoes in
reverse may help
keep the feet
corrected.
left shoe on
right foot
right shoe
on left foot
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