Clubfoot is a birth defect. Even though it is one of the more common birth defects, but you will not see children struggling to walk with clubfoot in America, because doctors have a very reliable way of fixing this condition. Treatment starts soon after birth and it rarely requires major surgery. For most children, clubfoot has already been corrected before it is time to start walking.
What Is Clubfoot?
Clubfoot occurs in about one out of 1,000 babies. A baby born with clubfoot has the foot turned inwards at the ankle. The outside of the foot faces down and the sole of the foot is turned up toward the body. A child with untreated clubfoot would have to walk on the outside of the foot. About half of children born with clubfoot have clubfeet, both feet are affected.
Clubfoot is usually an isolated – also called idiopathic – birth defect, and babies have no other medical problems. Less commonly, it may be part of a more serious neuromuscular condition called nonisolated or syndrome clubfoot. These conditions include spina bifida and cerebral palsy.
The cause of isolated clubfoot is not known. It may be a genetic defect that causes the tendons attaching muscles to the foot to be too tight. Although it may run in families, it usually occurs without any family history. Boys are twice as likely to be born with clubfoot, and if you have one child with clubfoot, there is a higher risk that another child will be born with clubfoot.
What to Do?
In most cases, you will know about clubfoot before your baby is born, so you will be ready to start treatment soon after birth. By 24 weeks of pregnancy, 80 percent of babies with clubfoot can be diagnosed from a prenatal ultrasound.
Treatment almost always goes something like this:
- The baby’s foot is gently stretched into the correct position and held in place with a full leg cast.
- Every week or every few weeks, the cast is removed, the foot is stretched again and the cast is replaced.
- After 6 to 8 weeks of stretching and casting, a minor surgical procedure is usually done to release a tight tendon attached to the baby’s heel (Achilles tendon). This is done with a local anesthetic through a tiny incision. No stitches are needed. The cast is then replaced for another 3 weeks.
- After 3 weeks, the cast is removed and the baby will start to wear a brace that keeps the foot in the correct position. The brace is usually made of baby shoes attached to a bar.
- The brace is worn for 23 hours every day for about 3 months.
- After 3 months, use of the brace can be reduced to sleeping and nap times.
- At age 6 months, there is no brace when the baby is awake and most babies will start to crawl and walk at about the same time as babies without clubfoot.
- Bracing at night will continue for another two to four years to prevent the foot from clubbing again.
- During the bracing period, it is very important for parents to follow all their doctor’s directions for bracing and to keep all follow-up appointments.
Most children with clubfoot will have good results from casting and bracing. They will go on to develop and play normally. The clubfoot may be bit smaller and stiffer than a normal foot, but should be hardly noticeable. Reconstructive surgery is always a last resort, but may be needed for severe clubfoot or clubfoot that reoccurs after casting and bracing.
Learning that your baby will be born with clubfoot can be difficult for any parent, but you should be assured that treatment is very successful. It will take a lot of effort on your part during the early years of bracing. But if you stick with it, your child will have an excellent chance of living a full and active life with a foot that looks normal and functions well.