Clubfoot is a birth defect where one or both feet are rotated inward and downward, and the affected foot may be smaller in size compared to what is expected in healthy babies. In about 50% of the cases, the condition affects both feet. Clubfoot occurs in 1 to 4 of every 1,000 births, making it one of the most common birth defects affecting the legs. About 80% of cases occur in developing countries where there is limited access to care. Without treatment, the foot remains deformed, and people walk on the sides or even the front of their feet, leading to pain and difficulty in walking. The underlying mechanism involves disruption of the muscles and connective tissue of the lower leg, leading to joint contracture. Diagnosis of the condition may be made at birth by examination or before birth during an ultrasound exam. The most common and successful treatment of the clubfoot condition is based on the Ponseti method. The method involves a gradual manipulation of the foot into an improved position, usually done once a week and followed by casting, and this process continues until the end of the treatment regime which is usually prolonged. While the method has been proven successful in the majority of cases, there are cases where it leads to poor outcome. There is also a need to develop an implementation method that removes the need for the high level of skill needed for success with the casting method. This project seeks to study the ankle joint in healthy feet as well as feet suffering from the clubfoot condition. Numerical modelling of the foot will be developed and used to study the Ponseti method. A number of novel implementation techniques to be used in the management of this technique will also be investigated in detail along with any improvements that may be necessary.
The study is mainly numerical using nonlinear finite element analysis and will benefit from access to CT scans of clubfoot joints.