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Clubfoot is a common birth defect that occurs in infants; the incidence rate is one to two children per 1,000 live births. The cause is unknown but can sometimes be determined in utero. Clubfoot is twice as common in males than in females.

One foot or both feet can be affected. Clubfoot turns the foot down and inward, and affects the tendons and ligaments not only in the foot, but in the calf muscle as well.

Though it is not painful to babies, parents will want to fix the foot as quickly as possible so it doesn’t affect the child when he or she starts walking.

Shriners Hospitals for Children — St. Louis physicians Mark Miller, M.D., and Pooya Hosseinzadeh, M.D., use the Ponseti method to treat clubfoot, which involves serial casting, a heel cord procedure and brace wear. Each child’s progress is different so length of treatment and the number of casts will vary.

Clubfoot will not resolve on its own and can range from mild to severe. A brace must be worn 23 hours a day for three months, then 18 hours a day for three months, then 12–14 hours per day until the child is four years old. Clubfoot will relapse if the brace is not worn.

Treatment of clubfoot: Three phases

  1. Casting – series of casts changed every one to two weeks to gently stretch and reposition the foot
  2. Tenotomy (heel cord) – Achilles tendon is clipped to lengthen the heel
  3. Bracing – designed to prevent clubfoot from reoccurring – bracing systems vary