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    This is when it comes to children¡¯s foot varus, which is a very common sign in pediatric orthopedics, commonly known as clubfoot.  Its cause is not closely related to bones, but to abnormal development of tendons and ligaments.

    Where did clubfoot come from?  In some babies, clubfoot can be detected through B-ultrasound in the second and third trimester of pregnancy before they are born. This means that it is probably not an embryonic malformation, because clubfoot is almost never seen in B-ultrasound during the first trimester.

    The general medical explanation is that clubfoot occurs when the child's mother changes from normal feet to clubfoot during pregnancy.  The reason may be that the fetus is in an incorrect position or the fetus is too large. The child is compressed in the mother's uterus and the feet are deformed.  Since medicine cannot completely determine the only cause and other causes cannot be ruled out, doctors have been investigating whether genetic and other factors may lead to abnormal foot pronation during child development.

    Clubfoot is the same as other diseases. It may be a simple congenital foot deformity itself, or it may be secondary to signs of other diseases.  The most common diseases secondary to other diseases are neurosurgical diseases, which include diseases of the central nervous system and peripheral nervous system.  Central nervous system diseases are problems with the brain and spinal cord. This is a serious matter and requires careful examination and identification by a doctor.

    The neurosurgical examination of children is similar to that of adults. It examines the child¡¯s state of consciousness and various shallow and deep reflexes.  The only difference between children and adults is that infants and young children are still growing and developing, unlike adults who have completed development.  This results in the child's brain not being fully grown upon birth.  After a child is born, the brain will continue to develop, and the head will gradually become larger along with the growth of the entire body. This is reflected in the normal physiological range of head circumference.

    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 physical 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 development.  In order to meet the needs of growth in this area, human physiological structure deliberately does not close all the cranial sutures immediately after birth. Instead, it waits for the child's brain to develop and then the entire skull grows together to form the strongest helmet to protect the brain.  Because of this, the heads of infants and young children are much more fragile than those of adults before their heads grow together.  Once trauma occurs to the brains of infants and young children, it is conceivable that the injuries will be more severe than those of adults.

    Before several skull bones grow together and close, the gap area left between them is like a temporarily opened door, so it is called a fontanelle.  There are two such fontanels in total. One is in the center of the front of the child's head. It is diamond-shaped and is the anterior fontanel. It takes until the child is one to one and a half years old to close completely.  The posterior fontanel is a triangular shape at the back of the head. Some children are already closed when they are born, and the latest it closes is six to eight weeks.

    We sometimes see clinically that the pointy head of a child seems to be deformed when he is born. This is mostly due to the fact that the anterior fontanel is not closed. There is no need to be nervous. It will grow back naturally after it closes.  Experienced old people say that the pointy head of the child is squeezed out by the mother when he is born. This is not completely unreasonable.  Because the baby's unclosed fontanel is also used to adjust the baby's brain to the changes in the mother's birth canal, making it easier for the mother to give birth smoothly.

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