About clubfoot

Clubfoot is a structural problem with the foot. In a baby with clubfoot, the foot is twisted out of its normal position. The foot can’t be moved into a normal position.

Clubfoot happens in approximately 1 in 1000 births. Clubfoot can affect one or both feet.

Its medical name is congenital talipes equinovarus.

Clubfoot symptoms

If your baby has clubfoot, his foot points downwards and inwards like a golf club. The middle section of your baby’s foot also twists inwards, which makes the foot look short and wide.

There are usually deep creases on the inside of the foot and back of the heel.

Your baby might also have poorly developed calf muscles.

Positional talipes is a condition that’s similar to clubfoot. But with positional talipes, the foot can be gently moved into a normal position. It’s milder than clubfoot and usually fixes itself without treatment.

Diagnosis of clubfoot

Clubfoot can be diagnosed at the 20-week ultrasound scan, which is a standard test in pregnancy.

Sometimes a midwife or paediatrician will diagnose clubfoot when a baby is born.

If your baby is diagnosed with clubfoot, you’ll see a paediatric orthopaedic surgeon.

Sometimes children with clubfoot also have developmental dysplasia of the hip. When babies are born, the doctors always check their hips carefully and if the doctor is concerned that your baby has developmental dysplasia of the hip, he will  refer your baby for a hip ultrasound.

Treatment for clubfoot

Treatment for clubfoot usually begins shortly, ideally within a week or two after birth. It involves using plaster casts to gradually put the foot back into its correct position. The plaster casts are changed weekly for 6-8 weeks.

Babies then need to have a procedure to lengthen their Achilles tendons, followed by another plaster cast for 2-3 weeks.

After the plaster cast treatment is finished, babies wear a brace to hold feet in the correct position. This part of the treatment goes on until children are around four years old.

Careful follow-up is essential, because the condition might come back.

With early specialist treatment, most children born with clubfoot will go on to crawl, walk and run at similar ages to other children. They can usually wear normal shoes, lead active lives and take part in sports.

Causes of clubfoot

Clubfoot is a congenital condition. This means it’s present at birth. It happens when a baby’s foot and leg muscles, ligaments and tendons don’t develop properly while the baby is in the womb.

Clubfoot is thought to be a genetic condition. It happens twice as often in boys than girls. Sometimes clubfoot happens along with other conditions like trisomy 18, spina bifida and cerebral palsy.

Smoking during pregnancy increases the risk of clubfoot in babies.

Another cause is not enough amniotic fluid during pregnancy: Too little of the fluid that surrounds the baby in the womb may increase the risk of clubfoot.