Clubfeet

Clubfoot is a common foot deformity present at birth, wherein one or both the feet are turned inward and downward. It is also called as talipes equinovarus and is more common in boys than girls.

Clubfoot is of two types:

• Postural or positional clubfoot: This occurs as a result of the abnormal positioning of the fetus in the mother’s womb. The foot is flexible and can be moved to a near normal position after birth.
• Rigid or fixed clubfoot: The muscles at the back of the lower leg become very tight, making the foot stiff and rigid.

Although clubfoot does not cause any pain, it can affect the physical appearance and the child’s ability to walk. Children with clubfeet may have abnormal feet where

• The foot may be slightly smaller than normal
• The front of the foot may be twisted toward the other foot
• The muscles in the lower leg may be stiff, affecting the range of motion

The exact cause of clubfoot is unknown. Genetic and environmental factors may play a role in the development of the condition. Other congenital malformations, such as spina bifida, may also cause clubfoot.

Treatment options include:

Stretching and casting: It is also known as the Ponseti method. The foot is manipulated into the correct position and a cast is placed to maintain that position. Repositioning and recasting are repeated for every 1 to 2 weeks for 2 to 4 months; each time bringing the foot toward the normal position. After realignment of the foot, it is maintained through splinting with braces to keep the foot in the corrected position. The brace is worn for 3 months, following which it is worn only at night for up to 3 years, to maintain the correction.

Clubfoot repair: It is the surgical repair that involves lengthening or shortening the tendons (tissues that help attach muscles to bones) of the foot.

Osteotomy: It is a surgical procedure where a part of the bone is cut to shorten or lengthen its alignment. The procedure involves the removal of a wedge-shaped bone located near the damaged joint, and joining and securing the remaining bones together with staples or pins.