Clubfoot, known to doctors as talipes equinovarus, is a congenital (present at birth) abnormality of the foot. A common birth defect, clubfoot occurs in approximately one out of 1,000 births in the United States. Clubfoot describes a variety of foot abnormalities in which a newborn’s foot is twisted inward. The actual term, “clubfoot” refers to the way the foot is positioned at a sharp angle to the ankle, similar to the head of a golf club.
Clubfoot can be mild or severe, affecting one or both feet. In most cases, clubfoot causes the top of the baby’s foot to bend downward, increasing the arch and turning the heel inward. In some instances, the foot may be severely turned so that it looks as if it is upside down. Also, the calf muscles may be under-developed, making the affected foot shorter than the other foot.
Clubfoot can inhibit a child’s ability to walk, but with early treatment the appearance and overall function of the child’s foot or feet should show improvement.
While the actual cause of clubfoot is unknown, the condition can run in families and occurs more frequently in males. Some studies have linked clubfoot to cigarette smoking during pregnancy in susceptible families.
Clubfoot is usually diagnosed during the initial physical examination of your newborn. The doctor can recognize clubfoot by looking at the shape and positioning of a newborn’s feet. The doctor may request X-rays to fully understand the severity of the deformity.
In some cases, clubfoot may be diagnosed prenatally by ultrasound after the 16thweek of gestation. While no treatment can be done prior to birth, knowing that your baby has clubfoot may give you more time to get in touch with the appropriate health experts who can help treat your baby after he or she is born.
Since a newborn’s bones and joints are flexible, treatment for clubfoot generally starts soon after birth. The goal of the treatment is to restore the look and function of the affected foot before the onset of walking, preventing long-term disabilities. The treatments offered at Shriners Hospitals for Children® will vary depending on the severity of the condition. Treatment options may include:
Stretching and casting (also known as the Ponseti method): Stretching and casting involves manipulating your child’s foot into the proper position and then casting it to maintain the position. This process occurs weekly for several weeks until the shape of the foot has been corrected. Once the shape has been aligned, the foot is maintained through stretching exercises, special shoes or splinting with braces at night for up to three years. For the bracing to be most effective, you will need to apply the braces according to your doctor’s specifications so that the foot doesn’t return to its original position.
Stretching and taping: This treatment includes daily manipulation of your child’s foot and taping to maintain the correct position until the next day. Usually after two months the treatments are reduced to three times per week until your newborn is six months old. Once the shape of the baby’s foot is corrected, daily exercises and night splints continue until they are walking.
Surgery: Surgery is sometimes necessary in more severe cases or if the stretching and casting approach does not correct the clubfoot. A pediatric orthopaedic surgeon can lengthen tendons properly position the foot. After surgery, your child may need to wear a brace to prevent any recurrence of the deformities.
Although clubfoot may not always be completely correctable, in many cases newborns that are treated early are able to wear normal shoes and lead active lives. The most important aspect of care is early diagnosis and treatment, so if your child’s doctor identifies a clubfoot, starting treatment as soon as possible is a key factor in ensuring a successful outcome.