Clubfoot
What is Clubfoot?
Clubfoot is a birth deformity in which an infant’s foot is turned inwards. This is caused by the tendons in the baby’s legs and foot, whereby the tendons are shorter and tighter than it should be, causing the feet to twist inwards. Clubfoot is not painful during infancy, however, if left untreated, the foot will remain deformed and could impair the child’s walking abilities. There are two types of clubfoot:
1. Isolated or idiopathic clubfoot
This indicates that the child has clubfoot but no other underlying medical issues, and the cause of the condition is unknown.
2. Non isolated clubfoot
This indicates that there are other medical conditions occurring alongside the clubfoot. Some of these conditions typically include a joint problem or spina bifida.
Who is at Risk?
Since clubfoot is a congenital birth deformity, the following factors pose a higher risk of your child developing clubfoot:
- Gender (males have a higher chance of developing this condition)
- Family history
- Genetic condition (e.g., Trisomy 18, Edward syndrome)
- Other birth defects (e.g., Spina bifida or cerebral palsy)
- Inadequate amniotic fluid during pregnancy
Causes of Clubfoot
The causes of clubfoot remain unknown, but they could be due to a combination of genetics and environmental factors such as smoking or drug use.
Symptoms of Clubfoot
The most common sign of clubfoot is one or both feet are turned inwards. Other symptoms include:
- Kidney-shaped feet
- Deep crease on the inside
- High arch
- Smaller calf muscle
- Shorter foot
- Ankle stiffness
- Limited range of foot motion
How Does Clubfoot Affect My Baby?
Although clubfoot is not painful, if left untreated, the condition can impair your child’s walking and standing abilities. Untreated clubfoot can also lead to:
- Foot infections
- Foot problems such as calluses
- Arthritis
When should I seek help?
If you notice the symptoms and signs indicating clubfoot, it is recommended to seek medical help to correct it quickly. Untreated clubfoot can have negative impacts on your child’s walking abilities, and it is crucial to begin treatment as early as possible to avoid future complications.
Treatment Options
The aim of the treatment is to ensure a functional, pain-free foot that allows standing and walking with sole of the foot flat on the ground. Since a newborn’s bones, joints and tendons are malleable, treatment usually involves correcting the feet. Some correction options include:
1. Ponseti method
This method involves moving the baby’s foot into the correct position and placing it in a cast to correct the deformity. After manipulation and casting of the foot, a minor procedure known as Achilles tenotomy is required to release the tightness in the Achilles tendon by making a small cut. The cut is very small and does not require stitches. Once the cast is removed, the Achilles tendon would have regrown to its proper length. Next, to ensure that the foot is permanently in the correct position, your child will need to wear a brace. Bracing helps keep the foot at the proper angle to maintain the correction and prevent the condition from recurring.
2. French method
This method is similar to the Ponseti method but utilises splinting and taping instead of casting. Furthermore, Achilles tenotomy will be required to improve dorsiflexion of the ankle. Constant stretching, taping, and splinting are required to prevent the condition from recurring. This usually lasts until the child is 2 to 3 years old.
Can Clubfoot Be Prevented?
Clubfoot cannot completely be prevented. However, if you are pregnant, it is advisable to avoid smoking, alcohol intake, and drug use, to help lower the risk of birth defects such as clubfoot.