Clubfoot

Clubfoot is a deformity in which a baby’s foot is turned inward at birth, often so severely that the bottom of the foot faces sideways - or even upward. The condition isn’t painful, but can become so as the child gets older, and it can cause difficulties in walking if it isn’t treated. However, if treated early, the position and function of the foot can be greatly improved.  

Causes
The  cause of club foot is usually unknown, although there may be a genetic link because the condition is known to run in families. In a small number of cases, club foot is part of a more serious condition, such as spina bifida.

Diagnosis
Although the problem may first be spotted during the routine ultrasound scans carried out during pregnancy, club foot is usually diagnosed post-birth. It can’t be treated before birth, but if it’s detected during pregnancy you can talk to doctors about the condition, and learn what to expect after your baby is born. Further tests can then also be made during pregnancy, to check for conditions such as spina bifida.

Treatment
Ideally, treatment for club foot should start very soon (within a week or two) of birth, but it can still be effective if started later in childhood.Today, the main treatment for clubfoot is known as the Ponseti method. This means gently manipulating the affected foot into a better position and then putting it in a cast. This process is repeated weekly for several weeks. After this, the baby will probably need a minor procedure (under local anaesthetic) to make a small cut in the Achilles tendon, in order to adjust the foot to a more natural position. The baby will then require special footwear, to prevent the condition from recurring. These are worn full-time for the first three months, then overnight until the child is four or five years old.