Clubfoot
What is clubfoot in children?
Clubfoot is a deformity of the foot. It’s when one or both feet are turned inward.
The condition affects the bones, muscles, tendons, and blood vessels. Clubfoot is
present at birth. It tends to affect more boys than girls.
What causes clubfoot in a child?
A combination of things may lead to clubfoot. It is partly genetic.
This means it tends to run in families. It may also be environmental.
Which children are at risk for clubfoot?
A child with a family history of clubfoot is more likely to develop it. Other risk
factors are:
- Multiple births such as twins or
triplets
- Position of the baby in the uterus
- Nervous system disorders such as
cerebral palsy and spina bifida
- Less amniotic fluid surrounding the baby in the uterus (oligohydramnios) during pregnancy
Babies born with clubfoot may also
have a higher risk for developmental dysplasia of the hip (DDH). This health problem
affects the hip joint. The top of the thighbone (femur) slips in and out of the hip
socket because the socket is too shallow.
What are the symptoms of clubfoot in a child?
The symptoms of clubfoot are:
- The foot is usually short and broad in appearance.
- The heel points downward while the front half of the foot (forefoot) turns inward.
- The heel cord (Achilles tendon) is tight.
- The heel can appear narrow.
- The calf muscles are smaller compared with a normal lower leg.
How is clubfoot diagnosed in a child?
Your child’s healthcare provider makes the diagnosis of clubfoot at birth with a physical
exam. During the exam, your child’s healthcare provider may ask about your child’s
birth history and if other family members are known to have clubfoot.
If the diagnosis of clubfoot is
made in an older infant or child, your child’s healthcare provider may ask about
developmental milestones. Clubfoot can be linked to other disorders. Developmental
delays may need more follow-up to look at an underlying problem.
Your child may also need X-rays.
How is clubfoot treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
The goal of treatment is to
straighten the foot so that it can grow and develop more normally. Without treatment,
your child would have trouble walking. Treatment choices include:
- Nonsurgery treatments. These are usually tried first no
matter how severe the deformity is. The most common treatment in the U.S. is the
Ponseti method. It uses gentle stretching and a cast to gradually fix clubfoot. It
often takes about 2 to 3 months. Other methods include taping, physical therapy, and
splinting.
- Braces. Because clubfoot may happen again, your child will
have to wear braces for several years to prevent relapse. At first, the braces are
worn for 23 hours a day for up to 3 months. Then they are worn at night for 2 to 4
years.
- Surgery. Your child may need surgery if other treatments
don't fix clubfoot. The specific surgery depends on the type and extent of the
deformity. Your child may need surgical wires, pins, or a cast to keep the foot in
place until it has healed.
Most infants with clubfoot don’t need surgery. Those who do may need more than one
surgery because the deformity may come back as the child grows and develops.
Key points about clubfoot in children
- Clubfoot is a deformity of the foot
and lower leg. It’s when one or both feet are turned inward.
- Children with a family history of the condition are more likely to be born with it.
- Clubfoot causes the heel to point downward while the front half of the foot (forefoot)
turns inward. The foot is usually short and broad in appearance.
- Most cases of clubfoot are diagnosed at birth.
- Treatment includes stretching and casting. Your child may need surgery if other methods
don’t work.
Next steps
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.
Online Medical Reviewers:
- Raymond Kent Turley BSN MSN RN
- Thomas N Joseph MD