Introduction
Congenital talipes equinovarus, or clubfoot, is a condition where the foot turns inwards, causing the bottom of the foot to point sideways or upwards.
Clubfoot develops during pregnancy. It happens when the tendons that connect muscles to bones are shorter than normal, causing the foot to twist inward.
Clubfoot is more common in male babies, and around half of babies with clubfoot have it in both feet.
Although clubfoot is treatable, it won't get better on its own. Early treatment is important to ensure your child develops and moves well.
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
During pregnancy
Around half of babies born with clubfoot will be diagnosed by an ultrasound during pregnancy.
This usually happens at the 19-20-week scan, where each part of the growing baby's body is checked.
If clubfoot is found during the scan, your doctor will refer you to a specialist for another ultrasound to make sure there are no other issues.
Clubfoot does not affect the rest of your pregnancy or birth, and your baby will not have any pain from the condition.
A specialist doctor will check your baby when they are born.
At birth
Clubfoot is diagnosed at birth by looking at the shape of your baby’s feet.
Treatment
Clubfoot will not get better on its own, but it can be treated.
Treatment should start early, usually a few weeks after they are born. This is so their muscles and ligaments are still flexible and easy to move.
The first step is to see a specialist doctor who looks after bones in babies and children. This doctor is called a paediatric orthopaedic surgeon. Your child will also need to go to a specialist physiotherapy clinic.
The most common treatment method for clubfoot is called the Ponseti method.
The Ponseti method can take some time but is proven to treat clubfoot effectively.
After successful treatment, your child should be able to reach all their developmental milestones without any pain.
Casting
After each cast is removed, the foot is gently stretched before a new cast is applied. This process is repeated until the foot is in the correct position, which usually takes around 6 weeks.
Once the final cast is removed, your child may need a small procedure to cut and release the Achilles tendon to improve movement. The Achilles tendon is a thick cord that attaches the calf muscles to the back of the heel.
After the procedure, your child will have a final cast put on, which will stay in place for 3 weeks.
Bracing
After casting is finished, your child may need to wear a brace to help their feet stay in the correct position.
Your child will see a specialist called an orthotist who will manage your child’s brace based on their individual treatment needs.
Management
Follow-up care
After treatment, your child will continue to have regular checks with the doctor until they stop growing to make sure their foot stays in the correct position and works properly.
Some children may need more treatment as they grow.