Treating Clubfoot
What is Clubfoot?
Clubfoot is a birth defect in which one or both of a newborn’s feet are twisted inward or downward.
The cause of clubfoot is unknown, but it may be related to genetics or environmental factors.
Treatment typically involves two phases: casting and bracing.
With early treatment and follow-up care, most children with clubfoot can participate in sports, dance and wear regular shoes.
What Causes Clubfoot?
Some studies suggest that specific genes may make a person more likely to develop clubfoot, and environmental factors, such as a mother's diet or lifestyle choices during pregnancy, may also influence the development of clubfoot in some cases.
The baby's position while growing in the womb has also been linked to an increased risk of developing clubfoot.
Signs & Symptoms
Common signs and symptoms of clubfoot include:
- A foot twisted inward, with the heel rotated toward the inside of the leg
- The top of the foot faces outward, with the sole facing inward
- Limited range of motion in the affected foot
- Weakness in the muscle of the affected foot
- A small heel is on the affected foot, while the unaffected one has a normal-sized heel
- Thickened tendons around the ankle and heel on the affected side
- The calf muscle may be smaller or less defined
- The toes on the affected foot may be held in a claw-like position
Risk Factors
If you are concerned that your child may have clubfoot, speaking with your health care provider is essential. Early diagnosis and treatment can help prevent further complications and improve outcomes.
Common risk factors for clubfoot include:
- Family history of the condition
- Certain genetic conditions, such as spina bifida
- Boys are more likely to develop clubfoot than girls
- Smoking during pregnancy
- Insufficient amniotic fluid during pregnancy
Diagnosis
The diagnosis of clubfoot involves a thorough physical examination and often imaging such as an X-ray or ultrasound to determine the severity of the condition. Clubfoot is classified into four stages based on severity.
Starting with Stage I (mildest) and progressing to Stage IV (most severe).
Early diagnosis and treatment are essential to prevent long-term complications such as pain, arthritis or recurrent deformities.
Treatment
The treatment for clubfoot involves a series of manipulations and casts to stretching, followed by bracing and, potentially, surgery.
First, the doctor will manipulate the foot while the baby is still in the womb or soon after birth to help improve its position.
After that, serial casting is done over several weeks. This stretches tendons and ligaments in the foot, allowing for gradual correction.
During this time, a physician or orthopedic specialist will monitor the baby's progress and adjust the casts as necessary.
Bracing: In some cases, bracing may help maintain the corrected foot position. Braces are typically worn during nighttime hours and help keep the foot in the correct position while allowing for some movement.
Surgery: In severe cases, surgery may be required to correct the condition entirely. This usually involves cutting tendons or ligaments and stitching them into a new position. The foot is also sometimes broken and re-set to help with alignment. Surgery should always be discussed with the orthopedic surgeon in detail before making any decisions.
Overall: The prognosis for clubfoot is generally good, with most children able to live healthy and active lives. With proper treatment, the vast majority of feet treated can be successfully corrected, allowing the child to walk pain-free by their first birthday or shortly after that.
Pediatric Orthopedic Surgery program
The Children’s Hospital of San Antonio specializes in pediatric care for infants, children and adolescents and maternal and fetal care for women with high-risk and routine pregnancies. From birth to age 18, Children’s provides comprehensive, coordinated care from a team of pediatric and maternal experts.