Clubfoot, its types and forms

Clubfoot - a complex combination foot deformity in which there are the following changes in its shape and position:

• Internal clubfoot - foot turned inward (supine), mostly the heel;
• stop is in the plantar flexion;
• forefoot is in the cast.

Clubfoot can be unilateral and bilateral congenital and acquired. Congenital Clubfoot - a common congenital anomaly, it can manifest itself in several forms. So, bring the forefoot due to changes in the muscles called clubfoot varus, it is quite easy to treat. Changes in the ligaments can be treated not as quickly treatment is carried out in several stages. Changes in the bones are rare and difficult to treat.

Why can occur clubfoot

Clubfoot may occur if the early stages of pregnancy, a woman was exposed to some toxic effects, for example, take some drugs, while the primary process is broken bookmarks tissues and there are various anomalies. The cause of clubfoot may be the wrong position of the fetus in the uterus, which interferes with the blood supply and innervation of this area of ​​the body. Congenital clubfoot can be one of the signs of systemic disease or hypoplasia of the skeleton. Skeletal system is broken while rare, but often found thickening of ligaments or muscles wrong location at which the traction of muscles and ligaments more with one hand, which causes the foot to take the wrong position.

Acquired clubfoot is less common than congenital. It occurs in various lesions of the nervous system (for example, paralysis), if properly fused bone fractures that form the ankle joint, bone dysplasia leg and foot, after burns and various bone diseases.

As shown

Clubfoot is detected at birth and progresses in the future. It is manifested wrong position of the foot, most commonly the heel of the foot turned inwards to some extent, the outer edge of the foot is lowered, the inner edge is raised upward and the forefoot is shown, i.e. the foot is in a state of flexion. Flexion of the foot can be so severe that the heel can touch the shin. Such a position of the foot, especially if it is heavily expressed, does not allow the right move. In addition, often a twisting leg bones.

Depending on the severity of the clubfoot deformity are divided into:

• slight degree - movement in the ankle and kept deformation can be corrected by conservative methods of treatment;
• average degree - movements are limited; Clubfoot yielded only partial correction;
• Severe - movement severely restricted, subject only clubfoot surgery.

To confirm the diagnosis of clubfoot radiography feet and legs with a few different positions (projections).

How to treat clubfoot

Treatment of congenital clubfoot Congenital clubfoot - can you handle it?   provides an orthopedic children's clinic, it starts a week after the birth of the child and conducted conservative. Apply different fixing bandages (flannel bandage, landmark casts), gymnastics and massage. Staged first casts are changed weekly, and after several months of treatment - once in 9-12 days. By the age of six months, and sometimes by the time the child begins to walk, foot deformities can be completely eliminated in most children. The success of conservative treatment depends on the severity of the clubfoot, the timeliness and adequacy of treatment.

Surgical treatment is used in the case where the conservative fails, after the age of two years. Deals in the tendons and muscles of the foot, if necessary, removed and bone deformation. After surgery on the foot and lower leg plaster is applied. Term casting of depends on the operation. For a quick restoration of function of the foot held physiotherapy treatments, physiotherapy and massages.

The most important thing to do when clubfoot - this time to see a doctor and a full course of treatment.

Galina Romanenko

Mechanism of action

Lidaza (international non-proprietary name - hyaluronidase) - this enzyme preparation derived from bovine testes and comprising hyaluronic acid. Hyaluronic acid has high viscosity and is composed of acetylglucosamine and glucuronic acid. The biological significance of hyaluronic acid is that it is a cementing substance of connective tissue.

Hyaluronidase causes the decomposition of hyaluronic acid and thereby reduces the viscosity and increases tissue permeability and facilitates the movement of fluid in the interstices spaces.

Hyaluronidase is found in various tissues of the body .  The ratio of hyaluronic acid - hyaluronidase largely regulated tissue permeability .  Anti-inflammatory effects of various drugs (e.g., aspirin) due to the fact that they can reduce the activity of hyaluronidase .  Conversely, the effects of some substances that increase the permeability (for example, the action of bee or snake venom) is associated with the presence of hyaluronidase .  Action hyaluronidase is reversible .  While reducing its viscosity hyaluronic acid concentration is restored .  Thus lidaza can be used to temporarily reduce the viscosity of hyaluronic acid .  It reduces its viscosity, increases the tissue and vascular permeability, facilitates the movement of fluids in the interstices spaces; reduces swelling of tissues, softens and decreases in the amount of scarring, increases range of motion in the joints, reduces contracture (a persistent reduction of the joints due to violation of the soft tissues or nerves) and prevents their formation .

Available lidasa as a lyophilized (dried) powder for solution for injection and topical application, as well as a powder for external use.

Indications for use

Indications for use lidazy are:

• Any scars on the body - after injuries, burns, operations and so on);
• chronic, long-term healing ulcers, including after exposure to radiation;
• fibrous transformation and shortening of palmar tendons, resulting in shorter and gradually fixed half-bent fingers, losing the ability to extension (Dupuytren's contracture)
• stiffness, and joint contractures that developed after inflammatory processes and injuries;
• osteoarthritis - the exchange joint disease;
• Ankylosing spondylitis (ankylosing spondylitis) - an inflammatory disease of the joints of the spine with the formation of its complete immobility;
• hard disc disease of the lumbar vertebrae;
• Chronic tenosynovitis Tenosynovitis - how to avoid becoming a victim of art   (inflammation of the tendon sheath - dense connective tissue sheath surrounding a tendon);
• cutaneous manifestations of scleroderma Scleroderma - affects all the organs   - Proliferation of connective tissue in the skin;
• bleeding (hematoma, bruising) in superficial soft tissues;
• Preparation for plastic surgery for scars, tightening the skin surface;
• myocardial infarction - prevents the formation of scars on the heart muscle;
• hydrocephalus or brain edema - excessive accumulation of fluid contained in the cavities of the brain and the spinal canal;
• tuberculosis Tuberculosis - a full recovery is not guaranteed   pulmonary complications of nonspecific (due to normal bacterial flora) lesions of the bronchial tubes;
• inflammation of the upper respiratory tract and bronchi with symptoms of obstruction - obstruction of the bronchi, which developed as a result of the inflammatory process;
• as part of a treatment for allergic rhinitis, rheumatoid arthritis - swelling of tissue is removed;
• injury of nerve plexus and peripheral nerves (plexitis);
• corneal inflammation (keratitis) - to reduce the amount of scarring;
• to improve absorption of drugs administered by injection into soft tissue.

Contraindications and side effects

Contraindications for external and injecting lidazy are:

• Hypersensitivity to the drug;
• acute infectious and inflammatory diseases;
• recent hemorrhage.

Inhalation Lydasum contraindicated in pulmonary tuberculosis with severe respiratory failure, pulmonary hemorrhage, hemoptysis, all acute diseases, malignant tumors, fresh hemorrhage in the eye.

C care should be given lidazu while taking female sex hormones estrogen (they are in hormonal contraceptives), pregnancy and breastfeeding Breast-feeding: feed - and no nails! .

Side effects when using lidazy may manifest allergic reactions and tissue irritation with prolonged use.

In overdose lidazy appear nausea, vomiting, dizziness, palpitations, low blood pressure, swelling at the site of exposure to the drug, a skin rash. Treatment of overdose lidazy should take place in the hospital.

Lidaza - a time-tested effective drug, which can be used only on prescription.

Galina Romanenko