Clubfoot
One of the most common birth defects, clubfoot affects a child’s foot and ankle, twisting the heel and toes inward. It may look like the top of the foot is on the bottom. The clubfoot, calf and leg are smaller and shorter than normal. Clubfoot is not painful and is correctable. Approximately one in every 1,000 newborns has clubfoot. Of those, one in three have both feet clubbed.
Causes
No one knows why it happens, but babies have been born with clubfoot for many hundreds of years. Two out of three clubfoot babies are boys. Clubfoot is twice as likely if you, your spouse or your other children have also developed clubfoot. Less severe infant foot problems are common and are often incorrectly called clubfoot.
Symptoms and Diagnosis
You will know immediately if your newborn has clubfoot by the position and appearance of the foot, which may appear as if the top of the foot is on the bottom. If your child’s clubfoot is not treated, he or she will have a severe functioning disability.
Treatment
The treatment goal is to make your newborn’s clubfoot (or feet) functional, painless and stable by the time he or she is ready to walk. Doctors start by gently stretching your child’s clubfoot toward the correct position. They put on a cast to hold it in place. One week later, they take off the cast and stretch your baby’s foot a little more, always working it toward the correct position. They apply a new cast each week in a process called serial casting, which slowly moves the bones in the clubfoot into proper alignment. Doctors use X-rays to check the progress of the bones’ alignment. Casting is generally repeated for 6-12 weeks, and may take up to four months.
About half the time, your child’s clubfoot straightens with casting. If it does, he will be fitted with special shoes or braces to keep the foot straight once corrected. These holding devices are usually needed until your child has been walking for up to a year or more. Muscles often try to return to the clubfoot position. This is common when your child is 2-3 years old, but may continue up to age 7.
Sometimes stretching, casting and bracing is not enough to correct your baby’s clubfoot. He may need surgery to adjust the tendons, ligaments and joints in the foot/ankle.