Your newborn is perfect—healthy weight, 10 fingers, 10 toes, robust crier. You couldn’t be happier. But then you notice that one or both of his feet aren’t straight. Or maybe the condition was diagnosed during one of your prenatal ultrasounds. Either way, you have learned that your baby has clubfoot. What does that mean? Will he grow out of it? Will it prevent him from walking and leading a normal life? We have the answers you need to all of your questions about clubfoot.
What Is Clubfoot?
It’s hard for a parent to hear the word “deformity” when it comes to their newborn, but that is essentially what a clubfoot is. It is a congenital—meaning it is present at birth—abnormality of one or both feet. One in every 1,000 babies born has a clubfoot, making it one of the most common foot deformities in newborns. The name clubfoot comes from the fact that the baby’s foot is turned inward so that the leg and foot resemble a golf club. It is not painful for the infant, and it can be corrected to a certain degree with prompt and consistent treatment over several years. In about half of all cases, both feet are affected—a condition known as bilateral clubfoot. Boys are twice as likely as girls to be born with clubfoot.
What Causes Clubfoot?
Clubfoot is caused by short and tight tendons connecting the leg muscles to the foot bones. It is believed to be primarily a genetic condition, but environmental factors such as positioning in utero or a breech birth can also play a role. The extent of the clubfoot can range from a slight bend in one or both feet to a severe inward turn. Clubfoot also causes the leg to be shorter and the calf muscle to be smaller than average, but this is usually only observable when only one foot and leg are affected.
Your doctor may determine that your baby’s club foot is one of the following:
- Idiopathic. In most cases, clubfoot has no known cause, and the baby has no other medical problems.
- Syndromic. A child born with spina bifida, certain genetic syndromes, cerebral palsy, or arthrogryposis might have clubfeet as a symptom of the medical condition. For this reason, newborns with clubfoot might be screened for other conditions.
Regardless of the cause or severity, treatment for clubfoot must begin soon after birth in order to correct the issue as much as possible.
How Is Clubfoot Treated?
Ideally, treatment should begin before the baby is four weeks old. The most common treatment for clubfoot is the Ponseti method. It is a gradual process that involves stretching the tendons and using casts and braces to hold the foot in progressively straighter positions. The treatment stage will usually look something like this:
- The podiatrist will gently stretch the foot and place a hard cast on the foot, ankle, and leg to hold the foot in the new position.
- This will be repeated every week for about five to eight weeks until the foot is as straight as possible.
- In about 95 percent of cases, a minor surgical procedure will be performed at this stage to lengthen the Achilles tendon.
Following the treatment stage is the bracing stage. Clubfoot bracing lasts for several years and is critically important to the child’s long-term improvement and mobility. The brace consists of a Velcro boot on each foot connected by a bar. For several months, the baby will wear the brace for about 22 hours a day. After that, the baby will wear it at night and while napping, or about 15 hours a day. As the baby begins to crawl and then walk, they can do so without the brace; however, the child will need to spend significant time in the brace until they are about four years old. It is not an easy process, but it is essential to achieve the best outcome for your child.
We Treat Clubfoot in Babies
Our board-certified pediatric foot specialists are available in our state-of-the-art facilities throughout the greater Portland area to treat your newborn’s clubfoot. To schedule an appointment with the Northwest Extremity Specialists, call your nearest office today or drop us a line using our online contact form.