The term "clubfoot" describes a number of anomalies in the structure of the foot, which are usually congenital. It is a common disorder, usually present in the overall health of the child. Clubfoot can be mild or severe, it is striking how one or both legs. Because it can slow down the development of the child, when he begins to learn to walk, it is generally recommended to start treatment of clubfoot soon after birth.

Symptoms

In most cases of clubfoot foot deflected inwards and downwards, because of which the arch of the foot becomes higher. Calves on the foot with this disorder are usually underdeveloped. In addition, stop, struck clubfoot, can be up to one centimeter shorter than the healthy foot. However, despite all this, clubfoot itself does not cause any discomfort or pain.

In most cases, the child's doctor says it is a violation and he offers to undergo treatment.

Causes

The reasons are unknown clubfoot (the so-called idiopathic disease). It is known that toed not related to the position of the fetus in the uterus. In some cases of clubfoot in children with other skeletal malformations such as spina bifida, a serious birth defect that occurs when the tissue surrounding the developing spinal cord of the fetus does not close properly.

Risk factors

• Paul. Clubfoot is more common among men;
• Family history. If the mother, the father or that of their previous children born had clubfoot, there is a significant likelihood that it will have the following children;
• Smoking during pregnancy. If a woman, whose family history of clubfoot, smoking during pregnancy, the likelihood that it will be a violation of her child, twenty times higher than the average.

Complications

Clubfoot does not usually cause any problems as long as the child begins to stand and walk. Later, however, if left untreated, clubfoot can become a heavy burden. This disorder increases the risk of arthritis Arthritis - a variety of forms and complications ; unusual appearance of the foot and gait characteristics associated with clubfoot can lead to various psychological problems in adolescence.

Diagnostics

Most often, doctors detect clubfoot soon after birth or in the first months of life. The degree of deformity was evaluated by X-rays. Sometimes toed already noticeable at ultrasound during pregnancy.

Treatment

Since the bones and joints of the newborn are very flexible clubfoot usually begins shortly after birth. The goal of treatment is to restore the appearance and functionality of the foot before the child begins to learn to walk, in the hope of preventing long-term disability.

One of the most common methods of treating clubfoot - Ponseti technique. In the first step foot deformities corrected with casts. They vary, depending on the characteristics of the patient, every week or every few weeks. When you reach the desired result, the child will have to wear special locking device. It is necessary to stop has not returned to its original position. The whole course of treatment can last up to three years.

In some cases, when the clubfoot can not be conservative methods of treatment, it is corrected by means of surgical methods. Surgeon lengthens the tendons of the foot, the foot that took normal form. After surgery, the child will have about a year to wear the locking device and / or orthopedic shoes Orthopedic shoes - how to determine what is right for you? .

As a rule, timely treatment can not correct the clubfoot and the child in the future, is a full active life.

There are three main types of acquired deformities of the chest: funnel chest ("sunken chest"), keeled (wedge-shaped) chest deformity and distortion caused by scoliosis. The most commonly considered funnel and keeled chest deformation.

Funnel chest

The main reason for funnel chest - connective tissue abnormalities that cause depression of the breastbone inward toward the spine. In most cases this kind of chest deformation occurs at birth or within the first two years of life.

Funnel chest - a congenital anomaly, the most common form of chest wall deformity in children, occurs in one to three or four hundred babies. This type of deformation is more common in boys than in girls. It is assumed that funnel chest - inherited anomaly.

Diagnostics

• The first stage of diagnosis of funnel chest - a standard chest X-ray.
• Cytometry comprises measuring chest chest circumference in the distal third of the sternum or the region of greatest deformation at the time of inhalation depths.
• Calculation of the index suggests anthropomorphic measurement of symmetry and the depth of the funnel-shaped deformation.
• In some cases, to determine whether surgery is performed standard cardiopulmonary function test.
• Computed tomography of the thorax is performed to determine the degree of deformation, the degree of compression of light due to the deformation and the presence of displacement of the mediastinum.

Treatment funnel chest

In mild to moderate cases, the deformation treatment is not required, because the funnel deformation does not disrupt the operation of the internal organs.

The main method of correction of funnel chest - osteochondroplasty, suggesting opening the front of the chest wall, the formation of skin and muscle flaps, removal of damaged cartilage and perform sternal (sternum) osteotomy Osteotomy - orthopedic surgery bone dissection   (procedures dissecting bones).

A more modern and less invasive procedure for correction of the deformity - endoscopic technique involves injecting retrosternal (retrosternal) metal rod through the two slits using toraskopa. After two or three years, the rod is removed. This procedure is used mainly for children aged twelve to fourteen years for young children and adults may require the introduction of two rods. In endoscopic correction techniques funnel chest risk of complications is higher than that of traditional methods of correction.

Keeled chest deformity ("chicken breast")

For keeled chest deformation is characterized by an increase in the anterior-posterior size of the breast Breast size - does it matter? . The main causes of this type of deformation - rickets Rickets - all about vitamins   and severe asthma in children, sometimes complicated by ventricular septal defect of the heart. Twenty percent of the keeled chest deformation observed scoliosis Scoliosis - when the spine is curved .

Keeled chest deformation is much less common than the funnel-shaped deformation, and usually occurs at an early age - most often in children aged three to five years. To diagnose keeled chest deformation applied radiography and computed tomography of the chest, as well as a number of other specific tests - including cardiopulmonary function test to determine lung function and an echocardiogram to determine the abnormality of the heart, caused by the deformation of the chest.

Correction keeled chest deformation

In many cases, correction of keeled chest deformation is required.

The main method of correction of the deformity of the chest - ekdoskopicheskaya resection of costal cartilages and sternal osteotomy. Such methods are for cosmetic deformity correction, but do not contribute to the normalization of functional disorders caused by deformation of the chest.

In very rare cases, when keeled chest deformation causes a disturbance of cardiac or pulmonary performed reconstructive surgery.