On the sidelines of the on-going two-day seminar on disability management being held at Kanakakkunnu Palace hall, several strange-looking shoes were on display on a table. They were stiff and sturdy, open at the toes and connected to each other by thin, cylindrical metal rods. These special shoes, known as Foot Abduction Braces (FAB), are used for the correction of Clubfoot in children.
People whose feet are not formed properly and seem to be twisted inwards so that they seem to be walking on the sides of their feet are those who suffer from Clubfoot.
Some of the characteristics are: a smaller than normal foot, especially the heel; the foot pointing downward; the front of the foot rotated toward the other foot or turning inwards, as mentioned above. This is a congenital disease, that is, a deformity at birth and it is said that 50,000 children in India are born with clubfoot every year.
“What many people do not know is that this can be cured if treatment is started early,” said Smitha Daniel, Senior Counsellor at CURE Clubfoot Kerala, which is part of the Dept of Orthopedics at Trivandrum Medical College. “This means saving the child from a lifetime of disability. Although now the treatment is available for children upto 14 years, it is best that the treatment is started in infancy itself.”
The non-surgical treatment now available is known as the Ponseti method. This involves two stages - casting and foot abduction braces (FAB). In the first stage, the feet are set into plaster casts for six to eight weeks, depending on the age of the child. This cast has to be changed weekly. Before the final cast is put, a process known as Tenotomy – cutting of the tendon – is carried out, which is the only surgical procedure involved.
The second stage involves making the child wear the brace, initially, that is for the first three months and later for 23 hours a day,” said Smitha. Later it has to be worn only during sleep.
But the brace has to be worn for three to four years, the consellor said. This is because there is a chance of relapse till the child is five years of age.
“As the child grows, different sizes of the brace should be given,” she said. “But most parents stop after the child outgrows one but then there might be relapse.”
Last year, CURE Clubfoot Kerala (under CURE International India) started in the Orthopedics department of the five Govt Medical Colleges and one District Hospital (Kannur) in Kerala. Here, treatment is free for Clubfoot patients and Foot Abduction Braces are also distributed for free.