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Clubfoot
 
 
 


 
Clubfoot is the most common newborn deformity of the bones and joints. It affects your child's foot and ankle, twisting the heel and toes inward. The clubfoot and calf are usually smaller and shorter than normal. Clubfoot is not painful, and parents can be reassured that when treated appropriately their baby will have a normal appearing foot with essentially normal function. We utilize Dr. Ponseti’s method of treatment that is effective and minimally invasive.

Approximately one in every 1,000 newborns has clubfoot. Of those, one in three have bilateral clubfoot. The exact cause is unknown, but likely secondary to a genetic disorder.

The goal of treating clubfoot is to make your newborn's clubfoot (or feet) functional, painless and stable by the time he or she is ready to walk. Treatment should begin around the first couple weeks of life to utilize the inherent properties of elasticity of your newborn’s tissues. Doctors start by gently stretching your child's clubfoot toward the correct position. They apply a cast from the groin to toes to maintain correction and relax tissues for the subsequent manipulation. Every week the cast and manipulation process is repeated always working the foot/feet toward the correct position.

This process (called serial casting) slowly moves the displaced bones and joints into proper alignment. Casting generally repeats for five to seven weeks. X-rays are seldom necessary, because the doctor can feel the position of the bones and joints. A minor office procedure is usually required to complete the correction. Relapse tends to occur after correction due to the transient gene activity, thus to prevent relapse a foot abduction brace must be worn. After casting, the brace is worn 23 hours a day for at least the next 3 months, then for naps and night for 2-4 years. The use of the brace does not delay the child’s development.

After full correction is achieved, clinic visits will be scheduled every 3 months for 2 years, then yearly to check for possible relapses. If the deformity relapses during the first couple years, the casting and manipulations are reinstituted. In some cases despite proper casting and bracing a minor operation is needed to prevent further relapses. This may consist of transferring a tendon from the inside of the foot to the center of the foot.

Muscles often try to return to the clubfoot position. This is common when your child is 2-3 years old, but may continue up to age 7. Sometimes stretching, casting and bracing is not enough to correct your baby's clubfoot. He or she may need surgery to adjust the tendons, ligaments and joints in the foot/ankle.

By utilizing the Ponseti method, your child can be expected to have a close to normal foot with only minor differences to include a slightly smaller foot and a reduction in the calf muscles.  Several outcome studies show that treatment with the Ponseti method enables children and adults with corrected clubfoot to participate and compete in all athletics and extracurricular activities.  Several support groups exist which include: http://groups.yahoo.com/group/nosurgery4clubfoot and http://groups.yahoo.com/group/clubfoot.

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