Talipes

[cupofteaplease]

Hi,

We found out at our anomoly scan last week that our dd has talipes (club foot) on her right foot. They said it is not positional, whatever that means. We are waiting to meet with a physiotherapist who will teach us some methods before baby is born.

Has anyone any experience with this? Was your child's talipes treated with physiotherapy alone? When looking on the internet, it seems to be mainly boys that develop talipes, so helpful(!) people have suggested that our baby must be a boy- does anyone on MN have a girl with talipes?!

Lastly! Can talipes be linked to any other problems at all? I know I'm worrying over nothing, and we are incerdibly lucky to have a healthy baby, I'm just a bot anxious I suppose, having had no experience of this at all.

Thanks.

Hi, couldn't not respond as we were in the exact same position this time last year! We have a gorgeous 7mth old who was born with unilateral talipes (left foot). It was also picked up at the 20wk scan but we were reasured it was positional and that he would only require Physio. Unfortunately it turned out to be Structural so he was referred to the local Ponsetti Clinic at birth and got his first cast at 10days old. I'm not sure if you know about Ponsetti but it's basically a non-surgical treatment for talipes which involves gradual manipulation of the affected foot or feet using a series of casts and then corrective boots and a brace.
I know it must seem very daunting and I was very upset when I found out the extent of the treatment but honestly I barely think about it now! He wore the boots 23hours a day for 3 months and now just wears them at nighttime. He doesn't seem to mind them at all and its just part of the bedtime routine.
Reading over my post, I realise how calm I must sound about it all but that must be the effects of time because I remember being so anxious when I was first told and then when the Orthopaedic Surgeon came to see him at 5days old so any questions just ask!
We also suspected he was a boy because of the talipes and while it is mostly boys at the clinic appointments, there are some girls too! Regarding other conditions, I know talipes can occur with others but are often just isolated cases of talipes. We had scans on his hips which were fine and he is otherwise healthy and happy apart from a minor problem with his kidneys which is not related. I believe there is a slightly higher risk of it in subsequent pregnancies too. I'm not in the UK but the STEPS website is very helpful. If I can help with more information, please just ask. If possible, try not to spend the next few months googling talipes to death (that's what I did and stressed myself out!). If Ponsetti is the treatment you choose, its very well established and gets great results. Our little guy has two beautiful feet now and I know I'll be so proud of him when he walks! It's very true what they say, its much harder on the parents as the babies don't know any different. Hope this helps!

Thanks so much for your response, Lageo, it was very reassuring. I'm so pleased your little boy is doing well! I assume our baby has structural talipes too, as they said it is not positional. However, they didn't mention casts at all. I have only heard about them through googling (and now your post). They only mentioned physiotherapy.

I shall look forward to meeting with the paedriatric physiotherapist so I can ask about the Ponsetti method as this seems to crop up a lot. The sonographer mentioned surgery, but then came back and said no surgery would be necessary.

This is our 3rd dd, so was a bit of a surprise as the other two have no feet problems at all.

You say an orthopaedic surgeon came to see your son at 5 days- did you stay in hospital with him for that long? Was that due to the talipes? (Sorry if that is an intrusive question.) I am having an ELCS so I assume I'll be in for a few days. DD2 was in SCBU so I stayed in for 6 days, I can't remember what is normal anymore!

Hi, I don't have much to add, but wanted to .... I don't know what really!

The boy of my boy/girl twins was born with positional talipes on his left hand side. I think it was classes as positional because he had free movement of his foot, and could choose to straighten his foot. Basically he wiggled it straight, but it was twisted when relaxed. His foot gradually spent untwisted, presumably because it now had space to move rather than being crammed into my tummy with his sister, and was declared negligible at his 6 week check.

Although this was a different scenario as it was positional, and I didn't know about it until he was born, I wanted to say that it really didn't seem that big a deal at the time. When I was told about the talipes, I obviously didn't know it was going to fix itself, but I really remember thinking 'what's a foot in the grand scheme of things? Looknatbhim, he's perfect ')

I guess I just wanted to say don't worry too much. Whatever it is you will deal with it, and it really won't take away from the joy of having your child with you

Hi, not intrusive at all. The long hospital stay wasn't anything to do with talipes. I also had an ELCS and in Ireland they usually keep you for about 5days after a CS so that was why! They also mentioned surgery to us but it was a minor procedure where they cut the Achilles tendon under local anaesthetic (sounds awful but worse part was holding him still!).

Maybe Physio intervention will be enough for your baby-don't want to panic you unnecessarily with thoughts of casts, boots and braces etc, I know they wouldn't commit to any treatment plan for our DS until he was born and they could see the extent of the talipes. Treatment options also seem to vary by geographical area and Ponsetti was the main option where we live but I'm glad we did although it takes some dedication! As far as I'm aware, surgical interventions are not favoured as they leave so much scar tissue but I'm open to correction!
It's great that you can meet the Paediatric Physio beforehand to answer any questions-I have found them so helpful. It is tough to get your head around it and for us seeing our baby in a cast, not being able to bathe him, worrying about the cast slipping or being sore definitely was stressful but looking back I think it was exacerbated by him being our first so we worried about everything! I'm sure with your 3rd, it won't all seem so scary! My DH always felt that going through it would make him stronger and he's definitely a determined little guy!

Apologies for the longwinded posts!

Usually these days treated with Ponsetti casting - loads of stuff online about the serial casting - the Children's hospital I worked in did this in the physio department and there was a senior physio who did the casting, with the orthopaedic team around and "available". Sometimes at the end of treatment there was a need for a tiny op to release the Achilles tendon a bit - we did that under local in the department (parents present if they wanted) but your department will have its own rules.

Ponsetti has far better results than initial surgery -even if they do end up needing surgery later it's a lot less than without the casting, and the babies themselves don't mind the plasters at all (and the things a 2 year old will manage to do in boots/bars at the end are mindboggling!)

Thank you all for your advice and anecdotes. In the grand scheme of things, I can't allow myself to worry too much about this.

Hi cupoftea, sorry to come to this thread late but have only just seen it. My ds was born with bilateral (both feet) structural talipes, it was not picked up at the 20 week scan so i was spared the worry you must be going through.
Someone previosly mentioned Ponsetti treatment- this is vital, you need to make sure that your local hospital treats talipes in this way, if it doesn't you need to get referred before your baby is born. This is a much gentler method of treatment and avoids major surgery.
I would say it is very unlikely that physio alone will sort out structural talipes. My ds had 7 weeks of casts as a new born and wore (wears!) the boots & bar brace at night. He is fine, he walked at an average age (13 months), runs, climbs and loves sports. You cannot tell there is a problem with his feet just by looking.
When my ds was born I was worried about associated conditions. But, in the vast majority of cases, talipes is an isolated condition. And, as nothing else showed up on the scan i think you shouldn't worry too much!
PM me if yo want to know anything else. My ds has just turned 4, in his next check-up in 6 months, I'm hoping to be told that he can stop wearing the boots at night. I remember searching mumsnet 4 years ago and a poster told me that moment would come around quickly, I couldn't believe it but yet here I am.
Enjoy the rest of your pregnancy, and don't worry about the talipes, it's easily dealt with.