Introduction
Clubfoot, also known as congenital talipes equinovarus, is a condition where the foot's position turns inwards. The bottom of the foot can point sideways or upwards, depending on how severe the condition is.
The condition develops while your baby is growing during pregnancy. It happens when the tendons that connect muscles to bones are shorter than usual. This causes the foot to twist inwards.
Clubfoot is more common in male babies, and around half of babies with clubfoot will have both feet affected.
Clubfoot is a treatable condition, and it will not stop your child from developing and moving normally. The condition will not improve on its own, so your child must get treatment early.
Signs and symptoms
Signs that your baby has clubfoot on one or both feet include:
- the top of the foot is twisted down and inward
- the arch of the foot is higher than normal
- the foot appears to be upside down
- the leg or foot appears shorter than the other
- the calf muscles in the leg appear smaller
- stiffness in the ankle joint
- difficulty moving the foot properly.
Diagnosis
Clubfoot can be diagnosed at birth by looking at the foot's shape.
Around half of babies with clubfoot will have their condition picked up by an ultrasound during pregnancy. This usually happens during the 19–20-week scan, where every part of your baby's growing body is checked.
If it is picked up during the scan, your doctor will refer you for another ultrasound with a specialist to ensure no other issues.
Clubfoot does not mean that there will be any issues with the rest of your pregnancy or birth. Your baby will not have any pain from the condition and will be checked by a specialist doctor when born.
Treatment
Clubfoot will not get better on its own. All babies born with clubfoot need treatment to help their feet grow normally. Treatment should be done early as your baby's muscles and ligaments are elastic and easy to move.
Your baby will be referred to a paediatric orthopaedic surgeon. This is a specialist doctor who looks after bones in babies and children. Your child will also go to a specialist physiotherapy clinic. Treatment can start a few weeks after your baby is born when you get settled at home.
The Ponseti method is the most common treatment program for clubfoot, done in two stages.
Casting
Your baby's treating team will gently stretch the foot before putting on a new cast that gently holds the foot in an adjusted position. Each cast will move the foot closer and closer to the correct position. This treatment should last about 6 weeks and should not be painful for your child.
Once the final cast is finished, your child may have a small procedure done to release their Achilles tendon. The Achilles tendon is the thick cord that attaches the calf muscles to the back of the heel. Releasing a tendon means it is cut through to let it move better.
Once the tendon procedure is done, your child will have a final cast put on, which will last for 3 weeks.
The Ponseti method can take some time but has been proven to give excellent results.
After your child is successfully treated, they should achieve all their typical developmental milestones with no pain.
Bracing
Following conclusion of Ponseti casting, your child may require ongoing Orthotic management dependent on your child’s needs.
Management
After your child is successfully treated, they should achieve all their typical developmental milestones with no pain.
Your child will have regular checks with their doctor until they stop growing to make sure their foot is still in the correct position and is moving properly. Some children may need more treatment as they grow.