Clubfoot

Clubfoot (also known as talipes equinovarus) is a congenital condition where a baby’s foot is twisted out of its normal position. The foot often points downward and inward, making it appear rotated or even upside down in severe cases. Clubfoot is one of the most common birth deformities, affecting about 1 in every 1,000 live births.

Symptoms

Clubfoot is usually identified at birth (or even on prenatal ultrasound). Common features include:

• One or both feet turned inward and downward
• The calf muscle on the affected side may be smaller
• The foot may appear shorter than normal
• Limited range of motion in the ankle

Despite its appearance, clubfoot is generally not painful in newborns. However, if left untreated, it can lead to difficulty walking and long-term disability.

Causes and Risk Factors

The exact cause of clubfoot is unknown, but several factors may contribute:

• Genetics: A family history increases risk.
• Environmental factors: Smoking during pregnancy and low amniotic fluid levels are linked.
• Neuromuscular conditions: In rare cases, clubfoot may be associated with conditions like spina bifida or cerebral palsy.
• Assigned sex: Clubfoot is more common in boys than girls.

It’s important to note that most cases are isolated, meaning the child is otherwise healthy.

Treatment

Early treatment is essential; ideally starting within the first weeks of life. The Ponseti method is the most widely used and effective treatment.

Ponseti Method Includes:

• Gentle manipulation and casting: The foot is gradually repositioned through a series of casts changed weekly.
• Achilles tendon release: A minor procedure (tenotomy) often performed under local anesthesia to lengthen the tight tendon.
• Bracing: After correction, a brace (boots and bar) is worn full-time for several months, then during sleep for a few years to prevent recurrence.

In some cases, additional treatments may include:

• Physical therapy: To maintain flexibility and strength.
• Surgical intervention: For severe or resistant cases, more extensive surgery may be needed to adjust tendons, ligaments, or joints.

With prompt and consistent treatment, most children with clubfoot grow up to walk, run, and play without any significant limitations. However, regular follow-up is crucial to monitor for recurrence.

Prevention

There is no known way to prevent clubfoot entirely, but some general prenatal health tips may help reduce risk:

• Avoid smoking and alcohol during pregnancy
• Get early and regular prenatal care
• Manage chronic conditions like diabetes properly

Clubfoot can look concerning at birth, but modern treatments are highly effective. With early intervention, most children go on to live active, healthy lives. If your child is diagnosed with clubfoot, partnering with a pediatric orthopedic specialist ensures the best outcome.

Read more on LuskinOIC’s specialty page for Clubfoot.