What Is Clubfoot?
Clubfoot occurs when a foot and ankle
are permanently twisted. In clubfoot, the ligaments and tendons that hold the
muscles to the bones are too tight. This causes the tissues around the ankle to
hold the foot in an abnormal position. Clubfoot resembles the head of a golf
club, which is how it got its name.
Clubfoot is a congenital deformity,
which means you’re born with the condition. Doctors usually diagnose it
immediately after birth. It's important to diagnose it as soon after birth as
possible and start treatment. If you get treatment early, it’s more likely to
be an easier and successful.
The causes of clubfoot are unclear,
but the risks of being born with it are higher if:
- you’re male
- your mother smoked during pregnancy
- someone else in your family has clubfoot
- you have spina bifida or other spinal cord
How Is Clubfoot Repaired?
can be repaired by casting or surgery.
Sometimes nonsurgical treatments, such
as casting, can correct clubfoot. Casting is a method
for correcting clubfoot in the hopes of avoiding surgery.
The Ponseti method is the most common
technique used. In this treatment, your doctor gently stretches your foot into
a more normal position and secures it with a cast. Every few days or weeks, the
foot’s position is stretched even more towards a normal position and the cast
Over the course of six to eight weeks,
clubfoot may be corrected without surgery. Casting is more successful for those
with mild clubfoot and those treated within the first two weeks of birth.
Babies and older patients who have
severe clubfoot may not respond to casting. They need surgery to correct the
During surgery, your surgeon lengthens
the Achilles tendon near the heel and releases tissues elsewhere in the foot.
They may also need to do a tendon transfer. These incisions loosen the tight
ligaments and tendons so that your surgeon can then manipulate your foot into a
normal position. A tendon transfer allows the foot to move in a more normal
Older children and adults are often
less flexible than babies and may require more extensive repair. It may require
several surgeries. Your surgeon might need to cut into the bone to turn the
foot. Cutting into the bone is called an osteotomy. In these cases, metal
plates or screws may be used to hold the foot in the correct position. Once
your foot and ankle are securely placed, your surgeon puts your leg in a cast.
Clubfoot repair is performed under a
general anesthetic. You’re asleep and don’t feel pain during the procedure.
Medication will help you manage the pain after surgery.
Clubfoot patients remain in the
hospital for up to three days after surgery. The casted leg stays elevated to
reduce swelling. Your child may be asked to wiggle their toes to make sure
blood flow to their foot isn’t interrupted.
Casting is an important part of the
recovery process. You’ll wear a cast for as long as three months to allow the
incisions, tendons, and bones to heal. The cast may need to be replaced several
times, especially for infants and toddlers who grow quickly. After the cast is
removed, the foot should look more like a normal foot and function better.
Physical therapy plays a crucial role
in the success of clubfoot surgery. Foot exercises help restore flexibility,
range of motion, and muscle tone to the leg. Many people who have clubfoot have
underdeveloped calf muscles in the affected leg. Even after surgery, the
muscles may remain permanently smaller than in the healthy leg.
Some people must wear a brace after
clubfoot surgery. The brace helps keep the foot in a more normal position and
assists with normal movement.
Children who undergo clubfoot repair
surgery can lead active lives with few risks. Potential risks associated with this
- nerve damage in the foot
- excessive foot swelling
- an interrupted blood flow to the foot
- the formation of an ulcer from a cast that’s too
The most common complaint people have
after clubfoot repair is stiffness in the foot and ankle. This can result in
arthritis as people age. As children get older and grow, having the surgery
again is sometimes necessary.