Treatments of the club-foot


Whatever the technique used, the treatment of the club-foot passes by
three crucial steps :
1st stage : the reduction of the deformation
2nd stage : consolidation of the result obtained
3rd stage : risk management of repetition





1st stage : the reduction of the deformation : (Glossary)

It is about a capital phase, because the risk to cause lesions of the foot by handling fragile bones (cartilagineux to 75%) is important.
It requires experiment and softness.
The techniques of reduction used are variable according to the schools, but there exist common characteristics :

Duration of the phase
Beginning of the treatment
Principles of the treatment
Actors of the treatment
6 to 8 weeks
Early
(in the 3 first
days of life)
Mobilization
Application
Surgeons pediatrists
Kinesitherapists


To carry out this phase of reduction, 3 options are possible :

Orthopedic treatment

Application of the foot and correction by successive plasters
(technique of Ponseti)

Used in North America and since 5 years in Lyon
Functional treatment
Active and passive handling of the foot, repeated in the course of the day
Used in France
Mixed treatment
Associate handling and application
(technique of Finck)

Used in France







2nd stage : consolidation of the result obtained :

During this phase, the risk is that to see reproducing the deformation précocément.
Duration of the phase
Beginning of the treatment
Principles of the treatment
Actors of the treatment
3 months
As of the end of the phase of reduction
Physiotherapy
Postures
Parents
Kinesitherapists


 
Physiotherapy
Postures
Orthopedic treatment
Moderate kinesitherapy
Stimulation by the parents
Functional treatment
Intensive kinesitherapy
Splints of Denis-Browne
Clubax splints

Mixed treatment
Variable kinesitherapy
Splints








3rd stage : risk management of repetition :

The growth of the foot is likely to cause the repetition of the deformations.
It is thus VERY IMPORTANT not to stop the treatment, even in the event of good performance after the first two phases, and to make follow his child regularly (consultation of orthopedy every approximately 3 months).

Duration of the phase
Beginning of the treatment
Principles of the treatment
Actors of the treatment
Very variable, of 1 year at 10 years

To appoint 4 years in practice

As of the end of the phase of consolidation
Application of day (shoes)
Application of night
(splints)
Kinesitherapy

Parents
Surgeons pediatrists
Kinesitherapists
Fitters





 


Recommendations of A.N.A.E.S.
(National agency of Accreditation and Evaluation in Health)


Masso-kinesitherapy and orthopedic treatment of the deformations isolated from the foot
during the first 6 months of the life
.

Access to the site of A.N.A.E.S.

Recommandations for the clinical practice - Synthesis - January 2004

Recommandations for the clinical practice - Recommendations - January 2004

Recommandations for the clinical practice - Sales leaflet - January 2004

Clinical practice guidelines- -January 2004




The place of osteopathy
Osteopathy does not have ANY place in the treatment of the club-foot varus equine idiopathic.
More on osteopathy, to see the www.osteo-stop.com site.

 


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