Physical Medicine and Rehabilitation Management in Pediatric Patient with Postural (Positional) Clubfoot: A Case Report

Authors

  • Gloria Rondonuwu Universitas Sam Ratulangi
  • Joudy Gessal Universitas Sam Ratulangi
  • Patricia Kalangi Universitas Sam Ratulangi

DOI:

https://doi.org/10.35790/msj.v5i2.46886

Abstract

Abstract: Clubfoot, talipes equinovarus, is a common term used to describe several kinds of ankle or foot deformities present at birth. This condition is one of the most treatable birth defects, often leading to normal or near-normal athletic activities later in life. We reported a patient with positional clubfoot treated with serial casting, passive manipulation, and stimulation. Male, 6 days old, lived in Sonder, with a chief complaint of right foot that bent inward since birth. Patient was consulted by pediatrician to physiatrist since the birth day. The bent inward foot was not accompanied by swelling and redness, and patient was seen calm when the foot being moved. Patient was treated by physiatrist with passive manipulation, four times weekly with serial casting, and everyday stimulation for feet. During treatment session, patient’s deformity was getting improved. After treatment, the deformity was corrected and patient’s foot was in normal position without any complication. The aim of medical rehabilitation of clubfoot was to reduce the deformity with the success criteria that foot could be functional, free of pain, good mobility, and did not require correction shoes, therefore, the patient could carry out normal activities after growing up. In conclusion, to produce the maximum correction results, good cooperation is required with the patient’s parents. Even though correction is optimal and done as soon as possible, if bone growth has not stopped, the clubfoot problem can reappear. The first element of management is correction of the cavus deformity by positioning the forefoot in proper alignment with the hindfoot.  

Keywords: postural clubfoot; physical medicine and rehabilitation; children; passive manipulation; serial casting; everyday stimulation for feet

Author Biographies

Gloria Rondonuwu, Universitas Sam Ratulangi

Pediatric Divison, Department of Physical Medicine and Rehabilitation Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia

Joudy Gessal, Universitas Sam Ratulangi

Pediatric Divison, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia

Patricia Kalangi, Universitas Sam Ratulangi

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia

References

Staheli LT. Foot (Chapter 9). In: Fundamentals of Pediatric Orthopedics (5th ed). Philadelphia: Wolters Kluwer; 2016.

Wahyuni LK, Soebadi RD, Wulan SM. Deformitas kaki dan pergelangan kaki. In: Wahyui LK, Tulaar ABM. Ilmu Kedokteran Fisik dan Rehabilitasi pada Anak (Cetakan 1). Jakarta: PERDOSRI; 2014. p. 562-96.

Brunner R, Freuler F, Hasler C, Jundt G. Pediatric Orthopedics in Practice. Heidelberg: Springer – Verlag; 2007. p. 374- 88.

Schoenecker P, Rich MM, Gordon JE. The lower extremity. In: Lovell and Winter’s. Pediatric Orthopaedics Vol. 1 (7th ed) Vol 1. Philadelphia: Lippincott Wiliiams; 2014. p. 1261-341.

Murphy KP, Wuenderlich CA, Pico EL. Orthopedics and musculoskeletal conditions (Chapter 10). In: Alexander MA, Matthews DJ, editors. Pediatric Rehabilitation Principle and Practice (5th ed). New York: Demos Medical; 2015.

Visser JD. Foot. In: Visser JD, editor. Pediatric Orthopedics Symptoms, Differential Diagnosis, Supplementary Assessment and Treatment. Switzerland: Springer; 2017. p. 261-98.

Abdelgaward A, Naga O. Foot. In: Abdelgaward A, Naga O, editors. Pediatric Orthopedics A Handbook for Primary Care Physicians. Springer; El Paso; 2014: 157-198.

Brown DP, Freeman ED. In: Cuccurullo SJ, editor. Physical Medicine and Rehabilitation Board Review (3rd ed). New York: Demos Medical; 2015. p. 149- 340.

Herring JA. Congenital talipes equinovarus. In: Tachdjian's Pediatric Orthopaedics from The Texas Scottish Rite Hospital for Children (5th ed). Elsevier Saunders: 2013. p. 785-809.

Thomas J, Barry M. Congenital talipes equinovarus (Clubfoot). In: Paediatric Orthopaedics in Clinical Practice (3rd ed). Elsevier Saunders; 2016. p. 177-87.

Besselaar A, Sakkers R, Schuppers H, Witbreuk M, Zeegers E, Visser J, et al. Guideline on the diagnosis and treatment of primary idiopathic clubfoot. Acta Orthopaedica Journal. 2017;88(3):305-9.

Schoenecker P, Rich MM, Gordon JE. The lower extremity. In: Lovell and Winter’s. Pediatric Orthopaedics Vol 1 (7th ed). Philadelphia: Lippincott Williams; 2014. p. 1261-341.

Rani M, Kumari P. Congenital clubfoot: a comprehensive review. Ortho & Rheum Open Access Journal. 2017;8(1):1-5.

Mejabi J, Esan O, Adegbehingbe O, Orimolade E, Asuquo J, Badmus HD, et al. The Pirani scoring system is effective in assessing severity and monitoring treatment of clubfoot in children. British Journal of Medicine & Medical Research. 2016;17(4):1-9. Doi: 10.9734/BJMMR/2016/27439

Staheli L, Ponseti I, Morcuende J.A, Pirani S. In: Kaki Pengkor: Penanganan dengan Metode Ponseti (3rd ed). Global Help. 2010. Available from: https://global-help.org/products/kaki-pengkor-penanganan- dengan-metode-ponseti/

Jeans KA, Karol LA, Erdman AL. Outcomes after nonoperative treatment of idiopathic clubfoot. The American Academy of Pediatrics Journal. 2019;41(4):40-5. Available from: https://doi.org/ 10.1542/gr.41-4-40.

Digge V, Desai J, Das S. Expanded age indication for Ponseti method for correction of congenital idiopathic talipes equinovarus: a systematic review. J Foot Ankle Surg. 2018;57(1):155-8. Doi: 10.1053/j.jfas.2017.08.015.

Rani M, Kumari P. Congenital clubfoot: a comprehensive review. Orthopedics and Rheumatology Open Acces Journal. 2017;8(1):001-005. Doi: 10.19080/OROAJ.2017.08.555728.

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Published

2023-08-30

How to Cite

Rondonuwu, G., Gessal, J., & Kalangi, P. (2023). Physical Medicine and Rehabilitation Management in Pediatric Patient with Postural (Positional) Clubfoot: A Case Report . Medical Scope Journal, 5(2), 279–287. https://doi.org/10.35790/msj.v5i2.46886