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Clubfoot

Definition

Clubfoot is when the foot turns inward and downward. It is a congenital condition, which means it is present at birth.

Alternative Names

Talipes equinovarus; Talipes

Causes

Clubfoot is the most common congenital disorder of the legs. It can range from mild and flexible to severe and rigid.

The cause is not known, but the condition may be pass down through families in some cases. Risk factors include a family history of the disorder and being male. It occurs in about 1 out of 1,000 live births.

Symptoms

The physical appearance of the foot may vary. One or both feet may be affected.

The foot turns inward and downward at birth, resisting realignment. The calf muscle and the foot may be slightly smaller than normal.

Exams and Tests

The disorder is identified during a physical examination. A foot x-ray may be done.

Treatment

Treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible -- ideally, shortly after birth -- when reshaping the foot is easiest.

Gentle stretching and recasting occurs every week to improve the position of the foot. Generally, 5 to 10 casts are needed. The final cast remains in place for 3 weeks. After the foot is in the correct position, a special brace is worn nearly full-time for 3 months. After, it is used at night and during naps for up to 3 years.

Often, a simple outpatient procedure is needed to release a tightened Achilles tendon.

Some severe cases of clubfoot will require surgery if other treatments do not work or if the problem returns. The child should be monitored by a doctor until the foot is fully grown.

Outlook (Prognosis)

The outcome is usually good with treatment.

Possible Complications

Some defects may not be able to be completely fixed. However, with treatment the appearance and function of the foot can be improved. Treatment may be less successful if the clubfoot is linked to other birth disorders.

When to Contact a Medical Professional

If your child is being treated for clubfoot, call your health care provider if:

• Swelling, bleeding, or a change in color of the toes occurs under the cast
• The toes disappear into the cast
• The cast slides off
• The foot begins to turn in again after treatment

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