Innovative Botox Treatment Prevents Surgery
Better known for its cosmetic uses, Botox injection is now replacing surgery in the treatment of children with clubfoot.
Speaking of Children - BC Children's Hospital Foundation - Fall 2007
By ELLEN BARAGON
Little Cole Gyger came into the world a healthy baby boy, with a full head of black hair and the face of an angel. But like one in 1,000 newborns, Cole also came with what his parents Mayella and Jason now know is a common condition called clubfoot. Clubfoot is a malformation of one or both feet, which are twisted, facing downward, and unable to flatten on the sole.
ABOVE: Mayella and Jason Gyger travelled from Smithers, BC, with their infant son, Cole, who received Botox treatments for clubfoot from Dr. Christine Alvarez at the Clubfoot Clinic at BC Children’s Hospital.
“Of course you’re upset when you first find out it’s clubfoot, because you don’t know what the outcome is going to be, what it’s going to take to fix it, whether it’s correctable,” recalls Mayella, a first-time mom. Cole’s pediatrician referred the Smithers, BC, family to BC Children’s Hospital’s Clubfoot Clinic, where Dr. Christine Alvarez uses an innovative and effective technique that replaces traditional surgery with an injection of Botox.
“There was a week of scratching our heads, figuring out how we were going to get down to Children’s, get the treatment, and get him healthy,” says Jason.
Cole’s family learned that if not treated, clubfoot would eventually impede the boy’s ability to walk and run, and by his teen years could cause significant discomfort and disability. So at just 11 days old, Cole was on a flight to Vancouver for his first meeting with Dr. Alvarez.
Clubfoot usually requires six to 12 weeks of physical therapy and weekly applications of casts that gradually stretch the foot to a normal position. Traditionally, babies with clubfoot also undergo surgery to sever the Achilles tendon, enabling the muscles to relax and the foot to extend toward the correct position.
However, in 2000 Dr. Alvarez began to replace this surgery with an injection of Botox, the drug better known for smoothing lined faces. The injection serves the same function as surgery, but without the complications and the discomfort. So far 268 Clubfoot Clinic patients have benefitted from this innovation.
After Cole has his third cast applied, Dr. Alvarez leans over his tiny frame, and carefully attends to some final touches on the cast before his parents bundle him up for a 1,200-kilometre flight home. They will return in a week for his next treatment.
“Managing clubfoot can be a slow, dedicated process,” says Dr. Alvarez, whose patients range in age from three weeks to seven years. “But we just have to persist. We always get there eventually.”
Mayella and Jason know that to ensure clubfoot does not reoccur Cole faces years of monitoring and an exercise and physiotherapy regime that could last to age 14. “Our doctor told us that Dr. Alvarez was the best,” says Mayella. “And when you treat your child, you want to make sure they have the absolute best care they can get. We were more than willing to make sure we came here to get it.”
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