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Club Foot


Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which your baby's foot is twisted out of shape or position. The term "clubfoot" refers to the way the foot is positioned at a sharp angle to the ankle, like the head of a golf club. Clubfoot is a relatively common birth defect in children and is usually an isolated problem for an otherwise healthy newborn.
Clubfoot can be mild or severe, affecting one or both feet. Clubfoot will hinder your child's development once it's time for your child to walk, so treating clubfoot soon after birth is generally recommended. Treatment is usually successful, and the appearance and function of your child's foot should show improvement.

Causes of Clubbed Feet

The cause of club feet isn't known (idiopathic). But scientists do know that clubfoot isn't caused by the position of the fetus in the uterus. In some cases, clubfoot can be associated with other congenital abnormalities of the skeleton, such as spina bifida, a serious birth defect that occurs when the tissue surrounding the developing spinal cord of a fetus doesn't close properly.
Environmental factors play a role in causing clubfoot. Studies have strongly linked clubfoot to cigarette smoking during pregnancy, especially when a family history of clubfoot is already present.

 

Symptoms

In most cases, clubfoot twists the top of your baby's foot downward and inward, increasing the arch and turning the heel inward. The foot may be turned so severely that it actually looks as if it's upside-down. Also, the calf muscles in your child's affected leg are usually underdeveloped, and the affected foot may be up to 1 centimeter (about .4 inches) shorter than the other foot. Despite its look, however, clubfoot itself doesn't cause any discomfort or pain.

Treatment for Club Foot

Club foot treatment may involve moving the foot into the correct position and using a cast to keep it there. This is often done by an orthopedic specialist. Treatment should be started as early as possible - ideally, shortly after birth - when reshaping the foot is easiest. Gentle stretching and recasting occurs every week to improve the position of the foot. Generally, five to 10 casts are needed. The final cast remains in place for 3 weeks. After the foot is in the correct position, a special brace is worn nearly full time for 3 months. Then it is used at night and during naps for up to 3 years. Often, a simple outpatient procedure is needed to release a tightened Achilles tendon.
Some severe cases of clubfoot will require surgery if other treatments do not work, or if the problem returns. Children with club foot should be monitored by a doctor until the foot is fully grown.

Possible Complications

Some defects may not be completely fixed. However, treatment can improve the appearance and function of the foot. Treatment may be less successful if the clubfoot is linked to other birth disorders.

Authored By: Dr. S. V. Santpure

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