Clubfoot in children can be treated without surgery and without consequences, says Stanislava Bašatová, Director of Achilleus
We present a fascinating interview with Stanislava Bašatová – the founder and Director of the patient organisation Achilleus, which is celebrating its 15th anniversary this year. It is dedicated to educating and helping patients with the orthopaedic birth defect pes equinovarus congenitus (PEC for short), which you may also know as clubfoot. Stanislava and I talked about the organisation, PEC, and also about her encounter and experience with Foot Alignment Socks in children.
Who is Stanislava Bašatová
In addition to heading up the Achilleus patient organisation for 15 years, Stanislava Bašatová is also the mother of two children, one of whom (her daughter Eliška) was born with the birth defect pes equinovarus congenitus (PEC), and the wife of a man who also has this defect. Their son was born healthy, even though the doctors had predicted that he’d also be born with the same condition.
About the founding of Achilleus
And it was her son, although his diagnosis turned out to be unfounded, who was the impetus for founding the organisation. The main idea was to find information, which was very scarce at that time, and also to find other parents and to prepare ourselves a bit for what was to come. I could never have dreamed that it would gradually become my life's work and career. Over time, we’ve built up a community of parents, helped to bring about changes in the law, got doctors to use the modern Ponseti method, and generally spread the word so that from pregnancy onwards parents are informed and reassured that with good treatment this defect can be fairly easily resolved.
What is PEC
Pes equinovarus congenitus (PEC) is the most common orthopaedic congenital defect. This defect is also called "clubfoot" (formerly called "horse foot") due to its similarity to a golf club - at birth the foot is turned sharply inwards, and if left untreated, a person with this diagnosis would be unable to walk. In the Czech Republic, a family receives this diagnosis every other day. Worldwide, 200,000 children are affected each year, only 20% of whom unfortunately are born in countries which offer treatment using the Ponseti method, which is effective and requires almost no surgery.
The Ponseti method as a way to have healthy feet
The Ponseti method was developed by Dr. Ignacio Ponseti. Though it has been around for many years, it did not find its way to the Czech Republic until 2005. Even so, it still took a very long time for doctors to adopt it. Nowadays we already have several excellent doctors who practice this method. Previously, and in some places still, surgery was preferred over the Ponseti method, which in many cases left adult patients invalids as a result of the many operations on the delicate structure of the feet.
The Ponseti method is effective and gentle. Basically, it involves gentle, and correct - that should be emphasised - manipulation before applying casts. There are 5 casts in total and they change after a week. This is followed by a small surgical procedure which leaves a scar no larger than 3 mm, called a percutaneous Achilles tenotomy, which allows the ankle to flex. And after the last of the casts comes off, the legs look healthy.
This is followed by a period until the child reaches the age of five or so, when the parents then take responsibility and the child has to wear splints to prevent the defect from returning. The splints are first worn all day long, and gradually, as the child gets used to moving around, this time is reduced, until around 1 to 5 years later the child only wears the splints at night. However, the feet are used to being "enclosed" in something for a long time. First casts, then splints for 23 hours, then all night. They need to be stimulated by exercise, tickling or some other form of stimulation, to be loosened and relaxed whenever the feet aren’t enclosed in something. Imagine, for example, having shoes on your feet all day and all night.
About the effects of Foot Alignment Socks
I knew Foot Alignment Socks as a product for adults. But it was at the Children in Motion conference that I first saw Foot Alignment Socks for children. I was interested in this as another way to help parents care for their children's feet. In our case, relaxing them and loosening up is never enough.
We found several parent volunteers who were happy to try out the socks. And I have to say that I was very surprised by the result. I expected that the parents would soon give up on testing them, that the results would be a bit vague, and that it would be impossible to gauge the effect. But just the opposite, in fact. They all completed the test and continue to use the socks, and they themselves said they felt greater freedom and mobility in their feet, which also felt "soft" when exercising and massaging them. We didn’t see a single negative or neutral reaction.
The use of Foot Alignment Socks for children with pes equinovarus has been endorsed by doctors and physiotherapists. And that's crucial for us. We've included Foot Alignment Socks as one of the tips for how parents can help their children get some relief and enhance their treatment.
Pes equinovarus has one major risk. The muscles and tendons tend to shorten and contract all the time. Active movement and passive relaxation help to prevent the defect from recurring. And so, for our children, Foot Alignment Socks are a wonderful option that helps to them to enjoy a life with healthy, pain-free feet.
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We’d like to thank Stanislava for this enjoyable interview and we wish her and her family the best of health and energy in their work with Achilleus.
