Clubfoot is a birth defect that causes a child’s foot to point inward instead of forward. The condition is normally identified after birth, but doctors can also tell if a fetus has clubfoot during an ultrasound. Although the condition normally affects only one foot, it can affect both feet.
Clubfoot can be corrected through stretching and bracing, but surgery may be necessary in severe cases. According to the American Academy of Orthopaedic Surgeons, clubfoot occurs in one out of every 1,000 births. For unknown reasons, clubfoot occurs more often in boys than in girls. (AAOS)
The exact cause of clubfoot is unknown, but doctors agree that a family history of clubfoot increases the likelihood that a child will be born with the condition. In addition, mothers who smoke and drink during pregnancy are more likely to give birth to a child with a clubfoot or clubfeet. Clubfoot may also occur as part of a congenital skeletal abnormality, such as spina bifida.
A clubfoot is turned sharply inward. This makes the heel appear to be on the outside of the foot and the toes point inward toward the other foot. In severe cases, the foot may appear to be upside down.
Children with clubfoot wobble when they walk. They often walk on the outside of the affected foot to maintain balance.
Although clubfoot looks uncomfortable, it does not cause pain or discomfort. Children with untreated clubfoot may have a smaller calf on the affected leg. This leg may also be slightly shorter than the unaffected leg.
Clubfoot is diagnosed by visually inspecting a newborn’s foot. A doctor can also diagnose clubfoot in a fetus by using an ultrasound. Do not assume that your child has clubfoot if his or her foot appears to be turned inward. Deformities affecting the leg or the bones in the foot may also cause the foot to appear abnormal.
There are two effective methods of treatment for clubfoot: stretching and surgery. Surgery is used in severe cases of clubfoot, while stretching is used as an early treatment method.
Manipulation by Stretching
Shortly after birth and before the child can walk, your physician will show you how to manipulate and stretch your child’s foot into alignment. You will need to stretch the foot daily to encourage it to remain in a normal position.
Another stretching technique is called the Ponseti method. The Ponseti method involves placing a cast on the affected foot after stretching it into position. Your doctor will change the cast every few weeks, or, in some cases, every week. This method will be repeated until the clubfoot is corrected.
Another manipulation technique is called the French method. The French method involves applying adhesive tape to the clubfoot instead of using a cast. Doctors normally continue this treatment until the child is 6 months old.
If the clubfoot is corrected using a stretching method, a splint or brace will be placed on the child’s leg every night for up to three years to keep the foot in the corrected position.
If your baby’s clubfoot doesn’t respond to manual manipulation, or if it is severe, surgery may be necessary to correct it. Surgery is used to correct the position of the tendons, ligaments, bones, and joints of the clubfoot to bring it into alignment. After surgery, the child will have to wear a brace for up to one year in order to keep the foot in the correct position.
Because the cause of clubfoot is unknown, there are no definite ways to prevent it from occurring. However, you can minimize the risk that your child will be born with clubfoot by not smoking or drinking during your pregnancy.