If your child has clubfoot in one or both of their feet, you can feel secure in the knowledge that our orthopedic surgeons and specialists are experts in the care of kids with this condition. With the right treatment and therapy, your child should be able to enjoy as normal and active life as possible.
Clubfoot is a common type of birth defect that affects muscles and bones in the feet. Instead of being straight, a clubfoot points down and turns in. This twisting causes the toes to point toward the opposite leg. A baby can be born with the defect in one or both feet.
A clubfoot isn't painful and won't cause health problems until a child begins to stand and walk. But clubfoot that isn't treated can lead to serious problems — and even make a child unable to walk. So it's very important to begin to correct it quickly, ideally a week or two after birth.
Doctors often don't know what causes a baby's clubfoot. It's more common in boys, and can run in families. A baby with clubfoot usually has no other medical problems.
Clubfoot usually is found on an ultrasound around the 20th week of pregnancy. If not, it's diagnosed when a baby is born.
Clubfoot occurs more often in boys than in girls. Because the cause of clubfoot is not understood, not many of the risk factors for this condition are known. However, having a family history of clubfoot may increase your chance of developing it.
Clubfoot is usually easily diagnosed at birth during your baby’s physical examination, and includes:
- 1 or both feet that:
- Turn inward and downward, and will not straighten
- Are slightly smaller than normal
- Calf muscle slightly smaller than normal
The condition can sometimes be diagnosed before birth during an ultrasound examination. If you have a family history of clubfoot, you should discuss this with your obstetrician and your baby’s pediatrician prior to birth.
Clubfoot won't get better on its own. Treatment is usually done using the Ponsetti method, a small procedure after casting and and before bracing where the Achilles tendon is released under a local anesthetic.
A baby with clubfoot will be treated by an orthopedic surgeon (a doctor who focuses on conditions of the bones, muscles, and joints) who has been trained in the Ponseti method. If your baby has a clubfoot, make sure that your orthopedic surgeon has had this training.
The Ponseti method is done in two phases: the casting phase and the bracing phase.
- Casting. The first cast is put on a week or two after the baby is born. Then, the baby returns to the surgeon about once a week for gentle moving and stretching of the foot, and placement of a new cast. The new cast turns the foot a bit more in the correct direction than the one it is replacing. Most babies will wear a series of 5 to 7 casts over a few weeks or months. To help get the foot up, most babies need a minor heel cord release procedure (called an Achilles tenotomy) before the last cast is put on. A very tight tendon near your baby's heel is loosened (or "released") when the surgeon makes a small cut in it. The tendon is numbed with medicine first, and the cut is so small that it does not need stitches. It will heal while your child wears the final cast for about 3 weeks.
- Bracing. When the foot is in the correct position, the orthopedic surgeon will fit the baby with a brace (also called an "orthotic") instead of a cast. The brace is a bar with special shoes or boots at each end. It keeps the foot from twisting back to where it was before the casting. Feet grow a lot and very quickly in the first years of life. Without the brace to keep a corrected clubfoot in the proper place, that rapid growth would send the foot back into the clubfoot position.
Your child will need to wear the brace all the time for about 3 months, and then only at night or during naps for a few years. Most kids adapt well to wearing the brace, though it can take them a day or two to get used to it.
Our orthopedic team works closely with Cook Children’s Home Health team in order to fit your child with bracing or orthotics custom fit to their unique needs.
Permanently fixing a clubfoot can take several years. But a clubfoot that isn't corrected can cause physical and emotional problems.
By following the orthopedic surgeon's treatment plan, you can help make sure that your child will be able to walk, run, and play without pain. Consider yourself a partner in your child's care.
And remember — the orthopedic team has heard it all. If you have questions or concerns, they can offer you helpful advice or talk about the many Ponseti method successes they've seen.