A SURVEY OF CLUBFOOT PATIENTS IN ODISHA

In the survey of 34 patients of clubfoot, 20 were unilateral cases and 14 were bilateral. The ratio of unilateral: bilateral was 1.42:1. As per Kawashima and Uhth off classification, with this stucy 36 feet (75%) to be flexible and 12 feet (25%) to be rigid out of total 48 feet considered. The rigid foot was relatively smaller as compared to the flexible ones. The flexible feet were pliable on manipulation; but rigid feet were not amenable to correction by serial manipulation. Deep creases were more prominent in rigid feet. KEYWORD: Club foot, Survey, Odisha. INTRODUCTION: Clubfoot is a complex deformity of the foot occurring in various planes with multiple bones and joints involved. It is a birth defect in which the foot is inverted/twisted and pointed downwards. Without treatment, children born with this defect often appear to walk on their side ankles or sides of the feet.[1] It was first described by Hippocrates in 400 B. C. Nicholas Andry in 1743described it as Pades Equinal i.e. resembling the foot of a horse.[2] Clubfoot is also known as “Talipes equinovarus” which comes from Latin. “Talipes” is derived from the word “Talus” meaning “ankle bone” and “pes” means foot, thus describing the deformities around foot and ankle.“Equinus” means a “horse”, used in context to describe how children affected with clubfoot walk on their toes with foot pointed downwards, analogous to how horses walk on their toe nails.[2-4] About 1.2 per 1000 live birth is born with club foot each year.[5] For clinical purpose, clubfoot is categorized in two groups: i) clubfoot associated with other congenital deformities, ii) idiopathic clubfoot. The pathogenesis and biomechanics of clubfoot are not well known till now. Various theories have been postulated to explain its cause like otogenic theory or theory of arrested development, embryonic theory, neuromuscular theory, primary germ defect etc. Although, much progress has been made since then regarding its diagnosis, treatment and management, but still today there remains a lot of confusion and divergence of opinion regarding its gross anatomical changes, pathological anatomy and role of radiography in its treatment procedures for this condition. Till date there is no data available about the dermatoglyphic patterns of club foot patient in Odisha state. Therefore this work was carried out in this particular region of India. This study sought to survey cases of clubfoot presented for clinical examination in the department of anatomy in collaboration with the dept. of orthopaedics using a representative sample of cases at Department of Anatomy, SCB Medical College, Cuttack District, Odisha, India. The main objectives of this study were: i. Defining clubfoot and the various deformities associated with this condition. ii. To find out age incidence, sex ratio associated aetiological factors and any associated congenital anomalies. iii. To compare the normal and affected foot by utilizing foot prints and radiographs. DOI: 10.14260/jemds/2014/3667