Clubfoot - Congenital Tallipes Equinovarus (CTEV)
Steps Involved in IVF:
Procedure Description
Clubfoot, also known as Congenital Tallipes Equinovarus (CTEV), is a congenital deformity that affects the feet, causing them to turn inward and downward. The condition typically affects one or both feet and occurs in approximately 1 in 1,000 live births globally. Without treatment, the deformity can severely impair a child's ability to walk, but modern medical advances offer highly effective methods to correct the condition, enabling affected children to lead active, healthy lives.
The treatment for clubfoot generally begins shortly after birth, taking advantage of the malleability of an infant's bones and tissues. The most widely recognized treatment method is the Ponseti method, which involves a series of manipulations, casting, and sometimes minor surgeries. This non-invasive approach focuses on gently stretching the tendons and ligaments of the foot, followed by applying a cast to hold the foot in the corrected position. Over several weeks, the cast is regularly changed to gradually improve the foot’s alignment. After the casting phase, many children require a small surgical procedure called a tenotomy, where the Achilles tendon is released to allow the foot to be fully repositioned.
Once the foot is corrected, a brace is used to maintain the alignment. The child typically wears the brace for 23 hours a day for the first few months, gradually transitioning to wearing it only during sleep. This maintenance phase is crucial to prevent relapse, as clubfoot tends to recur if the bracing protocol is not strictly followed. The overall success of the Ponseti method is remarkable, with many children achieving near-normal foot function without the need for major surgical intervention.
In cases where the Ponseti method is not suitable or if the condition is not diagnosed early, more complex surgical procedures may be required. These can include osteotomies, where the bones are cut and realigned, or tendon transfers to improve muscle balance in the foot. Surgical options are typically reserved for older children or cases that do not respond to non-invasive methods. Surgery can be effective, but it comes with greater risks and a longer recovery period than early non-invasive treatments.
Procedure Duration
The duration of treatment for clubfoot depends on the specific method used and the individual case. In general, non-invasive treatments like the Ponseti method are preferred for their relatively short duration and high success rate.
- Initial Treatment Phase: The Ponseti method involves a series of weekly cast changes, usually over the course of 6-8 weeks. Each cast progressively stretches and repositions the foot, gradually correcting the deformity. In the final stages of casting, many children will require a minor procedure known as a tenotomy to release the Achilles tendon, which typically takes only a few minutes under local anesthesia.
- Bracing Phase: After the foot is corrected, the maintenance phase begins with the use of a brace, often referred to as foot abduction orthosis. For the first 2-3 months, the brace is worn nearly full-time (23 hours a day), followed by reduced wear during sleep until the child reaches 4-5 years of age. The goal of this phase is to prevent relapse, which is a common occurrence if the brace is not worn as prescribed.
- Surgical Options: If surgery is required, the procedure length will vary based on the complexity of the deformity and the specific surgical technique used. For more severe cases, surgical correction can take several hours, and recovery may involve several weeks to months of post-operative care, including physical therapy and continued bracing.
Recovery from non-invasive treatments like the Ponseti method is relatively quick, with most children resuming normal activity soon after the initial treatment phase. Surgical procedures, however, may require longer recovery times, with some children needing physical therapy to regain strength and mobility in the foot.
Benefits
- High Success Rate: The Ponseti method has a success rate of over 95% in properly treated cases, making it the gold standard for clubfoot correction.
- Minimally Invasive: Early intervention with non-surgical treatments reduces the need for more invasive procedures, minimizing the risks associated with surgery.
- Improved Mobility: Children who undergo treatment for clubfoot often achieve near-normal mobility and are able to participate in regular physical activities.
- Reduced Risk of Relapse: Proper bracing during the maintenance phase significantly lowers the risk of relapse, ensuring long-term correction.
- Early Intervention: Treating clubfoot in infancy leads to better outcomes, as the bones and tissues are more flexible and responsive to correction.
Potential Destinations
For medical tourists seeking clubfoot correction, several destinations offer high-quality care, advanced treatment options, and experienced specialists in pediatric orthopedics:
- India: Renowned for its affordability and world-class orthopedic services, India has many hospitals that specialize in the Ponseti method and pediatric surgeries, offering exceptional care at a fraction of the cost in other countries.
- Thailand: Known for its advanced medical infrastructure and top-notch pediatric care, Thailand is a preferred destination for clubfoot treatment, particularly for its state-of-the-art facilities and expertise in non-surgical correction methods.
- Turkey: Offering highly specialized pediatric orthopedic services, Turkey has become a hub for medical tourists. With its internationally accredited hospitals and experienced surgeons, it’s an ideal destination for comprehensive clubfoot treatment.
- Mexico: Mexico is a popular choice for medical tourists from North America due to its proximity and affordability. Pediatric orthopedic centers in the country provide high-quality care, often at significantly lower costs than in the U.S.
- Spain: Spain is known for its advanced healthcare system and experienced specialists in pediatric orthopedics. It offers excellent non-surgical and surgical treatment options for clubfoot, making it a top destination for European medical tourists.
Risks & Considerations
- Risk of Relapse: One of the most common risks associated with clubfoot treatment is the recurrence of the deformity, especially if the brace is not worn as directed.
- Infection: In cases where surgery is required, there is always a risk of infection, which can complicate recovery and require additional medical care.
- Overcorrection: There is a risk of overcorrecting the deformity, which can lead to other complications, such as flatfoot or restricted mobility.
- Anesthesia Risks: For both minor procedures like tenotomy and major surgeries, there are risks associated with the use of anesthesia, particularly in very young children.
- Long-term Physical Therapy: In some cases, children may require long-term physical therapy to strengthen the foot and improve mobility, especially after surgery.
How to Choose the Right Doctor and Hospital
When selecting a doctor and hospital for clubfoot treatment, it’s essential to consider the qualifications and experience of the medical team. Look for a pediatric orthopedic specialist who has extensive experience in treating clubfoot using the Ponseti method. The doctor should have a strong track record of successful outcomes, as early intervention and proper technique are crucial for long-term success.
Additionally, choose a hospital that specializes in pediatric care and offers comprehensive services, including non-surgical and surgical treatment options. The facility should have state-of-the-art equipment, a dedicated team for pediatric orthopedics, and excellent post-operative care if surgery is required. It’s also essential to ensure the hospital provides thorough patient education and follow-up care, particularly for the maintenance phase of treatment to prevent relapse.
To receive a free quote for this procedure please click on the link: https://www.medicaltourism.com/get-a-quote
Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. GHA accredits the top hospitals in the world. These are the best hospitals in the world for quality and providing the best patient experience. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com
Frequently Asked Questions
What actually happens during hyperstimulation of the ovaries?
The patient will take injectable FSH (follicle stimulating hormone) for eight to eleven days, depending on how long the follicles take to mature. This hormone is produced naturally in a woman’s body causing one egg to develop per cycle. Taking the injectable FSH causes several follicles to develop at once, at approximately the same rate. The development is monitored with vaginal ultrasounds and following the patient’s levels of estradiol and progesterone. FSH brand names include Repronex, Follistim, Menopur, Gonal-F and Bravelle. The patient injects herself daily.
What happens during egg retrieval?
When the follicles have developed enough to be harvested, the patient attends an appointment where she is anesthetized and prepared for the procedure. Next, the doctor uses an ultrasound probe to guide a needle through the vaginal wall and into the follicle of the ovary. The thin needle draws the follicle fluid, which is then examined by an embryologist to find the eggs. The whole process takes about 20 minutes.
What happens to the eggs?
In the next step, the harvested eggs are then fertilized. If the sperm from the potential father, or in some cases, anonymous donor, has normal functionality, the eggs and sperm are placed together in a dish with a nutrient fluid, then incubated overnight to fertilize normally. If the sperm functionality is suboptimal, an embryologist uses Intracytoplasmic Sperm Injection to inject a single sperm into a single egg with an extremely precise glass needle. Once fertilization is complete, the embryos are assessed and prepared to be transferred to the patient’s uterus.
How are the embryos transferred back to the uterus?
The doctor and the patient will discuss the number of embryos to be transferred. The number of successfully fertilized eggs usually determines the number of eggs to be placed in the uterus. Embryos are transferred to the uterus with transabdominal ultrasound guidance. This process does not require anesthesia, but it can cause minor cervical or uterine discomfort. Following transfer, the patient is advised to take at least one days bed rest and two or three additional days of rest, then 10 to 12 days later, two pregnancy tests are scheduled to confirm success. Once two positive tests are completed, an obstetrical ultrasound is ordered to show the sac, fetal pole, yolk sac and fetal heart rate.
Embryoscope©
Built into this technology there is a microscope with a powerful camera that allows the uninterrupted monitoring of the embryo during its first hours of life. In this way, we can keep a close eye on the embryo, from the moment when the oocyte is inseminated and begins to divide into smaller and smaller cells, until it can be transferred to the uterus.
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