Clubfoot (Pes Ekinovarus) Treatment
Correcting Deformity.
Restoring Natural Movement.
Comprehensive clubfoot treatment focused on correcting foot deformity, improving function and supporting healthy development and mobility.
What Is Pes Equinovarus (Clubfoot)?
Pes equinovarus, also known as clubfoot, is a congenital deformity in which the foot is turned inward and downward. It occurs in approximately 1 in 1,000 births and is more common in male infants.
The soft tissues on the inner side of the foot, including the muscles, tendons, and ligaments, are tight, and there are also deformities in the bone structure. The exact cause is unknown.
Pes equinovarus may be associated with developmental hip dysplasia. Therefore, these patients should undergo careful examination and appropriate investigations for the risk of hip dysplasia.
One of the most important factors determining the success of Pes Equinovarus treatment is family compliance. Regular and appropriately performed casting and subsequent brace treatment, carried out by experienced specialists, can significantly improve treatment outcomes.
How Is Pes Equinovarus Treated?
Treatment consists of weekly casting and manipulation. The patient typically undergoes 5–6 weekly casts.
If sufficient range of motion is not achieved at the ankle following the final casting, percutaneous Achilles tendon release may be required during the final casting procedure.
How Is Achilles Tendon Release Performed?
Achilles tendon release may be required, particularly in advanced and rigid deformities.
The Achilles tendon is released through a minimally invasive procedure using a single 3–5 mm skin incision. Local anesthesia combined with mild sedation is used to prevent discomfort during the procedure.
The procedure takes approximately 2 minutes, so general anesthesia is generally not required.
After the Achilles release, the skin is closed with a single absorbable suture, which does not need to be removed.
Following the Achilles release, the final cast remains in place for 3 weeks to allow the Achilles tendon to heal and is not changed during this period.
What Happens After Casting Treatment?
After the three-week cast is removed following the Achilles tendon release, a brace adjusted to the appropriate angle by the physician is applied to the patient’s foot to prevent recurrence of the deformity.
The brace should be worn continuously throughout the day and should only be removed for changing clothes and bathing, after which it should be put back on.
Failure to wear the brace for an adequate period may lead to recurrence of the deformity, potentially requiring another course of casting.
The duration of brace use varies depending on the patient’s compliance and the severity of the deformity. The brace is generally worn 24 hours a day until the child begins walking. Once walking begins, an orthopedic boot is used during the day and the brace is continued at night.
When Is Surgery Required for Pes Equinovarus?
Following treatment, recurrent deformities can generally be corrected with simple surgical release procedures and casting until approximately 1.5–2 years of age.
After this age, recurrent or incompletely corrected deformities may require more extensive procedures, including tendon transfers, ligament releases, and, in more advanced deformities, bone surgery.
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