Clubfoot

A condition, in which a baby is born with one or both feet twisted out of shape or position; also called talipes equinovarus

  • Present at birth
  • Sometimes runs in families
  • Gender as a risk factor depends on the type
  • Lifestyle is not a significant factor

Babies are often born with their feet in awkward positions (see Minor leg and foot problems). In severe cases, the defect is known as clubfoot. There are two types of clubfoot: positional clubfoot, in which the twisted foot is flexible and can be manipulated into a normal position, and structural clubfoot, in which the deformity is rigid.

In positional clubfoot, the foot is a normal size but appears twisted, possibly due to compression in the uterus. Most cases are mild and correct themselves. Structural clubfoot occurs in about 1 in 1,000 babies and is more serious. In this disorder, the foot turns downwards and inwards and is usually abnormally small in size. In about half of these babies, both feet are affected. Structural clubfoot may be related to low levels of fluid in the uterus during pregnancy or may be caused by an underlying condition such as spina bifida (see Neural tube defects), and is sometimes associated with developmental dysplasia of the hip. Structural clubfoot is twice as common in boys and can run in families.

What might be done?

Clubfoot is usually diagnosed during a routine examination after birth. Positional clubfoot may not need treatment, but physiotherapy may help to straighten the foot, and a cast may be used to move the foot into position. A normal position can usually be achieved within 3 months. Structural clubfoot requires physiotherapy and a cast for a long period. In more than half of cases, this treatment is successful. If not, surgery may be needed at the age of 6–9 months. Surgery is usually successful, enabling most children to walk normally.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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