Clubfoot (talipes equinovarus) is a deformity in which an infant's foot is turned inward, often so severely that the bottom of the foot faces sideways or even upward. Approximately one infant in every 1,000 live births will have clubfoot, making it one of the more common congenital (present at birth) foot deformities.
Club foot isn’t painful for babies, but it can become painful as they get older and cause difficulties walking if it isn’t treated. However, the position and function of the foot can be greatly improved, if treated early.
In most cases the cause of club foot is unknown, although there may be a genetic link because it can run in families. In a small number of cases, club foot occurs as part of a more serious underlying condition affecting the baby's development, such as spina bifida.
Diagnosing club foot
Club foot is usually diagnosed after a baby is born, although the problem may first be spotted during the routine ultrasound scan carried out between 18 and 21 weeks of pregnancy. It cannot be treated before birth, but picking up the problem during pregnancy means you can talk to doctors about the condition in detail and find out what to expect after your baby is born. Further tests may also be carried out during pregnancy, to check for conditions such as spina bifida.
Treatment for club foot should ideally start within a week or two of the baby being born, but it can still be effective if started later in childhood.
A technique known as the Ponseti method is the main treatment for club foot nowadays. This involves the baby's foot being gently manipulated into a better position and then being put in a cast. This is repeated weekly for around five to eight weeks.
After this stage, it's likely that the baby will need a minor procedure (carried out using a local anaesthetic) to make a small cut in their Achilles tendon. This can help to release their foot into a more natural position. The baby will need to wear special boots attached to each other with a bar, to prevent club foot returning. These are only worn full-time for the first three months, then overnight until the child is four or five years old.