Right rigid clubfoot "epidemic" in St.Petersburg - expert's comments

This situation is commented by our expert Dr.Nikolay Rumyantsev: "During the period from May 18-th to May 26-th , 2004, 5 children with congenital clubfoot were born in St.Petersburg. Curiously enough, all the babies suffered from a unilateral deformity - each had a right affected foot. Statistically, congenital clubfoot (CCF) occurs in 1 of every 1000 neonates, so this number of babies with CCF should be born in St.Petersburg in a period of 2 months - and not during 8 days. More to it, the fact, that all children had only right affected feet, and left feet were normal, can not be explained from statistical point of view. An expected possibility, or expectancy of this group of patients in any big city should not be over 0,1%.
Our doctors were prepared for this situation. In 2 cases out of 5 (40%) the CCF was diagnosed in prenatal period, therefore the treatment was started immediately during the first day of life.
The result of such an "urgent" orthopedic clubfoot correction was extraordinary and above anything we could expect, as, in fact , in immediate treatment of congenital knee dislocation.
We managed to achieve complete primary CCF correction in period less than 10 days, and it was confirmed clinically and by radiographs".

Here we offer as an example one of the cases of this congenital clubfoot (CCF) "epidemic":

1. congenital clubfoot (CCF) was diagnosed in prenatal period ( 15 weeks of gestation)

CCF was diagnosed in prenatal period







2.Right rigid clubfoot in the first hours of life.

Right rigid clubfoot in the first hours of life.  Right rigid clubfoot in the first hours of life.  clubfoot

3.This foot has a high grade of severity at the time of initial evaluation:

Congenital Clubfoot: resistant equinus 140 degrees
-resistant equinus 140 degrees
   
clubfeet
- resistant inward rotation 20 degrees

4. After 10 days of treatment. Excellent clinical result.
After 10 days of treatment. Excellent clinical result Excellent clinical result Good X-ray findings :
lateral talocalcaneal angle 40
degrees lateral tibiocalcaneal angle 70 degrees.

Excellent results were obtained in all patients during this CCF "epidemic".
So, here we have a similar situation to one with congenital knee dislocation - immediate treatment provides fast and effective primary correction in all patients.
Of course, it's too early to make the final conclusions. But facts remain to be facts.
Probably, by the end of 2004 we will publish the full conception of "emergency" in neonatal orthopedics, the more so we have special equipment to make this experience available in any medical facility.