CLUBFOOT

What is Clubfoot?

Clubfoot deformity is a physical disability that is easily treated in children, especially before they are 3 years of age.

In Australia, the UK and the Western world, identification of clubfoot often occurs before birth and correction commences very soon after birth. The incidence of clubfoot in developing countries such as Bangladesh is similar to the Western world but the large population makes this a substantial problem. Sadly, many parents have not been aware or able to access corrective treatment until recently.

The Challenge

The Challenge is to enable children like Halima to be able to walk, play and grow into a valuable member of the community and put the smiles back on her parent’s faces. Alternatively, life can be a struggle for the entire family and Halima’s prospects would be a life of debilitation and poverty.

Every year an estimated 5000 children are born with clubfoot deformity in Bangladesh. Through education, training, awareness and the operation of it’s clubfoot clinics Walk for Life is making a difference. You can help change a life forever! “Share the joy and be part of the Solution”

The Solution

A sustainable program has been built utilising our network of clinics, brace-making capability, ongoing training and education for communities, medical staff and students.

Walk for Life uses the globally preferred non-surgical Ponseti method to correct clubfoot deformity in babies and young children. Our Memorandum of Understanding (MOU) with the Ministry of Health in Bangladesh and the support of the orthopedic surgeons in Bangladesh is crucial in enabling us to reach as many children as possible.

Ponseti Method

Dr Ignacio Ponseti,a pediatric orthopedic specialist developed the Ponseti technique in the 1960s at the University of Iowa, USA after observing poor outcomes of clubfoot surgery.

The essence of the Ponseti technique is accurate manual correction of the developing foot anatomy which allows the tight ‘clubfoot ligaments to stretch and lengthen. This process of ‘stretch’ (by hand) and ‘hold’ (by casts) is gentle and sequential; gradually shifting the foot bones to the correct positions. The tendency of the clubfoot to relapse or ‘spring back’ needs to be appreciated and is the reason for the very necessary maintenance bracing phase –  arguably the most important part of the process.

The Ponseti technique consist of three sequential stages:

  1. manipulation and casting (up to 4-6 weeks)
  2. a small procedure to lengthen the Achilles tendon (heals in a ‘rest cast’ for 3 weeks)
  3. a brace (boots and bar) to maintain correction with growth (to age 4-5 years)

All time frames are approximate as individually cases do vary.

Many studies have shown that when applied correctly, the Ponseti technique can achieve correction of the clubfoot deformity in over 90% of cases. These outcomes have seen the Ponseti method become the treatment of choice for clubfoot by all medical and health professionals involved in clubfoot correction around the world.

Braces – to maintain the corrected foot position with growth

After the casting and achilles tendon lengthening the child is immediately fitted with a maintenance brace (boots and bar). It is crucial that all of the correction gained with plaster casts is maintained with the brace.

The clubfoot brace is an extremely important part of the Ponseti method. It holds the correction of the foot and helps to prevent relapse. For the first 3 months after the foot is corrected the baby should wear the brace for 23 hours a day. It can be removed for an hour at bath time.

After that it’s usually worn while the baby is sleeping (night and daytime naps) for between 12-18 hours up until the age of 4 years, gradually reducing and depending on the individual child’s progress.

The Bangla Brace is modeled on the brace designed in Uganda by Michel Steenbeek. It was endorsed by Dr Ponseti as an effective low-cost option for developing countries. Many studies have shown that correct use of the braces and good compliance gives the best outcomes with the Ponseti method and the least clubfoot relapses.

Walk for Life has established a local brace making facility in Bangladesh and produces over 10,000 braces per year and is even now providing braces to Myanmar, Brazil, Liberia, Papua New Guinea and the Philippines. The facility run by Walk for Life provides local employment and a great sense of satisfaction for those whose jobs are helping a known need in their own country.

Training

Walk for Life is training doctors, nurses and physiotherapists to treat clubfoot deformity in babies and young children using the best practice Ponseti method in Government Hospitals. Orthopedic surgeons, podiatrists and physiotherapists from USA, Australia and the UK join with skilled  practitioners in Bangladesh to provide education and training.

Walk for Life provides education and training in the treatment of clubfoot at the only medical university in Bangladesh. As part of this agreement our volunteers regularly visit Bangladesh to train local students and staff to evaluate the outcomes.

Just $120 can enable a child to walk, run and play!

Shane CuttsClubfoot