Clubfoot

What is clubfoot? 

Clubfoot is a condition that causes either one foot or both feet (clubfeet) to point inward and the heel to point downward.  It is a condition that a baby is born with. Clubfoot is caused by tight muscles and tendons around the ankle that force the foot into a rotated position. It affects the bones, muscles, tendons and blood vessels.  

About half of babies with clubfoot have the condition in both feet. Although clubfoot is not painful, it can cause problems walking if not treated. With treatment, babies with clubfoot can grow to have normal function of their feet and can walk and play normally.  

What are the signs and symptoms of clubfoot? 

Clubfoot is often diagnosed before birth during a routine ultrasound. If clubfoot is not found during pregnancy, it is diagnosed during a physical exam at birth.   

• Instead of being straight, a clubfoot points down and turns in. This twisting causes the toes to point toward the opposite leg.
• In some cases, the bottom of the foot can face sideways or up.  
• If the condition is only in one foot, the calf muscle may be smaller or the leg may be shorter on the side with clubfoot.  

Babies born with clubfoot may have an increased risk of developing developmental dysplasia of the hip, where the thigh bone slips in and out of the hip socket.  

What causes clubfoot? 

In most cases of clubfoot, experts do not know the exact cause. This is known as idiopathic clubfoot. Clubfoot may have genetic factors and can run in families. Clubfoot is more common in boys than girls.  

In some cases, clubfoot occurs as part of a larger syndrome or because of a neuromuscular disease, such as cerebral palsy or spina bifida.  

 

How is clubfoot treated? 

Your care team at Arkansas Children’s is experienced in treating clubfoot and clubfeet in children and will work with you to create the best treatment plan for your child. 

• Most cases of clubfoot are treated using the Ponseti method. Treatment should be started as soon as possible, ideally within a month of birth. 
• The purpose of the Ponseti method is to slowly correct the position of the foot or feet using casts. This is done by gently stretching the affected foot, then placing a cast over the foot, ankle and leg to hold the foot in place. This is repeated every week until the foot is correctly positioned. 
• Before the cast process is complete, most babies will need a minor surgery to lengthen the Achilles tendon, called tenotomy. Then, a final cast will be placed to allow the tendon to heal.  
• After the final cast is removed, your child will wear a brace for 22 to 23 hours a day for about three months to keep the feet positioned correctly. Gradually, the bracing time will be reduced to overnight and during naps only until they are about age 4 or 5.