Congenital talipes equinovarus, commonly referred to as clubfoot, is a complex deformity that occurs in an otherwise normal child. It presents in utero bilaterally or unilaterally with the affected feet completely turned inward. Clubfoot is the seventh most common congenital birth defect, and the first most common musculoskeletal birth defect, occurring in about 150,000-200,000 babies each year worldwide. In addition to its congenital presentation, clubfoot can also accompany such disorders as Spina Bifida and Arthrogryposis . Despite extensive research, the etiopathogenesis of clubfoot remains unknown. Regardless of the method of treatment, whether surgical or conservative, clubfoot has a stubborn tendency to relapse. Nearly all forms of treatment prescribe bracing to prevent relapse. While surgical and conservative treatments can last months after birth, brace wear is often maintained until a child is between three and five years of age.
A survey of the literature reveals extensive research over the last fifty years concerning the pathology of clubfoot and surgical versus conservative treatment of clubfoot. In contrast, while bracing is a topic that appears across such a survey, there are no investigations that are specifically focused on clubfoot bracing from an engineering perspective. One significant outcome of this research is the development of a clubfoot brace test method and apparatus (the surrogate biomodel) that provides accurate and repeatable results. For example, the results of current testing can be compared to the braces currently considered the standard-of-care. Such testing provides useful clinical information. For example, there are many alternatives to the standard-of-care brace and many adjustments that can be made to all braces, including parameters such as brace width, abduction angle, and dorsiflexion angle. An alternative brace configuration is one that allows motion (such as the Dobbs brace). This research provides information on how the standard-of-care and alternative braces stretch measured muscle-tendon systems, and how changing the parameters of each brace will affect that stretching.
The specific aims of this research are to:
- Build a surrogate biomodel of human pediatric lower extremity anatomy, see Figure 1 and Figure 2.
- To compare various clubfoot brace configurations within one brace type.
- To compare different brace types.