Chapter 2425 [2425] Much the Same with Minor Differences

This is to say that children's foot varus is a very common sign in pediatric orthopedics, commonly known as equinus. Its cause is not closely related to bones, but to abnormal development of tendons and ligaments.

How did the clubfoot come about? Some children can be detected through the b-ultrasound in the second and late pregnancy in the mother's womb before birth, which means that it is probably not an embryo deformity, because almost no equinus appears in the b-ultrasound examination in the first trimester.

The general medical explanation is that equinus is the equinus that appears during the child's mother's pregnancy, and the child changes from normal feet to equinus. The reason may be that the fetal position is not correct or the fetus is too large, and the baby is compressed in the mother's womb, causing the feet to deform. Since the sole cause cannot be completely determined medically, and other causes cannot be ruled out, doctors have been investigating whether genetic and other factors lead to abnormal foot inversion during the child's development.

Clubfoot, like other diseases, may be a simple congenital foot deformity itself, or it may be a sign secondary to other diseases. The most common neurosurgical diseases secondary to other diseases, neurosurgical diseases include central nervous system diseases and peripheral nervous system diseases. Diseases of the central nervous system are problems with the brain and spinal cord. This is a major event that requires careful examination and identification by doctors.

Pediatric neurosurgery examination is similar to that of adults. It checks the state of consciousness of the child and checks various shallow and deep reflexes. The only difference between children and adults is that infants and young children are growing and developing, unlike adults who have already developed. This leads to the fact that the child's head is not fully grown at birth. After the child is born, the brain will continue to develop, and the head will gradually grow larger along with the development of the whole body. The head circumference will have a relatively normal enlarged physiological range.

Measuring head circumference is a routine item in normal physical examination of infants and young children. Emergency re-examination is mainly to prevent children from sudden illnesses, and some parents are careless and do not take their children for medical examinations on time.

By measuring the head circumference, we can know that the child's brain is developing, and the brain is bound to expand outward during the development process. In order to meet the growth needs of this aspect, the human physiological structure deliberately does not close all the skull seams immediately after birth, but waits for the child's brain to develop and then grows the entire skull together to form the most solid helmet to protect the brain. Because of this, the skulls of infants and young children are much more fragile than those of adults before the skulls grow together. It is conceivable that infants and young children will be seriously heavier than adults once trauma occurs to their brains.

Before several skulls grow together and close, the gap area left between them is like a temporarily opened door, so it is called fontanel. There are two such fontanelles in total, one is in the front center of the child's head, and the diamond-shaped one is the anterior fontanel. It will not be completely closed until the child is one to one and a half years old. Posterior fontanel is the triangular back of the brain, and some children have been closed at birth, and the closing time is six to eight weeks at the latest.

Sometimes we can see in the clinic that the head of the newborn baby seems to be pointed and deformed, mostly because the anterior fontanel is not closed, so there is no need to be nervous, and it will grow back naturally after it is closed. Experienced old people said that it was the pointed head squeezed out by the mother when the child was born, which is not completely unreasonable. Because the baby's unclosed fontanel is also to make adjustments for his head to adapt to the changes of the mother's birth canal, so as to facilitate the mother's natural delivery.