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Family Foot & Ankle

Clubfoot

Clubfoot is Present at BirthEvery baby is perfect just the way they are—we know that—but that doesn’t mean parents aren’t understandably nervous about the health of their newborn. Most of us would go to just about any length to give our kids the best chance at a normal, healthy development.

Clubfoot, a condition where at least one of a baby’s feet is turned severely inward (or even upward) at birth, affects approximately 1 in 1,000 newborns. Fortunately, a trained podiatrist can help your little one successfully resolve the problem, although it will take time and parental dedication.

How Concerned Should You Be About Clubfoot?

First, the good news:

  • Although the visual impact may be extreme, newborns with clubfoot usually do not experience any pain or discomfort as long as they are not yet walking.
  • The deformity is usually an “isolated” condition, meaning that your baby is likely to be otherwise healthy.
  • Most cases can be successfully corrected non-surgically, allowing your child to walk, run, and play with only minor side effects.
     

A clubfoot that has been successfully treated may still present some minor complications. For example, the affected foot and calf may always be a little smaller, slightly less mobile, and more prone to soreness than the unaffected leg.

However, not treating the problem will have more severe consequences. It will not get better on its own, and treatment should begin shortly after birth in order to correct the problem before the walking stage.

What Causes Clubfoot?

Mechanically speaking, clubfoot is caused by tendons in the leg that are too short and tight, pulling the soft, flexible foot out of position. We aren’t sure exactly why this happens. Genetics seem to play a role—family history of the condition increases risk, and boys are twice as likely to suffer as girls. Smoking during pregnancy also increases the risk.

In some cases the curved feet may be symptoms of a more significant congenital neuromuscular condition, such as spina bifida. These cases may be more stubborn to treat.

How Is Clubfoot Treated?

The majority of these curved feet are successfully treated using the Ponsetti method, developed at the University of Iowa in 1950s. This treatment uses stretches and casting to gradually change your baby’s feet into a normal position.

In the first phase, the leg is gently stretched into a more normal position and held in place by a long, rigid cast spanning all the way from toes to thigh. Once or twice per week for a few months, the doctor will remove the cast, reposition the leg, and recast. When this phase is complete, the doctor will make a very minor incision (not even requiring stitches) to release and lengthen the tight Achilles tendon, then cast the foot one last time.

After the foot has been repositioned, stretching exercises, special shoes, and bracing are used for a time to prevent the clubfoot from returning. It is absolutely critical that you follow all instructions from your doctor about using the brace. In most cases your baby will have to wear it full-time for a few months, gradually reduced to just bedtime and naptime over a period of a few years.

Although this method requires a high level of commitment from parents, it is highly effective when followed faithfully.

Surgical Correction

In cases where the deformity is especially severe, or conservative methods are insufficient to fix the problem or prevent it from recurring, surgery may be considered to make the necessary adjustments to joints, ligaments, and tendons. Your child will likely wear a cast for a few months after the surgery, and need a brace for up to a year afterward.

Because surgery has a tendency to stiffen the foot—especially with more extensive procedures—every effort is made to correct the deformity as much as possible with conservative measures first.

The experts at Family Foot & Ankle Center are dedicated to providing the best foot care for your entire family, from newborns to centenarians. If your little one has clubfoot, make an appointment at one of our six Greater Cincinnati locations right away. You can request a visit online, or give us a call at 888-689-3317.