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Clubfoot

Clubfoot is a deformity where a baby’s foot turns inward. It’s very easy to see—in addition to the foot being turned, the clubfoot, calf, and leg are shorter and smaller than normal. It may look uncomfortable, but clubfoot is not painful during infancy.

With about one in every 1,000 newborns being born with clubfoot, it’s one of the most common non-major birth defects. And as long as it’s treated properly, a child with clubfoot should be able to walk normally and participate in physical activities.

Types

Clubfoot is either isolated (idiopathic) or non-isolated.

Clubfoot is usually isolated and idiopathic, meaning the child is otherwise healthy, and there is no known cause. About half of the time, idiopathic clubfoot only affects one foot.

Less frequently, clubfoot may be non-isolated, meaning it’s related to another medical condition. It could be due to a neurological condition (e.g. spina bifida), or a symptom of a larger disorder (e.g. arthrogryposis).

Symptoms

There’s only one major symptom of clubfoot: how it looks.

If a child has clubfoot, the top of her foot is usually twisted downward and inward. This increases the arch of the foot, and turns the heel inward. If the foot is turned severely, it can actually look like it’s upside down.

Additionally, her calf muscles in the affected leg could be underdeveloped, and her clubfoot might be a little shorter than her other foot.

Causes

Most cases of clubfoot have no known or definite cause. Researchers believe clubfoot is caused by a combination of environmental and genetic factors. It does tend to run in families, so a child has a higher risk if she’s born into a family with a history of clubfeet.

Diagnosis

Clubfoot is visible to the naked eye, meaning a physician can often diagnose it quickly and easily during a physical exam. Occasionally, the physician may order imaging tests (e.g. X-rays) to understand the severity of the condition.

Although clubfoot is usually diagnosed at birth, many cases are actually found during a prenatal ultrasound—sometimes as early as just 12 weeks’ gestation.  

Prevention

Since the cause of clubfoot is unknown, it’s hard to prevent it. However, it’s possible to prevent a recurrent clubfoot.

Once a clubfoot has been corrected, it’s important for parents to follow the physician’s instructions for bracing. If a brace isn’t worn correctly, or is not worn for a long enough time, clubfoot can return.

The OIC Clubfoot Team

Despite the many advantages of the Ponseti method, it should not be viewed as a “quick fix”. It requires a team to achieve a successful outcome including the parents, physician, nurse coordinator, cast technician and orthotist.

OIC’s Clubfoot Clinic is directed by Lewis E. Zionts, M.D, who learned the Ponseti technique from Dr. Ponseti himself. Dr. Zionts is currently listed as a preferred provider on the Ponseti International Association website and by Dr. Ponseti as well.

If your child is referred to OIC’s Clubfoot Clinic for treatment, you could have the following members of our staff on your team:

The Pediatric Orthopaedist specializes in the musculoskeletal system of children. They provide surgical interventions when necessary such as tendon lengthening.

The Pediatrician reviews medical issues and coordinates the general healthcare of the patient, in addition to working with the orthopaedic surgeon for pre-operative assessments if surgery is indicated and overseeing medical issues for hospitalized patients.

The Nurse Coordinator assists in making sure all medical orders are carried out, and provides case management and nursing assessment for the patient.

The Orthotist works with the team to prevent unequal or unbalanced muscle groups which can lead to deformities as the child grows.

The Cast Technician helps ensure that the unique casts and casting regimen required by the Ponseti Method are done correctly to ensure that patients heal properly.