ClubfootDefinition: In the disorder called clubfoot, the foot is turned inward and downward at birth and remains stuck in this position, resisting realignment.
Alternative Names: Talipes equinovarus; Talipes
Causes, incidence, and risk factors: Clubfoot is the most common disorder of the legs that children are born with. It can range from mild and flexible to severe and rigid. The cause is not known, but the condition may be inherited in some cases. Risk factors include a family history of the disorder and being male. It occurs in about 1 per 1,000 live births.
Symptoms: The physical appearance 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.
Signs and tests: The disorder is identified during a physical examination. A foot x-ray may be performed.
Treatment: A clubfoot may be treated by manipulating the foot into a correct position, and casting the foot to maintain the position. This is often done by an orthopedic specialist. The procedure should be started as early as possible -- ideally, shortly after birth -- when reshaping the foot is easiest. Gentle manipulation (stretching) and recasting occurs every week to improve the position of the foot. Generally, 5 - 10 casts are necessary. The final cast remains in place for 3 weeks. After the foot is realigned, the correction is maintained with a special type of brace, consisting of shoes attached to a bar. The best results are obtained when the brace is worn nearly fulltime for 3 months, and then at night and during naps for up to 3 years. Some severe cases of clubfoot will require surgery if the manipulation process is not successful, or if the deformity returns. Continued evaluation is recommended until the foot is fully grown.
Expectations (prognosis): The outcome is usually good with treatment.
Complications: Some defects may not be totally correctable, but with treatment the appearance and function of the foot can be improved. The treatment may be less successful if the clubfoot is associated with other birth disorders.
Calling your health care provider: If your child is being treated for clubfoot, call your health care provider if swelling, bleeding, or change in color of the toes occurs under the cast, if the toes disappear into the cast, if the cast slides off, or if the foot begins to turn in again after treatment.
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