Clubfoot describes a range of foot abnormalities usually present at birth (congenital) in which your baby's foot is twisted out of shape or position. In clubfoot, the tissues connecting the muscles to the bone (tendons) are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn.
Clubfoot can be mild or severe. About half of children with clubfoot have it in both feet. If your child has clubfoot, it will make it harder to walk normally, so doctors generally recommend treating it soon after birth.
Doctors are usually able to treat clubfoot successfully without surgery, though sometimes children need follow-up surgery later on.
If your child has clubfoot, here's what it might look like:
Despite its look, clubfoot itself doesn't cause any discomfort or pain.
More than likely your doctor will notice clubfoot soon after your child is born, based on appearance. Your doctor can advise you on the most appropriate treatment or refer you to a doctor who specializes in bone and muscle problems (pediatric orthopedist).
The cause of clubfoot is unknown (idiopathic), but it may be a combination of genetics and environment.
Boys are about twice as likely to develop clubfoot than girls are.
Risk factors include:
Clubfoot typically doesn't cause any problems until your child starts to stand and walk. If the clubfoot is treated, your child will most likely walk fairly normally. He or she may have some difficulty with:
However, if not treated, clubfoot causes more-serious problems. These can include:
Because doctors don't know what causes clubfoot, you can't completely prevent it. However, if you're pregnant, you can do things to limit your baby's risk of birth defects, such as:
Most commonly, a doctor recognizes clubfoot soon after birth just from looking at the shape and positioning of the newborn's foot. Occasionally, the doctor may request X-rays to fully understand how severe the clubfoot is, but usually X-rays are not necessary.
It's possible to clearly see most cases of clubfoot before birth during a routine ultrasound exam in week 20 of pregnancy. While nothing can be done before birth to solve the problem, knowing about the condition may give you time to learn more about clubfoot and get in touch with appropriate health experts, such as a pediatric orthopedic surgeon and a genetics counselor.
Because your newborn's bones, joints and tendons are very flexible, treatment for clubfoot usually begins in the first week or two after birth. The goal of treatment is to improve the way your child's foot looks and works before he or she learns to walk, in hopes of preventing long-term disabilities.
Treatment options include:
This is the most common treatment for clubfoot. Your doctor will:
After the shape of your baby's foot is realigned, you'll need to maintain it with one or more of the following:
For this method to be successful, you'll need to apply the braces according to your doctor's directions so that the foot doesn't return to its original position. The main reason this procedure sometimes doesn't work is because the braces are not used as directed.
If your baby's clubfoot is severe or doesn't respond to nonsurgical treatments, more-invasive surgery may be needed. An orthopedic surgeon can lengthen or reposition tendons and ligaments to help ease the foot into a better position. After surgery, your child will be in a cast for up to two months, and then need to wear a brace for a year or so to prevent the clubfoot from coming back.
Even with treatment, clubfoot may not be totally correctable. But in most cases, babies who are treated early grow up to wear ordinary shoes and lead full, active lives.
If your baby is born with clubfoot, he or she will likely be diagnosed soon after birth. In some cases, your baby's doctor may refer you to a pediatric orthopedist.
If you have time before meeting with your child's doctor, make a list of questions to ask. These may include:
In addition, tell your doctor:
Preparing and anticipating questions will help you make the most of your time with the doctor.
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