What Parents Should Know About Clubfoot

Any baby can seem perfect to loving parents, but approximately one in every 1,000 come into this world with a clubfoot. This kind of birth defect can make normal walking impossible later in life, so early treatment is a must.

If you worry about your baby’s clubfoot, you can start by learning as much as you can about this problem, from its causes and variations to the available surgical and non-surgical treatments for it. Start by absorbing the following key points about clubfoot and its correction.

Clubfoot Has Some Distinctive Characteristics

The term clubfoot refers, not to one specific ailment, but to various deformities that can twist the foot into an unnatural position. A baby with clubfoot has a foot that turns inward, sometimes to the point that it appears upside down. The bottom of the affected foot often displays a deep crease.

Clubfoot can occur in either one foot or both feet. In some cases, the leg attached to the affected foot may look slightly shorter than the other leg. The affected leg may also lack normal muscle development in the calf.

Clubfoot Stems From a Variety of Causes

The most direct cause of clubfoot stems from an abnormally short Achilles tendon, the tendon that connects the calf muscle to the heel. An Achilles tendon of normal length makes normal foot alignment and mobility possible, while a too-short Achilles tendon will pull the foot into a twisted position and hold it there. 

Clubfoot can either occur in the womb or develop early in an infant’s life. Congenital clubfoot may stem from prenatal issues such as low levels of amniotic fluid or the use of tobacco products during pregnancy. Babies may inherit clubfoot if the condition runs in the family.

Clubfoot can also have an underlying neuromuscular cause. Conditions such as spina bifida (a spinal defect that exposes the spinal cord), spinal nerve compression, or cerebral palsy may lead to clubfoot. Doctors refer to this category of clubfoot as neurogenic clubfoot. Other underlying syndromes may occasionally cause clubfoot.

Clubfoot Often Responds to Non-Surgical Treatment

Don’t assume right away that your baby needs surgery to correct a clubfoot. Many cases can respond nicely to conservative treatment methods. Your pediatric orthopedist will almost certainly recommend non-surgical approaches that involve braces or casts as the first line of treatment, preferably as early in life as possible.

Most orthopedic specialists rely on the Ponseti method for correcting clubfoot issues. Thanks to the tremendous flexibility of a baby’s tendons, your doctor can gently manipulate the foot into the correct position before encasing the foot (and the entire leg) in a cast. Your baby will wear this cast for six to eight weeks.

Most babies who complete this initial phase of clubfoot treatment will then receive a minimally invasive procedure called a tenotomy. The doctor makes a small cut in the Achilles tendon which will encourage it to lengthen as it heals. Three more weeks in a cast usually follow the tenotomy.

Even after these weeks in a cast have brought your baby’s foot into a more normal configuration, the foot will probably drift back into its previous position unless the doctor applies a brace. Your baby will wear a brace night and day over the next few formative growing years until the correction takes a permanent form.

Clubfoot Surgery May Succeed If Non-Surgical Treatment Fails

An unusually severe or stubbornly recurring case of clubfoot may resist conservative treatment techniques. If so, your pediatric orthopedic specialist can perform surgery to correct the foot’s position, although it may leave the foot with a certain degree of stiffness.

Clubfoot surgery can take several forms. Your baby may only need modifications to the Achilles tendon and whatever other connective tissues may contribute to the problem. However, some cases benefit from major reconstructive surgery.

Arizona Institute of Motion can successfully treat a wide range of foot problems in patients of all ages, including clubfoot in babies. Contact our office to discuss your child’s condition with us and schedule an initial evaluation.