Clubfoot
- What is clubfoot?
- How do you evaluate clubfoot?
- Who gets clubfoot?
- What is your experience with clubfoot?
- How do you treat clubfoot?
What is clubfoot?
Babies who are born with clubfoot have one foot or both feet pointing down and in. Their toes point toward the opposite leg, and the bottom of their feet face inward. In some cases, it looks like the baby’s foot is upside down.
A clubfoot cannot be straightened simply by moving it around. The joints and tendons on the inside and back of the foot and ankle are shorter than usual while those on the outside and front are stretched out, holding the baby’s foot in this unusual position.
Clubfoot does not get better on its own. If it is not treated, it can cause discomfort and make your child’s foot function poorly as he grows up. But with orthopedic treatment, there is an excellent chance that your baby’s foot will look good and function very well.
Clubfoot
How do you evaluate clubfoot?
Clubfoot looks like no other condition. In fact, doctors can see it on ultrasound images taken after about four months of pregnancy.
When your baby is born, the doctor will examine his feet, along with his arms, hands, hips and legs, to make sure he has no deformities. If the doctor sees that your newborn baby has a clubfoot, she may refer you to our Clubfoot Clinic for treatment.
Babies who have a clubfoot are no more likely than other children to have other bone or joint problems, unless they have an underlying condition such as spina bifida or arthrogryposis.
Who gets clubfoot?
About one in every 1,000 babies is born with clubfoot. Clubfoot does not have anything to do with the baby’s position in the womb. It is mostly a problem passed from parents to children (genetic), and it may run in families.
If you have one baby with clubfoot, the chances of having a second child with the condition are about one in 40.
About half of children with the condition have two clubfeet. Children with certain neurological and chromosome conditions are more likely to have clubfoot. Most times children who have clubfoot are otherwise completely healthy.
What is your experience with clubfoot?
For decades, orthopedic surgeons at Children’s Hospital have treated more clubfeet than any other center in the Northwest. As techniques to treat the disorder have changed, we have been at the forefront in learning, implementing and promoting the latest advances.
Dr. Ignacio Ponseti, at the University of Iowa, developed the Ponseti treatment method more than 60 years ago. This method corrects most clubfeet without major surgery, a marked contrast to treatment methods that were common at the time of Dr. Ponseti’s initial work.
The method’s long-term effectiveness was proven about a decade ago. Since then, it has become the leading treatment for clubfoot around the world.
Our doctors were among the first outside of Iowa to learn the method directly from Dr. Ponseti. We were the first in the Northwest to offer the Ponseti method for clubfoot treatment, and we are listed as approved practitioners.
In addition, we have been leaders in teaching the technique to other orthopedic surgeons at national and international conferences as well as through publications.
To read more about the Ponseti method, visit Global-HELP, a nonprofit medical literature publishing foundation started by the former director of our Department of Orthopedics, Dr. Lynn T. Staheli.
How do you treat clubfoot?
We treat clubfoot using the Ponseti method, which corrects the problem with minimal surgery, and sometimes with no surgery at all.
At our Clubfoot Clinic, we begin gently stretching your baby’s foot toward the correct position soon after he is born. After about a one-minute stretch, we apply a cast that extends from the hip to the toes.
We work with your baby each week, gently stretching the foot further and applying a new full leg cast.
After four to eight weeks of treatment, about 5% to 10% of babies’ clubfeet are completely corrected. Most other patients need a simple procedure in the clinic to release the tight tendon at the back of their ankles (Achilles tendon). These babies wear a final cast for about three weeks.
After your baby’s foot is in the correct position, he will wear a brace nearly all the time for the next three months, and then at night and nap times for three to four years. The brace, made up of leather shoes connected by an aluminum bar, turns your child’s feet outward.
It is vital to use the brace to make sure your child’s feet stay in the corrected position. Read more about braces and our other orthotics and prosthetics services.
After this treatment, two to three patients in every 10 will need a minor operation after age 3 to adjust their tendons.
Your participation during treatment with the Ponseti method is very important. Without using the brace, the clubfoot is likely to return. Our doctors and staff are ready to help you with all aspects of the treatment method, including how to care for a baby in casts and braces.
Over the past decade, we have helped hundreds of families whose children are undergoing Ponseti clubfoot treatment. We are ready to share our expertise and extensive experience with you.
About 5% to 10% of babies with clubfoot do not respond to the Ponseti method. These children may need major surgery. We are very experienced in these techniques as well.