05 June 2009

Club foot, Sebastian's story

Club foot, Sebastian's story

A clubfoot, or talipes equinovarus (TEV), is a birth defect. The foot is twisted in (inverted) and down. Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet. It is a common birth defect occurring in about one in every 1,000 live births. Approximately 50% of cases of clubfeet are bilateral. In most cases it is an isolated dysmelia. Incidence in males is higher than in females.(Wikipedia)

Scan revealed the condition
We first discovered the difficulty with Sebastian’s feet when we went for our 15 week, NT (neucal fold thickness) scan. Dr Engela Steyn said there was definitely something wrong, and that it was more than likely club foot. She did reassure us that it was one of the more common childhood abnormalities and recommended that we go and see a Dr Ryno du Plessis as he was one of the best orthopaedic surgeons.

Around 21 weeks we went to see Dr Madelene Carstens and she performed a 3d scan, which showed clearly that there was club foot in both feet. She also recommended Dr Ryno du Plessis.

The Ponseti method
Sebastian was born on the 8th of September 2004 and had his first visit to Dr du Plessis six days later. Dr du Plessis explained that Sebastian had Bilateral Congenital club foot, and talked us through the procedure that he would use to correct the problem, the Ponseti method, named after Dr Ignacio Ponseti.

The first casts
Sebastian received his first set of plaster casts that day, this was quite a traumatic experience for us as new parents - we were all in tears. Dr du Plessis manipulated the feet gently, and the plaster casts, which were from foot to the top of the thigh, held Sebastian’s feet in the correct position. This process was repeated for 8 weeks. The casts were removed by submerging them in a bath, the plaster then softened and the bandages easily removed.

A brave little boy
The most heart wrenching part of the process was the Tenotomy. Sebastian wasn’t allowed to eat from midnight, as he had to go under general anaesthetic. He was such a brave little boy. When the nurses took him through to theatre, his dad had to accompany him alone. He said that seeing this tiny little person on the huge operating table was a heart breaking sight. When performing a Tenotomy, a 2mm incision is cut in the Achilles tendon, and then the legs are encased in the last set of plaster casts. The casts are kept on for three weeks, giving time for the Achilles tendon to mend itself.

Procedure a success
After three weeks the casts were removed and Sebastian had to wear a brace, consisting of a pair of shoes that were joined together by a spreader bar. The brace had to be worn 23 hours a day for three months, and thereafter at night only, until he was 3 years old. The only problems we encountered with the brace was that Sebastian suffered from blisters and a few bouts of athlete’s foot.

The procedure, from the first set of casts to the last day that he wore the brace, was extremely unobtrusive and all it took from our side was perseverance, patience and dedication. The results are amazing, and Sebastian’s feet are beautiful.

Story sent in by Zita Tardrew November 2007

Read more:
Examinations after birth
Fix flat feet immediately
Keeping kids’ feet fit




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