What is Clubfoot?

Clubfoot, or talipes equinovarus, is a fairly serious deformity of the foot and ankle that may be treated by a podiatrist or an orthopedic surgeon. It is defined as a deformity in which the ankle is in a fixed equinus position (meaning that the ankle is pointed down, or plantarflexed), and the rearfoot is in a fixed varus position (meaning that the heel is inverted, or pointed towards the middle of the body). These two abnormalities will additionally position the forefoot towards the middle of the body.

Clubfoot has an incidence of about 1-2 per 1000 live births. This number, however, increases with a family history of clubfoot. In those with a parent, sibling, or cousin with clubfoot, the incidence rate jumps to 1 in 20. When two family members were born with clubfoot, the chances are 1 in 5. Though the exact cause of talipes equinovarus remains unknown in the majority of cases, these numbers strongly suggest a hereditary nature of the deformity.

When a child is born with a clubfoot deformity, the situation is best addressed immediately, while the bones and ligaments of the foot and ankle are still the most pliable. This means that within the first 24 hours of the infant’s life, an attempt will be made to correct the deformity without surgery. Casting methods are used, where the foot, ankle, and leg are manipulated into a more normal position, and a cast is put on in an attempt to correct the positional deformity. Casts are changed every couple of days, until hopefully the deformity is corrected. The specifics of this casting technique were developed by Igancio V. Ponseti, MD, an orthopedic surgeon who just recently passed away at the age of 95.

In many cases of clubfoot, the Ponseti method is successful in correcting the deformity within the first six to eight weeks of life. Unfortunately, there are cases that do not respond to this casting technique, and surgery may be required to achieve a foot that is more functional. Additionally, some cases of clubfoot go unnoticed or undiagnosed until later in the child’s life, where non-surgical intervention may not be a viable option anymore.

Clubfoot is often seen co-existing with other musculoskeletal anomalies and other abnormalities. Some of these conditions include cleft lip, cleft palate, scoliosis, deformities of the upper extremities, torticollis (a fixed contraction of the sternocleidomastoid, a muscle in the neck), cardiac abnormalities, and hip dislocation. Clubfoot is also seen as an occasional or regularly occurring deformity in over fifty named congenital syndromes.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com