What is Clubfoot?

Clubfoot is when a baby is born with one or both feet curved out of the traditional shape, position, and direction. Clubfoot is also known as Talipes Equinovarus, Talipes foot or clubfoot deformity. A clubfoot often appears crooked, twisted, or angled unnaturally. It is a common condition affecting approximately one in 1000 babies that are otherwise healthy. There is a range of severity in clubfoot cases, from mild to severe. Nearly half of the babies with clubfoot have it in both feet. Clubfoot is not painful, but it can lead to difficulties walking without a limp if not treated. Treatment of this condition has a high percentage of success and most children have no long-term effects.

Types of Clubfoot

The three main clubfoot types are Idiopathic, Neurogenic and Syndromic. Each type is unique with varying causes. The types also differ in gravity, from mild clubfoot to severe.

Idiopathic Clubfoot

Idiopathic clubfoot is the most common type of clubfoot in babies. Doctors do not know the cause of this form of clubfoot. Half of the cases affect only one foot, and the condition impacts baby boys twice as often as baby girls.

Neurogenic Clubfoot

Neurogenic clubfoot is caused by a neurological condition, a condition that affects the nervous system (brain, spinal cord and nerves). Two examples of a neurological condition are spina bifida and cerebral palsy.

Syndromic Clubfoot

Syndromic clubfoot is another one of the clubfoot types. In this type, the clubfoot is associated with other clinical conditions that indicate an underlying syndrome. For example, arthrogryposis, constriction band syndrome, tibial hemimelia and diastrophic dwarfism.

Symptoms

Clubfoot in infants usually appears at birth with easily observable clubfoot signs and symptoms. Once treated, babies with clubfoot can usually engage in standard activities with no long-term issues.

Clubfoot symptoms include:

• The front of the foot curves inward.
• The foot may appear curved under itself.
• The heel points downward.
• The impacted foot has a limited range of motion.
• The calf of the affected leg is smaller than the other calf muscle.
• The affected leg is shorter.
• The impacted foot can be short.
• The impacted foot can be wide.

Causes

There are separate causes for each of the three types of clubfoot. Doctors do not know the cause of Idiopathic clubfoot. Neurogenic clubfoot is caused by an underlying neurological condition. Syndromic clubfoot is caused by an underlying nervous system disorder. Each of the three clubfoot causes require a specific treatment.

Diagnosis

Clubfoot is typically diagnosed weeks or months before the baby is born. Doctors can usually see the shape and position of a baby’s foot during an ultrasound in week 20 of pregnancy. Early clubfoot diagnosis allows time for researching the condition and connecting with pediatric surgeons who can treat the condition once the baby is born.

Treatment

Clubfoot treatment options vary but there are two main options: (1) Stretching & Casting and (2) Clubfoot Surgery. Your doctor will recommend the treatment option with the best prognosis based on the specific characteristics of your baby’s clubfoot.

Stretching and Casting

Stretching and casting is the most common clubfoot treatment. In this procedure, your doctor will reposition your baby’s foot or feet into the correct position. Next, your doctor will put the foot or feet in a cast to keep it in place. Finally, your doctor will perform a minor surgery to extend the Achilles tendon. Post-treatment, your doctor will likely recommend regular stretching exercises with your baby, along with special shoes or braces to maintain the proper shape of your baby’s foot. Your baby will likely wear the shoes and braces 24 hours a day for three months, and then during nighttime sleep and naps for up to three years.

Surgery

In more severe cases of clubfoot, surgery may be needed. During clubfoot surgery, your doctor will elongate or change the position of the tendons and ligaments in your baby’s foot. This helps shape the foot into proper alignment. After surgery, your baby will wear a cast for two months, followed by a special brace for a year to maintain the healthy positioning of the foot.

Complications

There are typically few (if any) complications with early and proper treatment of clubfoot. A corrected foot looks no different than any other baby foot. Once treated, most children born with clubfoot experience no lasting complications and grow up to walk, dance, run and play.