Clubfoot is a congenital foot abnormality in which the tendons that connect the leg muscles to the foot bones are short and tight, causing the foot on the affected leg to turn downward and inward. In severe cases, the bottom of the foot faces sideways or upwards. The calf muscles in the leg affected by clubfoot are usually underdeveloped, and the affected foot may be slightly shorter than the unaffected foot.
The exact cause of clubfoot is unknown, but research has found that a combination of genetics and environmental factors, such as smoking during pregnancy, may increase the risk of a baby being born with clubfoot. Clubfoot is most often an isolated condition (baby is otherwise normal and healthy) but in some cases, clubfoot occurs in conjunction with other conditions, such as spina bifida.
Clubfoot is sometimes diagnosed during a prenatal ultrasound, allowing parents to plan ahead for the treatment, but if it is not, it will be identified by the doctor shortly after birth. Although clubfoot looks painful, the condition in itself does not cause pain. However, without treatment, a child with clubfoot will not be able to wear shoes and walk normally.
The treatment for clubfoot begins soon after birth and initially consists of non-surgical methods. The most widely used treatment is called the Ponseti method. The first phase of this method involves manipulating and stretching the foot into the proper position and then applying a cast to hold it in place. This process is repeated once a week, typically over a period of about 6 – 8 weeks. After this phase is completed, a minor procedure may be performed to relieve tightness in the Achilles tendon and a cast is then applied. After a few weeks, the cast is removed and the infant wears a brace to keep clubfoot from recurring.
In some cases, the foot deformity does not respond to the stretching treatment and surgery is required. The good news is that once treatment is completed, the structure of the affected foot should be nearly normal, allowing for normal, pain-free walking and running.
American Academy of Orthopedic Surgeons