About Club Foot Treatment

The treatment for clubfoot aims to correct the congenital deformities characterized by inward rotation of the ankle and foot. A common method for gradually correcting foot posture is the Ponseti method, which involves gentle manipulation, stretching, and casting of the foot. After casting, the child may require an Achilles tenotomy—a minor surgical procedure to lengthen the tight Achilles tendon. Following this, the child wears boots or braces with a bar at night to maintain the corrected position. Regular follow-up appointments are essential to monitor progress and ensure effective treatment. With early intervention and consistent care, most children can achieve normal foot function and mobility.

Treatment

The treatment process typically involves a series of manipulations, casts, and, in some cases, surgery to realign the foot’s position. Optimal results are achieved with early intervention, generally within the first few weeks of life. As the child grows, braces and stretching exercises may be necessary to maintain the correction and prevent relapse.

Symptoms of Clubfoot

Clubfoot affects a baby’s foot or feet, causing them to twist into an abnormal position. Common symptoms include:

• Foot Position: The most apparent symptom is the twisted appearance of the foot or feet, which may point downward and inward, resembling a club.

• Foot Shape: The affected foot may appear smaller than usual and have an unusual shape, with a high arch and an inward-tilted heel.

• Difficulty Moving: The baby may struggle to move the affected foot or feet, having difficulty bearing weight or achieving normal range of motion.

• Uneven Legs: The affected foot may look shorter or thinner than the other, leading to challenges with walking or standing as the child grows.

• Skin Changes: The skin on the affected foot may appear stretched or wrinkled due to its twisted position, particularly in severe cases.

• Discomfort: While clubfoot does not always cause pain, the abnormal position may lead to discomfort when the child begins walking or wearing shoes.

Causes of Clubfoot

While the exact cause of clubfoot is not fully understood, several factors are believed to contribute:

• Genetics: Clubfoot can run in families. If a parent or sibling had the condition, there is a higher chance it may occur in subsequent generations.

• Family History: A family history of clubfoot increases the risk, making it more likely for the condition to manifest in new family members.

• Abnormal Fetal Position: The baby’s position in the womb can affect foot development. If the feet are compressed or positioned abnormally, this may contribute to clubfoot.

• Lack of Amniotic Fluid: A deficiency in amniotic fluid (oligohydramnios) can limit the baby’s movement and increase the likelihood of developing clubfoot.

• Environmental Factors: Certain environmental factors and complications during pregnancy may also play a role, including maternal smoking, specific medications, or infections.

Procedure of Clubfoot Treatment

The treatment procedure for clubfoot typically involves casting and gentle stretching. Initially, a series of casts are applied to gradually correct the foot’s position, and in some cases, surgery may be necessary if casting alone is insufficient. Early treatment is crucial for aligning the foot for improved movement and function.

• Diagnosis: Clubfoot is identified at birth through a physical examination assessing the unique twisting of the foot.

• First Assessment: A thorough assessment is conducted to determine the severity of the clubfoot and check for any associated issues.

• Casting: Over several weeks, a series of plaster casts are applied after gently manipulating the foot into the correct position, gradually reshaping it.

• Tenotomy (if needed): If the Achilles tendon remains tight despite casting, a minor surgical procedure called tenotomy may be performed to help further correct the foot.

• Bracing: After achieving correction, the baby wears special braces (often Denis Browne splints) to maintain the foot’s position and prevent it from twisting back. Initially, these braces are worn full-time for a few months and then only at night.

• Follow-up: Regular follow-up visits with an orthopedic specialist are crucial to evaluate progress, make necessary adjustments to treatment, and ensure proper foot growth and development.

• Monitoring and Long-term Care: While most cases of clubfoot can be effectively treated with initial care, ongoing monitoring may be necessary to address any lingering issues or recurrence of the deformity as the child grows.