Club feet

Clubfoot

Clubfoot, also known as talipes equinovarus, is a congenital deformity involving one foot or both. The affected foot appears to have been rotated internally at the ankle. Without treatment, people with clubfoot often appear to walk on their ankles or on the sides of their feet. Clubfoot is a relatively common birth defect, occurring in about 1 in every 1,000 live births.

Etiology

The exact cause of clubfoot is unknown, but it is believed to be a combination of genetic and environmental factors. It is more common in males than females and can be associated with other conditions such as spina bifida.

Pathophysiology

In clubfoot, the tendons that connect the leg muscles to the foot are shorter than usual, causing the foot to be twisted out of shape or position. The condition can vary in severity from mild to severe.

Diagnosis

Clubfoot is usually diagnosed at birth through physical examination. In some cases, it can be detected before birth using ultrasound imaging. The foot is typically turned inward and downward, and the heel is smaller than normal.

Treatment

The goal of treatment is to correct the position of the foot so that the child can walk normally. The most common treatment is the Ponseti method, which involves:

• Manipulation and Casting: The foot is gently manipulated and then placed in a cast to hold it in the correct position. This process is repeated weekly for several weeks.
• Achilles Tenotomy: A minor surgical procedure to lengthen the Achilles tendon may be necessary.
• Bracing: After the casting phase, the child will need to wear a brace to maintain the correction.

In some cases, surgery may be required if the clubfoot does not respond to non-surgical treatments.

Prognosis

With proper treatment, most children with clubfoot can lead normal, active lives. However, they may have a slightly smaller foot and calf on the affected side.

Epidemiology

Clubfoot affects approximately 1 in 1,000 live births worldwide. It is more prevalent in males and can occur in one or both feet.

See Also

• Orthopedic surgery
• Congenital disorders

References

• Ponseti, I. V. (1996). "Congenital Clubfoot: Fundamentals of Treatment." Oxford University Press.
• Dobbs, M. B., & Gurnett, C. A. (2009). "Update on clubfoot: etiology and treatment." Clinical Orthopaedics and Related Research, 467(5), 1146-1153.