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Clubfoot

Clubfoot Treatment: What to Expect

How Is Clubfoot Diagnosed? 

Clubfoot is fairly easy to diagnose. In some cases, prenatal ultrasounds can detect the condition before a baby is born. In other cases, a physical exam can confirm the presence of clubfoot after birth.


 

What Is Clubfoot Treatment Like?

Here at OIC, the first line of clubfoot treatment is a three-stage process called the Ponseti Method. Treatment usually starts in the first two weeks after birth. However, the Ponseti Method can be successful in older babies and children, as well.  

The goals of clubfoot treatment are to make the foot (or feet): 

  • Functional
  • Flexible
  • Painless
  • Positioned so that the child can stand and walk with the sole flat on the floor

 

Clubfoot Treatment: The Ponseti Method

There are three stages to the Ponseti Method: 

  1. Manipulation and casting
  2. Achilles tenotomy in most cases
  3. Bracing 

The Ponseti Method is the gold standard treatment for clubfoot. It is an effective treatment in 95% of cases. 

Step 1: Manipulation and Casting

Timeline: 4 to 6 weeks 

During this first stage of clubfoot treatment, an OIC specialist in clubfoot will gently manipulate your baby’s foot into the right position. A long-leg cast that spans from your baby’s toes to the thigh will be applied to hold the foot in place. 

This step is repeated weekly for about 4 to 6 weeks until the foot’s positioning is ready for a retainer brace or a tenotomy. 

Step 2: Achilles Tenotomy

Timeline: 3 weeks 

After casting, a quick, minor medical procedure—called an Achilles tenotomy—is performed. It involves making a tiny cut in the Achilles tendon (the cord behind the baby’s heel). Because it is such a small incision, your child will not need stitches after this procedure. 

After the procedure, your baby will receive a new cast. This cast will protect the foot and tendon as they heal, typically for around 3 weeks. 

The cast will be removed when your child’s tendon has healed at the right length at which time the foot is completely corrected. 

Step 3: Bracing

Timeline: 3 to 5 years 

Once clubfoot has been corrected, your child will need to wear a brace for a few years to keep it from recurring.  

This brace is sometimes called “boots and bar” because it is made of two shoes connected by a metal bar. Some bars allow each leg to move on its own, while others only allow both feet to move together.

The brace is usually worn for 23 hours each day for the first 3 months. After that, your child might have to wear it during naptime and overnight (about 12 to 14 hours a day) for 3 to 5 years.


 

4 Tips to Get You Through the Clubfoot Brace Years

As a parent, you’ve got enough on your plate, and bracing may make that load even heavier. It takes a lot of time, and it’s demanding, but it’s also the best way to make sure your child’s clubfoot doesn’t return later.  

OIC’s clubfoot specialists can provide you with support and tips to make the process easier for you and your child. 

1. Turn the initial adjustment period into a game. 

Your child might struggle with the clubfoot brace, at first. To help them overcome their initial fussiness: 

  • Show them how to kick and swing their legs together while wearing the brace (if it has a solid bar) by pushing and pulling on the bar to bend and then straighten the knees.
  • Move their legs up and down as well (if the brace has a dynamic bar).
  • Encourage your child to practice these movements on their own. 

2. Apply padding to the bar. 

Foam, such as a piece of swimming pool noodle, or bicycle handlebar pads can fit over the bar to: 

  • Protect your child from accidental bumps or bruises
  • Keep you safe from unintentional injuries as well
  • Reduce the risk of the bar accidentally damaging your furniture

3. Keep an eye on your child’s skin.

 Bracing can cause minor redness on your child’s skin. Keep in mind that: 

  • You should take a look at your child’s feet a few times each day when they first start bracing.
  • If you see severe red patches or blisters—particularly near the back of the heel—the straps or buckles might be too loose, allowing the heel to slip.
  • Applying lotion to your child’s skin will only make things worse. 

4. Create a bracing schedule and stick to it. 

Eventually, your child will need to wear the brace only during naptime and at night. Incorporate the brace into their bedtime routine by: 

  • Applying the brace in the same place (such as the bedroom) each time
  • Fitting bracing into the rest of the routine—such as after bathtime but before storytime
  • Staying consistent with this routine as much as possible, even if you are not at home