Hesperian Health Guides
Chapter 60: Correcting Club Feet
The younger a child is when you begin, the more easily and quickly her foot can be straightened. For best results, begin 2 days after the baby is born. If the child is over 1 year old, usually a good correction is only possible with surgery. Ways to predict how easy or difficult correction may be for a particular child are listed for "How long will it take?".
This method works well in a baby with mild to moderate clubbing, especially when the foot can be put into a nearly normal position. The method is easier and cheaper than casting, and sometimes gives better results. You will need:
- tincture of benzoin (to paint on the skin to help the adhesive felt stick firmly. Zinc oxide in the tincture will help protect the skin.)
- cotton wool
- adhesive surgical felt (padding) 8 mm. thick and at least 2.5 cm (1 inch) wide
- adhesive tape (sticking plaster) or zinc oxide strapping 2.5 cm. wide
|1. Paint tincture of benzoin on the skin areas to be covered by the tape.|
|2. Hold the baby’s foot like this and gently straighten it as far as you can without forcing.|
|SIDE VIEW||FRONT VIEW|
|3. With the knee bent as far as possible, stick strips of felt around the foot and over the knee and leg as shown.|
|SIDE VIEW||FRONT VIEW|
|4. Stretch adhesive tape over the felt. Start on the outer side of the foot, go around the foot, up over the knee, and down the other side. Use the tape to pull the foot into a better position.||Tape coming down leg ends here.|
no tape here
|5. Put a second piece of tape around the leg twice here to hold the first tape.|
Every 2 or 3 days, tighten the correction by stretching new tape over the old, in the same way. On the 7th day, remove everything and leave the leg free until the next day. On the 8th day, apply new felt and tape.
Exercises during strapping
While the baby’s foot is strapped, someone in the family should do stretching exercises on his foot every time he is fed or changed (at least 8 times a day).
|1. Hold the baby’s leg like this and turn his whole foot UP and OUT.||2. Turn it as if you were trying to touch the little toe to the outer side of the knee.|
|Hold and count to 10. Repeat 10 times.||The strapping and exercises should be continued until the foot is overcorrected (bends outward a little).|
|3. If the foot is shaped like a bean, also do an exercise to stretch the foot in the opposite direction of the deformity, like this.||4. After stretching the baby’s foot this way, help the baby to stretch it himself by tickling the outer edge of his foot.|
If the foot is not straightened completely within about 3 months of strapping and exercises, surgery is probably needed.