Clubfoot repair is a surgical procedure that corrects a deformity of the foot and ankle called clubfoot. Clubfoot is a condition in which the foot and ankle are permanently twisted. A clubfoot is shaped like a golf club.
Clubfoot is a condition that one is born with, called a congenital deformity. Clubfoot can interfere with developmental milestones like standing and walking. Surgical repair is most often performed on babies before their first birthday. Older children and adults who have uncorrected clubfoot might also need repositioning surgery.
Surgery is necessary when other forms of treatment, such as casting, do not correct clubfoot.
The causes of clubfoot are not known. However, risks of being born with the condition are higher if:
- you are male
- your mother smoked during pregnancy
- someone else in your family has clubfoot
- you suffer from spina bifida or other spinal cord injuries
While the origins of clubfoot are unclear, the physical manifestations are well understood. The ligaments and tendons that hold the muscles to the bones are too tight, causing the tissues around the ankle to hold the foot in an abnormal position.
Clubfoot is usually apparent when a baby is born, and therefore diagnosed very shortly after birth. The earlier the condition is diagnosed, the easier it is to treat before the baby begins to be mobile.
Casting is a treatment method used to correct clubfoot in the hopes that surgery will not be necessary. The foot is gently stretched into a more normal position and is secured with a cast. Every week or two, the foot’s position is stretched even more towards normalcy and the cast is replaced.
Over the course of two to four months, clubfoot may be repaired permanently without surgery. Those with mild clubfoot are more likely to see improvements through casting.
Babies and older patients that suffer from severe clubfoot may not respond to casting. In this instance, surgery is the treatment option to consider.
During clubfoot repair surgery, a surgeon cuts the Achilles tendon near the heel and an area near the front of the foot. The incisions loosen the tight ligaments and tendons. The surgeon is then able to manipulate the foot into a normal position.
Older children and adults are often less flexible than babies and may require more extensive repair. The surgeon might need to cut into the bone to turn the foot. In these cases, metal plates or screws are used to hold the foot in the right position. Once the foot and ankle are placed appropriately, the surgeon places the leg in a cast.
Clubfoot repair is performed under a general anesthetic. Patients are asleep and do not feel pain during the procedure. Pain after surgery is managed with medication.
Clubfoot patients remain in the hospital for up to three days after surgery. Keep the casted leg elevated to reduce swelling. Your child may be asked to wiggle their toes to make sure blood flow to the foot is not interrupted.
Casting is an important part of the recovery process. Patients will wear a cast for as long as three months to allow the incisions, tendons, and bones to heal. Your doctor will replace the cast several times throughout, especially with infants and toddlers who grow quickly. After the cast is removed, the foot should look and function normally.
Physical therapy plays a crucial role in the efficacy of clubfoot surgery. Foot exercises help restore flexibility, range of motion, and muscle tone to the leg. Many people who have clubfoot have underdeveloped calf muscles in the affected leg. Even after surgery, the muscles may remain permanently smaller than in the healthy leg. This is normal in those with clubfoot.
Some people are required to wear a brace after clubfoot surgery. The brace helps strengthen the foot and assists with normal mobility.
Children who have had clubfoot repair surgery can lead active lives with few risks. Potential risks associated with surgery include:
- nerve damage in the foot
- excessive foot swelling
- interrupted blood flow to the foot
The most common complaint of people who have had clubfoot repair is stiffness in the foot and ankle. Repeat surgery is sometimes necessary as a child gets older to accommodate his or her growth.