Clubfoot is a condition that affects the shape and position of a child’s foot or feet. It is present at birth and can affect one or both feet. Clubfoot is not painful for babies but can cause problems later in life if not treated early. In this article, we will explain what clubfoot is, what causes it, how it is diagnosed and treated, and what to expect for your child’s future.

What is clubfoot?

Clubfoot is a term that describes a range of foot deformities that make the foot turn inward and downward. The medical name for clubfoot is talipes equinovarus. In clubfoot, the tendons that connect the muscles to the bones are shorter than normal, causing the foot to twist out of shape. The severity of clubfoot can vary from mild to severe. In some cases, the foot may look as if it is upside down or sideways.

Clubfoot is one of the most common congenital foot deformities, affecting about one to four out of every 1,000 babies. It is more common in boys than girls and about half of the children with clubfoot have it in both feet.

What causes clubfoot?

The exact cause of clubfoot is unknown, but it is likely a combination of genetic and environmental factors. Some possible risk factors include:

– Family history. If a parent or sibling has had clubfoot, the baby has a higher chance of having it too.

– Congenital conditions. Some genetic syndromes or birth defects, such as spina bifida or arthrogryposis, can be associated with clubfoot.

– Environment. Smoking during pregnancy, having low amniotic fluid, or having a breech birth (bottom first) can increase the risk of clubfoot.

How is clubfoot diagnosed?

Clubfoot can be diagnosed before or after birth. Some parents may find out their child has clubfoot during a prenatal ultrasound, which can show the shape and position of the baby’s feet. After birth, clubfoot is easily visible by looking at the baby’s feet. The doctor will also examine the baby’s legs, hips, and spine to check for other abnormalities.

How is clubfoot treated?

The goal of clubfoot treatment is to correct the foot deformity and allow the child to walk normally. The earlier the treatment starts, the better the results. Ideally, treatment should begin within the first month of life.

The most common and effective method of treating clubfoot is called the Ponseti method, named after the doctor who developed it. The Ponseti method involves two steps:

– Stretching and casting. The doctor gently manipulates the baby’s foot into a more normal position and applies a plaster cast to hold it in place. The cast is changed every week for several weeks, gradually improving the foot’s alignment.

– Bracing. After the casting is done, the baby wears a special brace that consists of shoes attached to a bar. The brace keeps the foot in the correct position and prevents it from relapsing. The baby wears the brace for 23 hours a day for the first three months, then only at night and during naps for the next three to four years.

Some children may need minor surgery to release a tight tendon in the back of the ankle (Achilles tendon) or to correct any residual deformity. This is usually done after the casting phase when the child is about six to nine months old.

In rare cases, when the Ponseti method is not successful or the clubfoot is very severe, more extensive surgery may be needed to correct the bones, joints, and tendons in the foot. This is usually done when the child is older, between two and four years of age.

What are the outcomes and complications of clubfoot?

With early and proper treatment, most children with clubfoot can have normal-looking and functioning feet. They can walk, run, play, and wear regular shoes without any problems. However, some possible complications or challenges include:

– Movement. The affected foot may be less flexible and have a smaller range of motion than the normal foot.

– Leg length. The affected leg may be slightly shorter than the normal leg, but this usually does not affect mobility or balance.

– Shoe size. The affected foot may be up to 1 1/2 shoe sizes smaller than the normal foot, which can make it hard to find matching shoes.

– Pain. Some children may experience pain or stiffness in the foot, especially during growth spurts or after physical activity. This can be managed with painkillers, stretching exercises, or physical therapy.

– Relapse. The foot may revert to its original position if the brace is not worn as prescribed or if the child has a growth spurt. This may require additional casting or surgery.

How can parents support their child with clubfoot?

Having a child with clubfoot can be stressful and challenging for parents, but there are ways to cope and help your child. Some tips include:

– Educate yourself. Learn as much as you can about clubfoot, its causes, treatments, and outcomes. Ask your doctor any questions you have and seek reliable sources of information.

– Follow the treatment plan. Adhere to the doctor’s instructions and casting, bracing, and surgery recommendations. Keep all the appointments and check-ups and report any problems or concerns.

– Support your child. Encourage your child to be active and participate in sports and hobbies. Praise your child’s achievements and efforts and help them deal with any challenges or frustrations. Seek emotional support from family, friends, or professionals if needed.

– Connect with others. Join a support group or an online community of parents and children with clubfoot. Share your experiences, tips, and resources, and learn from others who have gone through similar situations.