Doç.Dr.İlker Sarıkaya

Congenital Pes equinovarus (Talipes Equinovarus, Pes equinovarus)

Pes equinovarus, which occurs in one in every 1,000 live births, is a disease that worries families, but if treatment is started early, the rate of complete recovery of the foot is very high.

In the diagnosis of pes equinovarus, the sole of the foot is turned towards the shin bone and that leg is thin. Although the cause is not known exactly, familial factors and the posture of the baby in the womb have an effect. Although it is very rarely seen together with other congenital anomalies, it is usually a disease that occurs alone.

When seen together with other congenital anomalies, the treatment process differs. Early diagnosis and treatment is of great importance in congenital clubfoot disease when seen alone. If there is a delay in treatment, the disease may cause permanent disabilities or long surgical processes.

How is this disease diagnosed?

The disease can be diagnosed during pregnancy by an obstetrician and gynecologist using ultrasound. In cases where it is not recognized during pregnancy, the diagnosis is easy after birth because the disease is evident. In addition to healing with massage, serial plaster casts or minor interventions, cases requiring serious surgeries can also be encountered.

What is the gold standard in this treatment?

In the treatment of the disease, it is very important to put in a plaster cast in the week after birth. This

cast treatment is called the Ponseti Method. In the serial cast method, the pediatric orthopedist who applies the treatment evaluates the foot pathology and casts are applied every week according to the Ponseti technique. Serial plastering continues until the child’s foot is fully recovered. Usually 4 weeks of plaster cast application is sufficient for complete recovery of the foot. However, the necessary healing is achieved with a maximum of 8 weeks of application. After the plaster cast treatment is finished, the child is fitted with a device called Orthosis, which is similar to a shoe but slightly larger than it, which the child will wear for 23 hours for 3 months. Afterwards, the device should continue to be used only at night until the age of 4.

Does Pes Equinovarus recur?

The most important complication of congenital pes equinovarus is recurrence. Families may have difficulties during the use of the device after the successful outcome of the cast treatment. If the disease recurs before the age of 2, serial casts are applied again with the Ponseti Method. If it recurs after 2 years of age, solutions up to surgery may be required. After recovery, these children can continue their lives normally and do sports. There are also people who have become national athletes despite having this disease in their childhood.

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