Clubfoot, or talipes equinovarus, is a congenital deformity characterized by a twisted foot that appears rotated internally at the ankle. The condition can affect one or both feet and is present at birth. The exact cause of clubfoot is unknown, but it is thought to be a combination of genetic and environmental factors.

Common Symptoms

• Abnormal Foot Position: The foot is turned inward and downward, and the toes point toward the opposite leg.
• Rigid and Stiff Foot: The affected foot is typically less flexible and stiffer than normal.
• Shortened Achilles Tendon: The tendon at the back of the heel is often tighter and shorter.
• Calf Muscle Underdevelopment: The calf muscles of the affected leg may be smaller than those of the unaffected leg.

Cause & Anatomy

• Genetic Factors: Family history of clubfoot increases the risk.
• Environmental Factors: Conditions during pregnancy, such as oligohydramnios (low amniotic fluid), may contribute.
• Neuromuscular Disorders: Conditions such as spina bifida can be associated with clubfoot.
• Idiopathic: In many cases, the cause is unknown and not associated with any other medical condition.

Diagnosis

• Prenatal Ultrasound: Clubfoot can often be detected before birth during routine ultrasound examinations.
• Physical Examination: Post-birth examination of the foot’s position, flexibility, and appearance confirms the diagnosis.
• X-rays: Occasionally used to assess the severity and plan treatment.

Prevention

Early Detection and Treatment: Early diagnosis and intervention can improve outcomes and reduce the need for surgery.

Treatment

Ponseti Method:

• Serial Casting: Gentle manipulation and weekly casting to gradually correct the foot position.
• Achilles Tenotomy: A minor procedure to release the tight Achilles tendon.
• Bracing: After casting, a brace is worn to maintain correction and prevent recurrence.

French Functional Method:

• Physical Therapy: Daily stretching, strengthening, and mobilization exercises.
• Taping and Splinting: To maintain the correct position after therapy sessions.

Surgery

• Extensive Soft Tissue Release: Surgical correction may be necessary for severe cases or when non-surgical methods are ineffective. This involves releasing tight tendons and ligaments.
• Tendon Transfers: Moving tendons to improve foot function and appearance.
• Osteotomy: Cutting and repositioning bones to correct deformity.

Rehabilitation

• Physical Therapy: Post-treatment therapy focuses on maintaining flexibility, strength, and function.
• Regular Follow-Up: Monitoring the child’s growth and development to ensure continued correction and address any recurrence.

FAQ’s

What is the success rate of the Ponseti method?
The Ponseti method has a success rate of over 90% when started early and followed correctly.

Can clubfoot recur after treatment?
Recurrence can happen, especially if bracing is not followed diligently. Regular follow-up and adherence to treatment protocols are crucial.

Can children with treated clubfoot lead normal lives?
Yes, with proper treatment, most children with clubfoot can walk, run, and lead active, normal lives.

Is clubfoot painful for infants?
Clubfoot itself is not painful for infants, but untreated clubfoot can lead to discomfort and difficulty walking as the child grows.

Are there long-term effects of clubfoot?
With effective treatment, long-term effects are minimal. However, the affected foot and leg may be slightly smaller, and there may be minor residual stiffness.