HealthWACH: Clubfoot


Clubfoot describes a range of foot abnormalities that is usually present at birth in which a babyâ??s foot is twisted out of shape or position. In clubfoot, the tissues that connect muscles to the bone (tendons) are shorter than usual. The term â??clubfootâ?? refers to the way the foot is positioned at a sharp angle to the ankle, similar to the head of a gulf club. It can be mild or severe. About half of children with clubfoot have it in both feet. If a child has clubfoot, walking normally will be difficult. So, doctors recommend treating it soon after birth.

If a baby has clubfoot, his or her foot may have the following appearance:

· The foot may be turned so severely that it actually looks as if itâ??s upside down.

· The calf muscles are usually underdeveloped.

· The top of the foot is usually twisted downward and inward, increasing the arch and turning the heel inward.

· The affected foot may be up to half an inch shorter than the other foot.

Stretching and casting, Ponseti Method, is the most common treatment for clubfoot. The doctor will move the babyâ??s foot into a correct position and then place it in a cast to hold it in that position. Then, the doctor will reposition and recast the babyâ??s foot once or twice a week for several months. Towards the end of this process, the doctor will perform a minor surgical procedure to lengthen the Achilles tendon. After the shape of the foot is realigned, parents will need to maintain it by doing stretches with their baby, putting them in special shoes and braces, and making sure they wear them as long as needed (usually three months at the most). Another approach is called the functional method or the physiotherapy method, which consists of stretching and taping. For this method parents work with physical therapist. First, they move the foot daily and hold it in position with adhesive tape. When the baby is asleep, a machine continuously moves the babyâ??s foot. After two months, treatment is cut back to three times a week until the baby is six months old. Once the shape is corrected, parents still perform daily exercises and use night splints until the baby is old enough to walk. This method requires a much greater time commitment than the Ponseti Method.