Definition

What is clubfoot?

Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which your baby’s foot is twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone (tendons) are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn.

Clubfoot can be mild or severe. About half of children with clubfoot have it in both feet. If your child has clubfoot, it will make it harder to walk normally, so doctors generally recommend treating it soon after birth.

Doctors are usually able to treat clubfoot successfully without surgery, though sometimes children need follow-up surgery later on.

How common is clubfoot?

Clubfoot is a common birth defect. About 1 in 1,000 babies is born with clubfoot in the United States each year. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of clubfoot?

The common symptoms of clubfoot are:

  • The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.
  • The foot may be turned so severely that it actually looks as if it’s upside down.
  • The calf muscles in the affected leg are usually underdeveloped.
  • The affected foot may be up to 1/2 inch (about 1 centimeter) shorter than the other foot.

Despite its look, however, clubfoot itself doesn’t cause any discomfort or pain.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes clubfoot?

In some cases, clubfoot is just the result of the position of the baby while it is developing in the mother’s womb (postural clubfoot).

But more often clubfoot is caused by a combination of genetic and environmental factors that is not well understood. If someone in your family has clubfoot, then it is more likely to occur in your infant. If your family has one child with clubfoot, the chances of a second infant having the condition increase.

Clubfoot present at birth can point to further health problems because clubfoot can be linked with other conditions such as spina bifida. For this reason, as soon as clubfoot is noticed, it’s important that the infant be screened for other health conditions. Clubfoot can also be the result of problems that affect the nerve, muscle, and bone systems, such as stroke or brain injury.

Risk factors

What increases my risk for clubfoot?

There are many risk factors for clubfoot, such as:

  • Family history. If either of the parents or their other children have had clubfoot, the baby is more likely to have it as well.
  • Congenital conditions. In some cases, clubfoot can be associated with other abnormalities of the skeleton that are present at birth (congenital), such as spina bifida, a serious birth defect that occurs when the tissue surrounding the developing spinal cord of a fetus doesn’t close properly.
  • If a woman with a family history of clubfoot smokes during pregnancy, her baby’s risk of the condition may be double that of nonsmokers. Also, getting an infection or using recreational drugs during pregnancy can increase the risk of clubfoot.
  • Not enough amniotic fluid during pregnancy. Too little of the fluid that surrounds the baby in the womb may increase the risk of clubfoot.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is clubfoot diagnosed?

Ultrasound done while a baby is in the womb can sometimes detect clubfoot. It is more common for your doctor to diagnose the condition after the infant is born, though, based on the appearance and mobility of the feet and legs. In some cases, especially if the clubfoot is due just to the position of the growing baby (postural clubfoot), the foot is flexible and can be moved into a normal or nearly normal position after the baby is born. In other cases, the foot is more rigid or stiff, and the muscles at the back of the calf are very tight.

X-rays may not be helpful to confirm the diagnosis. Some of the baby’s foot and ankle bones are not fully ossified (filled in with bony material) and do not show well on X-ray.

How is clubfoot treated?

Because your newborn’s bones, joints and tendons are very flexible, treatment for clubfoot usually begins in the first week or two after birth. The goal of treatment is to improve the way your child’s foot looks and works before he or she learns to walk, in hopes of preventing long-term disabilities.

Treatment options include:

  • Stretching and casting (Ponseti method)
  • Surgery

Stretching and casting (Ponseti method)

This is the most common treatment for clubfoot. Your doctor will:

  • Move your baby’s foot into a correct position and then place it in a cast to hold it there
  • Reposition and recast your baby’s foot once or twice a week for several months
  • Perform a minor surgical procedure to lengthen the Achilles tendon (percutaneous Achilles tenotomy) toward the end of this process

After the shape of your baby’s foot is realigned, you’ll need to maintain it by doing one or more of the following:

  • Doing stretching exercises with your baby
  • Putting your child in special shoes and braces
  • Making sure your child wears the shoes and braces as long as needed — usually full time for three months, and then at night for up to three years

For this method to be successful, you’ll need to apply the braces according to your doctor’s directions so that the foot doesn’t return to its original position. The main reason this procedure sometimes doesn’t work is because the braces are not used constantly.

Surgery

If your baby’s clubfoot is severe or doesn’t respond to nonsurgical treatments, more invasive surgery may be needed. An orthopedic surgeon can lengthen tendons to help ease the foot into a better position. After surgery, your child will be in a cast for up to two months, and then need to wear a brace for a year or so to prevent the clubfoot from coming back.

Even with treatment, clubfoot may not be totally correctable. But in most cases babies who are treated early grow up to wear ordinary shoes and lead normal, active lives.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage clubfoot?

Because doctors don’t know what causes clubfoot, you can’t completely prevent it. However, if you’re pregnant, you can do things to limit your baby’s risk of birth defects, such as:

  • Not smoking or spending time in smoky environments
  • Not drinking alcohol
  • Avoiding drugs not approved by your doctor

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 11, 2017 | Last Modified: August 11, 2017

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.