Pediatric Clubbed Foot

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.

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.

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 around the baby in the uterus (oligohydramnios) during pregnancy

Babies born with clubfoot may also have a higher risk for developmental dysplasia of the hip. 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.

Your child’s healthcare provider makes the diagnosis of clubfoot at birth with a physical exam. During the exam, your child’s 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.

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:

• Nonsurgical treatment. These are often 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 casting to slowly fix clubfoot. It often takes about two to three 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 three months. Then they are worn at night for two to four years.
• Surgery. Rarely, 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.