What is Club Foot?
Clubfoot is a congenital foot deformity observed in infants and can be characterised by the inward twisting of the heel and toes. In some cases, clubfoot can be so severe that the sole is found facing sideways or even upwards. Approximately 1 in 1,000 children are born with clubfoot, and half of these cases involve both feet.
UNDERSTANDING CLUB FOOT
Overview
Clubfoot can be diagnosed during a prenatal ultrasound around the 20th week of pregnancy or immediately after birth. As early intervention yields the best results, expectant parents often seek consultations before the baby is born to discuss corrective plans for clubfoot. Since the bones and joints of newborns are very flexible, interventions can start within the first week of life.
Risk Factors for Clubfoot
While the definitive causes for clubfoot remain unclear, there are several factors that can contribute to a child being born with this condition, including:
Male gender
Family history of clubfoot
Smoking during pregnancy
Congenital deformities associated with spinal defects like spina bifida
Other birth defects
In most infants, clubfoot itself may not be painful initially but without intervention, the condition. may escalate and impede mobility. This can significantly impact the child in adulthood, leading to abnormal walking patterns and an increased risk of arthiritis.
Patients may eventually develop calluses due to their abnormal gait, which can progress to skin breakdown, ulceration, and possibly infection. In severe, unaddressed cases, amputation may become necessary.
How Is Clubfoot Managed with Podiatry?
Clubfoot management focuses on restoring full function, reducing pain, and addressing visual deformities. Traditional surgical approaches have given way to conservative or minimally invasive podiatric care, with various techniques, including:
Examination, evaluation, and advice
Progressive serial rigid casting sessions
Soft casting and splints
Long-term orthotics, ankle-foot orthotics, or braces to prevent recurrence
Specific footwear
The Ponseti method
The Ponseti method is a highly specialised approach involving gradual stretching and casting of the leg(s). This process is repeated weekly for 6 – 8 weeks until a fully corrected position is achieved. After the casting is removed, your podiatrist may recommend ankle foot orthotics (AFOs), bracing, and prescription insoles to maintain the corrected alignment and to prevent relapses.
Parents are urged to consult a podiatrist to determine their child’s specific needs for a customised plan. Early intervention and proper care can effectively manage clubfoot. If podiatric care proves unresponsive, surgery by an orthopedic surgeon may be necessary to adjust tendons and ligaments for improved realignment.
Common Symptoms
The top of the foot is twisted downwards and inwards
If only one foot is affected, it may be up to 1cm shorter than the other limb
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