Clubfoot

Clubfoot, or talipes equinovarus, is a condition characterised by a specific altered shape of the foot.
Image courtesy of Miracle Feet
It is not known why children get clubfoot, but there is a hereditary element to it, as well as possible mechanical and environmental triggers. It is not the result of any problems during pregnancy or witchcraft. In the majority of the cases there is no other health problem with the baby.

Is it limb or life threatening?

It is not life threatening but if not treated well it is a disabling condition. As the child becomes bigger and heavier, walking becomes increasingly difficult.

How is it treated?

Thankfully, in most cases, treatment is non-invasive with serial casting that slowly corrects the position of the foot. Using the methods developed by Dr Ponseti, the foot is corrected in a specific manner and after each manoeuvre the foot is placed in a cast (plaster). Towards the end of the correction, typically after 6 weeks, a small operation to lengthen the tendon at the back of the foot is undertaken and the final cast is left in place for 3 weeks. After this the child must wear special boots to keep the achieved position for 4 months, and then during night time and naps for 4 years to prevent recurrence of the deformity.

Image courtesy of HSS

How can we tell it is getting better?

We monitor the foot weekly and measure the range of motion of the joints to ensure progress. We also use the scoring system developed by Dr Pirani, to make sure there is objective evidence of improvement.

What happens if the deformity happens again

If the deformity recurs then it is treated by further casting. In a small minority of patients with resistant clubfoot, surgery is required to correct the foot position.

For more information on clubfoot or for a consultation please contact the EA-O team

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