Clubfoot

Clubfoot is a common birth abnormality that occurs in one infant out of every 1,000 births. It is a condition where the tendons that connect the leg muscles to the foot bones are short and tight, and cause the foot to turn inward. It can occur in one or both feet. It is not painful to the infant, but it does require treatment so the child can walk, wear shoes, and enjoy physical activities without pain.

Causes and risk factors

While there is no known cause of clubfoot, there is an increased risk in families with a history of clubfeet. It also occurs more often in males than females.

Symptoms

Clubfoot is diagnosed at birth but can often be detected at a prenatal ultrasound.

  • Appearance of the foot is turned inwards and/or upwards
  • Deep crease on the bottom of the foot
  • Foot and leg are usually shorter than normal
  • Calf is thinner than normal
  • Foot size is smaller than normal

Diagnosis and treatment

Although it is possible to treat in older children, treatment usually starts shortly after birth and generally does not require surgery. A set of long-leg casts (toes to thigh) is applied weekly for 6-8 weeks. It gently stretches the foot until it reaches a neutral position. A small procedure is usually necessary to lengthen the Achilles tendon after the last cast is removed.

After treatment, the baby wears a brace that looks like shoes attached to a bar to maintain the neutral foot position. If the baby does not wear the brace, clubfoot can come back. The brace needs to be worn consistently for three months and then only during naps and at night for several years. This method of treating clubfoot is long and can be difficult for parents, but it has proven to be very effective. If clubfoot can’t be corrected by this method or if it recurs, surgery may be necessary to lengthen or move tendons.