20 week ultrasound shows club foot need to know more.

Last week I had my 20 week ultrasound and my little boy has club foot with his right foot. The sonographer spent about 40 minutes with me and kept going back to check the position and it never moved the whole time so it was determined by her and the specialist that it is indefinate. Needless to say I was crying afterwards but my mental image of a club foot was a big foot haha. I now know that it is a crooked foot pointing in and downwards but it is still upseting because I do not know enough about it or its treatments. I was just wondering if there was anyone else who has gone through the same thing and has any info about it or its treatments and any other relevent info. I will try to get treatment at the Royal Childrens Hospital in Melbourne once he is born, I just feel a little lost and just wondering what I could have done to change this but I don't think there is anything I could have changed it was just the luck of the draw.

Hi Sarah, sorry I have no real experience or knowledge in club foot. I do know of a boy who has one though and he is in his 20's now so any treatment he recieved would probably be different of that offered today.

I had a look around and found this bit of info for you if you want to read it.

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Also known as Talipes: a birth deformity of the foot, sometimes resulting from crowding in the uterus. In a clubfoot the bones in the front part of the foot are misaligned. In 95 percent of clubfoot deformities the front half of the foot turns in and down (equinovarus). In the rest of the defects the front part of the foot turns out and up (calcaneovalgus or calcaneovarus).


Treatment

Treatment of club foot deformities must be started as soon as possible. During the first three weeks of life, the ligamentous tissues are still somewhat lax and may respond to manipulations and casting. Casting is normally continued for months later. If correction has been achieved it must be maintained during weight bearing years. A custom orthotic is then indicated to maintain proper posture and development.

Mild Talipes (club foot) can be treated and success achieved with the use of orthotic therapy by controlling the gait supporting the arch structures additional wedging can be applied to the orthotic to restrict the patient from ‘sliding laterally’ on the orthotic. The use of orthotics would be a supportive treatment and would need to be combined with other treatment modalities to gain the correction …… use of gait plate orthotics for tibial torsion is also recommended whilst the child is still growing.

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Huge hugs for you sweety :hugs:

Please don't think that you have done something wrong to have caused this - it is just one of those things unfortunately.

Lindsay had positional talipes because he basically ran out of room in there and this was corrected by some exercises by a phsyio, he has since had no problems. The surgery they use to correct it is fantastic - I know a woman whose son was operated on at 6 weeks and he is fine and you would hardly have known he had it. He does have to wear special orthotic shoes though for a few years.

Sarah, I am sure your little boy will be fine.

Hi Sarah,

I was born with Club feet back in 1982....

Both of my feet were turned inwards - imagine the ball of your ankle flat on the floor and you legs straight up. BUT... My feet are fine now.

I walked around the 18 month mark, alot earlier than was expected and had plaste on my feet for quite a while. In my younger years I wore some foot braces, nothing like the thoughts of forest gump, just a very simple brace that you couldnt see.

I wore inserts in my shoes when i was in primary school just to keep my feet A1.

I do have scars on my feet on the insides of my legs / feet. But remembering this was all 24 years ago... the technology is much better now.

I have only come across one little boy in my whole life with club feet and the mother was going on about how she thought it was because his foot was caught up in her rib cage but this just isnt the case.

I have a family history with club feet and my doctors say it still isnt really linked. Its just something that comes up with some children.

No-one wants anything like this to come out in an ultrasound but please know that your little bub will be fine and walk when they are ready, its just a bump in the road.

If you want to chat my email is turbo_mirage_girl@hotmail.com - My mum knows alot about it, more so than me but i can completely tell you that its had no major impact on my life of walking / running. I dont have any problems with my feet at all.

:)

HI, I'm a physio and I've worked a little with kids with club feet. There are two main types of club foot - postural and structural or fixed. The postural sort is just due to running out of room - there's nothing wrong with the bones etc, just the position of the foot when he/she comes out. That can be easily fixed with simple exercises/stretching. The structural sort is harder because it involves abnormal bony alignment along with tendon problems. There are various sorts of treatment but the sort I remember doing most was casting and taping.

Perhaps you could talk to your local physio in Horsham about this (or one at the hospital, I know you've got a few there)? They may know another local family who have been through this, or have treated another child so could give you some more information so it is easier to understand the treatment.

Sounds as though all else was well on the U/S though, which is great.

Thanks for your support everyone, Colleen your story made me feel better.
The club foot is structural as far as the sonographer said, she didn't find any other problems and she was great about explaining everything to me. I did a little research on the club foot and other chromasonal problems associated with it and typed in ultrasound next to each disorder that was listed and for every one of those disorders they would have been able to pick them up as well. My main concern was that the club foot was not the only problem. Well, and I had a mental image of club foot being a very large foot :O I guess I am a little more educated now. I see the doc on Friday and I will most likely be refered to a specialist in Melbourne but I won't know for sure until then. My next big question for the doc is what happens if he is born in Horsham and needs to be plastered in Melbourne because from what i read it needs to be done within the first few days of birth. Oh the fun, I guess I won't be needing those bonds wondersuits if they aren't going to fit over a plaster.

Hi again,

If he needs to be plastered in Horsham, perhaps you could find out if one of the physios at the hospital already knows how to do it? If not, perhaps you could talk to them about one of the staff visiting RCH for a crash course in the plaster/taping before the baby is born? That way you'll have someone local who'll be able to do it.

Also, I think the hospital in Horsham has videoconferencing facilities, as does the RCH. This means the staff from the two hospitals can see and hear each other over a big screen tv, and so the Horsham people could do the plaster/tape while being supervised by the RCH people - saving you trips to Melbourne. Worth finding out more about!

Well the latest news, my doc is sending me to Royal Womens Hospital for another ultrasound, they are looking for trisomy 18 so fingers crossed they don't find it. I could care less about the club foot now, the doc did say they can plaster it in Horsham temporarly and then I go to Melbs to have it done by a specialist. I will worry about it after I hear about the results of the next ultrasound.........Deep Breaths..............

Oh Sarah I am so sorry hun.

I have everything crossed for you that your scan come back perfect. Can they not do a amnio to check for trisomy instead or are you too far pg for that ??

Please let us know how you scan goes sweety. I am praying for a healthy bub for you :hugs:

Sarah, I just wanted to wish you all the best for your u/s, do you know when it is? I'm sorry you have this worry right now, I hope it all turns out really well.

I am booked in to the Royal Womens Hospital for the 15th. The worse part is the doctor who is standing in while mine is on holidays didn't even tell me what they are looking for, I was told by the receptionist at RWH. I asked her what would happen and she said the ultrasound and if they feel like there is a chance they will do an Amnio and get the results in the same day and then give me the option to continue with the pregnancy. I am reading a bit about it and I really only have the club foot as a soft marker, everything else looks fine according to the local ultrasound. Noah is 11 days bigger than his original due date and my uterus is at the right height. Maybe they are just covering themselves with the further testing, I won't know until Monday. Grrr it has not been a good start to the year at all in many ways but what doesn't kill you makes you stronger I guess. The most disapointing thing in my mind is that if Noah has Trisomy 18 then it is very likely that once uf us or both of us are carriers and this could happen with every pregnancy and I know I was born to be a mother, but i am getting ahead of myself with worry even though there may be nothing at all. Time for sleep, God knows I need some rest.

Hi - it's hard not to think ahead and sometimes to think the worst. Try not to be hard on yourself, as far as I know this sort of thing is not hereditary so it's not something that you carry.

Someone more knowledgable will be able to confirm this.

Sarah, first of all the club foot may just be a bad sonographer or your lovely Noah being in a funny position (I know mein kleiner Liebling has done that on our scans), so the second scan may be a lot better for you.

Trisomy 18 isn't a carrier-based genetic illness, it's just a very rare thing that occasionally happens when a cell divides. If you or your DP had trisomy 18 then it would be very hard for you to fall pregnant due to the abnormalies making sperm and eggs harder to make. Even balanced translocations make fertility lower, an extra chromosome is a lot more (stupid word has gone, but noticable-difference-making is what I'm after) than that. If you want to know more on the science side of it, do let me know, but club foot and trisomy 18 do not occur because of something you or your DP has done.

Best of luck for the 15th, less than a week to go, and hope that everything is well and good on the scan.

Sarah, a friend that i grew up with had this at birth too....she never had to have surgery, just wore brace type things on her feet for a while. You would never have known...Good luck with everything.

Hi Sarah,

I just wanted to wish you well with your ultrasound on Monday.

Hi Sarah, Wishing you all the best.

At my 20 week ultrasound we found out our bubs has a cleft lip +/- palate so I know how you feel. No matter how little the problem is (compared to what can happen) we still feel devastated. Anyway as with you everything else looked fine but since it can be associated with other conditions we went on and had an amnio just to be sure which fortunately was all ok.

A club foot is the most common abnormality that a baby can be born with and generally is isolated and managed well with plastering +/- surgery. I'm sure, as in our case, they are doing the repeat scan + amnio if necessary just to be certain everything else is ok. Also, as was mentioned Trisomy 18 is not generally something that can be passed on like some other genetic conditions so I wouldn't worry about that.

Good luck with everything. I'm sure it will all go well.

Hi Sarah,

I hope that your ulstrasound goes well today.

Oooooh I forgot about this post oopsie! The ultrasound went great, they could only see the clubfoot but it seems Noah is fond of the position of his right foot and decided to match the 2 so now he has positional clubfoot with the left one. It is all easily fixed though and I decided not to stress. I opted not to do the amnio, I wouldn't be able to live with myself if I miscarried and there was no other problems. The doc agreed with me and said the risk of miscarriage was greater than the risk of Noah having other defects but she could not guarrantee that. I have been spending the better part of the afternoon trying to find out the contact details of the talipies support group in Melbourne to no avil, their website hasn't been updated since October, I am awaiting approval of the club foot yahoo group in Oz to see if they have the info, it looks like the group is not so active anymore.

srv, isn't it great to be reassured that there is only a "minor" problem that can be corrected with surgery? I hope all works out with your bub, did they see that on the 2d ultrasound? I know very little about clefts even though I have seen plenty. I didn't know about clubfoot and trisomy 18 until 2 and 3 weeks ago though either.

If anyone has any idea how to get in contact with the melbourne talipes group that would be great, in the meantime I will keep on trying....

Sarah,

I will ask my mum, she dealt with my club feet 24 years ago but she might know something about some people that can help you out

Sarah, Yep, they picked up the cleft on the 2D ultrasound. We then went on to have a 3D one to get a better look. We were really lucky the radiologist picked it up, I know it can be difficult. It gives us more the time to find out exactly what we're in for, but also to prepare the family, friends etc for it. I know for us this will be the most beautiful baby in the world, but I couldn't bear for other people who are close to us to look at bubs in a negative way...especially for something that is cosmetic and easily fixed with surgery so you'll barely even notice.

I'm glad all went well with your ultrasound and everything sounds very reassuring. Now you can get back to enjoying your pregnancy and keep getting excited about the little one on the way.

I know for us for about 2 weeks a lot of the joy was taken out of the pregnancy, but now we've done all the tests, we just can't wait for our little one to arrive.

SRV.... Just to let you know... there was a bub born when I had alexa.. a wee boy & he had a cleft palate... he was able to breastfeed & even fed better without the plate they made for the roof of his mouth... he is such a gorgeous wee boy....
Also, my brother was born with a cleft lip (not palate), & all his baby photos look so cute!!!! He had his scar recut & sticthed about 15ish & you can hardly even notice it now (and probably wouldnt if you didnt know it was there IYKWIM)...

Mitch, thanks for that. Everything I've heard and read is so reassuring. Am thrilled to hear about the little boy who could breastfeed. We are comfortable with everything else, but I got told that if the palate was involved, I would almost certainly not be able to breastfeed which was really upsetting. Fingers crossed it will be ok.

Hi Sarah, I have a 3year old son with bilateral talipes or club feet. If you need support from a Mum who has been through it all, you are most welcome to contact me. We have been through everything to do with club feet so I am most willing to help you in anyway I can.